Dermatology Management Flashcards
How can treatment modalities for dermatology be broadly categorised?
- Medical therapy
- Physical therapy
How can medical therapy in dermatology be further categorised?
- Topical
- Systemic
What are the types of physical dermatology treatments?
- Cryotherapy
- Phototherapy
- Photodynamic therapy
- Lasers
- Surgery
How do topical dermatological therapies work?
Deliver treatment directly to the affected areas
What is the advantage of topical therapies?
Reduces the systemic side-effects
What conditions are topical therapies suitable for?
Localised and less severe skin conditions
What do topical therapies consist of?
- Active constituents
- Base
What is the role of the base in topical therapies?
Transport the active constituents into the skin
What are some examples of active constituents in dermatological topical therapies?
- Steroids
- Tar
- Immunomodulators
- Retinoids
- Antibiotics
What are the common forms of base used in topical therapies?
- Lotion
- Cream
- Gel
- Ointment
- Paste
What is a lotion?
A liquid
What is a cream?
Oil in water
What is a gel?
Organic polymers in liquid - transparent
What is an ointment?
Oil with little to no water
What is a paste?
Powder in an ointment
When are systemic therapies preferred in dermatology?
- Extensive disease
- Serious disease
- Systemic involvement
- Topical treatment failure
What is the main disadvantage of systemic therapies?
Can cause systemic side-effects
What are the most common medical therapies used in dermatology?
- Emollients
- Topical/oral steroids
- Oral aciclovir
- Oral antihistamines
- Topical/oral antibiotics
- Topical antiseptics
- Oral retinoids
What is the aim of emollients?
Rehydrate the skin and re-establish the surface lipid layer
When are emollients used?
Dry, scaling conditions and as soap substitutes
What are some examples of emollients?
- Aqueous cream
- Emulsifying ointment
- Liquid paraffin
What are the potential side-effects of emollients?
Irritant or allergic reactions
What are the aims of steroids in dermatology?
Anti-inflammatory and anti-proliferative effects
What conditions can steroids be used for in dermatology?
- Allergic and immune reactions
- Inflammatory skin conditions
- Blistering disorders
- Connective tissue diseases
- Vasculitis
What types of steroids are used in dermatology?
- Topical
- Oral
How are topical steroids classified?
By their potency
What are the different potencies of topical steroids?
- Mildly potent
- Moderately potent
- Potent
- Very potent
What is a mildly potent topical steroid?
Hydrocortisone
What is a moderately potent topical steroid?
Eumovate
What is a potent topical steroid?
Betnovate
What is a very potent topical steroid?
Dermovate
What is an example of an oral steroid?
Prednisolone
What are the local side-effects of topical steroids?
- Skin thinning (atrophy)
- Telangiectasia
- Striae
- Skin infections
- Acne
- Perioral and allergic contact dermatitis
What are the systemic side-effects of steroids?
- Cushing’s syndrome
- Immunosuppression
- Hypertension
- Diabetes
- Osteoporosis
- Cataract
- Steroid-induced psychosis
What are the indications of oral aciclovir?
Viral infections due to herpes simplex and herpes zoster
What are the side-effects of oral aciclovir?
- GI upset
- Raised liver enzymes
- Reversible neurological reactions
- Haematological disorders
What are the uses of oral antihistamines?
- Type-1 hypersensitivity reactions
- Eczema (especially sedative type in children)
How do oral antihistamines work?
Block histamine receptors producing an anti-pruritic effect
How can oral antihistamines be classified?
- Sedative
- Nonsedative
What are some examples of sedative oral antihistamines?
- Chlorpheniramine
- Hydroxyzine
What are some examples of nonsedative oral antihistamines?
- Cetirizine
- Loratidine
What are the side-effects of sedative antihistamines?
- Sedation
- Anticholinergic effects
What are some examples of anticholinergic effects caused by sedative antihistamines?
- Dry mouth
- Blurred vision
- Urinary retention
- Constipation
What are topical/oral antibiotics used for in dermatology?
- Bacterial skin conditions
- Acne
What are some examples of topical antibiotics?
- Fusidic acid
- Mupirocin
- Neomycin
What are some examples of oral antibiotics?
- Penicillins
- Cephalosporins
- Gentamicin
- Macrolides
- Nitrofurantoin
- Quinolones
- Tetracyclines
- Vancomycin
- Metronidazole
- Trimethoprim
What are the side-effects of topical antibiotics?
Local skin irritation/allergy
What are the potential side-effects of oral antibiotics?
- GI upset
- Rashes
- Anaphylaxis
- Vaginal candidiasis
- C. diff
- Antibiotic resistance
What are the indications of topical antiseptics?
Treat and prevent skin infection
What are some examples of topical antiseptics?
- Chlorhexidine
- Cetrimide
- Povidone-iodine
What are the potential side-effects of topical antiseptics?
Local skin irritation/allergy
What are the indications for oral retinoids?
- Acne
- Psoriasis
- Disorders of keratinisation
What are the side-effects of oral retinoids?
- Mucocutaneous reactions
- Disordered liver function
- Hypercholesterolaemia
- Hypertriglyceridaemia
- Myalgia
- Arthralgia
- Depression
- Teratogenicity
What are the mucocutaneous side-effects of oral retinoids?
- Dry skin
- Dry eyes
- Dry lips
What precautions must be taken when prescribing oral retinoids?
Effective contraception
What are some examples of oral retinoids?
- Isotretinoin
- Acitretin
How long must effective contraception be used in isotretinoin?
- One month before
- During
- One month after
How long must effective contraception . be used in acitretin?
- One month before
- During
- 2 years after
