DERMATOLOGY Flashcards
What are the referral symptoms for those suffering with eczema?
Children under 10 needing steroids. Lesions on the face that are unresponsive to emollients. Suspected pompholyx Widespread and severe Secondary infection Pregnancy Treatment failure
How do we treat eczema?
Emollients
Topical steroids
Advice
Sedating anti-histamines
What advice should we give to those with eczema?
Decrease level of house dust mite Avoid drying soaps Avoid perfumed toiletries Avoid abrasive clothing Stress management Wet-wrap technique Sunshine No evidence that dietary manipulation has an effect
What are the symptoms of infantile seborrhoeic dermatitis?
Large yellow, greasy scales and crusts on the scalp.
What are the symptoms of adult seborrhoeic dermatitis?
History of intermittent skin problems, red rash, greasy looking scales and mildly itchy.
How should we treat seborrhoeic dermatitis?
coal tar shampoo or keratlytic tar combination: Capasal.
Ketoconazole shampoo or Selenium sulphide shampoo.
When should we refer a patient with seborrhoeic dermatitis?
Treatment failure so the GP can prescribe corticosteroids.
If symptoms are extensive on face and body,.
How does psoriasis present?
Well defined, thickened red plaques covered with silvery scales.
When should we refer a patient with psoriasis?
Extensive lesions.
Lesions that cause moderate to severe itching.
Patients with no history or family history of psoriasis.
Pustular psoriasis.
What type of plaque psoriasis can we treat?
Mild to moderate with emollients, tar preparations, cocois, exorex, polytar.
Dithranol. etc.
When would a patient presenting with acne be referred? [5]
Moderate or severe acne. Risk of scarring. Occupational/drug-induced acne. OTC treatment failure - after two months of acne treatment OTC. Rosacea.
What treatments are available for acne? [4]
Benzoyl peroxide.
Antibiotics.
Isotretinoin
Hormonal treatments in women.
Well defined, thickened red plaques covered with silvery scales.
How does psoriasis present?
How should freederm gel be used to treat acne?
Twice daily sparingly following skin cleansing.
What advice should be given to those suffering from acne?
8-12 weeks for an improvement. Benzoyl peroxide can bleach hair, clothes, towels etc. Wash area before application. Apply sparingly. Apply to whole area not just lesions. Sunlight can help Avoid greasy, heavy make up. Avoid squeezing spots.
What advice should be given to someone suffering from athlete’s foot?
Wash affected area daily and dry carefully
Do not share towels
Avoid scratching the area since this might spread
the infection further
Wear non-occlusive footwear to minimise foot
perspiration and alternate footwear every 2 to 3
days
Wear cotton socks
Use flip-flops in communal areas
Consider anti-fungal sprays and talcs in shoes to
eliminate spores
No need for children to miss school
How should ringworm be treated?
Treat with imidazole
cream (or certain
terbinafine products)
History of intermittent skin problems, red rash, greasy looking scales and mildly itchy.
What are the symptoms of adult seborrhoeic dermatitis?
How should jock itch be treated?
Treat with imidazole or terbinafine cream
When should patients presenting with fungal nail infections be referred?
Those with conditions which predispose them to fungal infections Pregnant or breastfeeding women Under 18’s Those with fungal nail infections other than DLSO Those with more than TWO infected nails Nail dystrophy or a destroyed nail Failed treatment or no improvement within 3 months
How is fungal nail treated?
Amorolfine 5% nail lacquer
Topical anti-fungal, works by causing ergosterol
depletion and accumulation of ignosterol – cell
wall thickening
Because nail grows very slowly, treatment is long
What advice should be given to those suffering from fungal nail?
Wash and dry feet thoroughly everyday
Try to prevent infection spreading to other
toes
Avoid tight fitting or occlusive shoes
Alternate use of shoes
Exercise good nail care
Use anti-fungal sprays in shoes
Visit podiatrist regularly
Avoid going bare foot in communal areas
Avoid nail varnish and artificial nails
When should warts be referred to the GP?
Anogenital warts Diabetics Lesions on the face Multiple and widespread warts Patients over 50 presenting with wart for first time Warts that itch or bleed without provocation Warts that have grown and changed in colour
How are warts treated?
50% of all warts and verrucas will spontaneously
resolve after 2 years
Salicylic acid – destructive treatment
Is a keratolytic, which acts slowly by destroying
the virus containing epidermis
OTC treatments contain between 11 & 50%
salicylic acid alone or in combination with lactic acid or podophyllum
What advice should be given to those treating their warts/verrucas?
Soak affected area prior to treatment
The affected skin should then be lightly rubbed with pumice or emery board
Application of product should only be made to the affected skin
Allow product to dry – many products now form an occlusive layer to stop spread of HPV
How are cold sores treated?
Treatment – aciclovir or penciclovir
Pain relief
How long should hydrocortisone be used for in the treatment of eczema?
7 days at most.
What is cradle cap and what are the symptoms?
Infantile seborrhoeic dermatitis.
Large yellow scales and crusts on the scalp.
What does psoriasis present like?
Well defined plaques covered with silvery scales.
What is dithranol used to treat?
Dithrocream: psoriasis who had it on Rx before.
What is rosacea?
Referral symptom
Facial butterfly.
What is dimeticone?
Headlice treatment that is save to use in 6 months+ and in pregnancy.
What is the max size of corticosteroid cream that can be sold OTC?
15 grams.
