Exam 3 Spring 2025 Flashcards
Acne, Hair loss, Scaly Dermatoses, Dermatitis, Wounds, and Burns
1
Q
Define closed comedo.
A
White head
2
Q
Define open comedo.
A
Black head due to oxidized lipids.
3
Q
Define a papule.
A
Enlarged comedo with redness and inflammation
4
Q
Define pustule.
A
Papule filled with pus.
5
Q
What is a nodule/cyst?
A
These are painful lumps under the skin that are formed when the follicular wall ruptures and it can cause scarring.
6
Q
Why does our skin have sebum?
A
Sebum is an oily, waxy substance that is produced by the sebaceous glands that is used to moisturize the exam.
7
Q
What is the difference between acne and rosacea?
A
Rosacea will present with redness and flushing but no comedones will be presents while acne will have redness and maybe some flushing and obviously redness.
8
Q
Which level can acne can be treated OTC?
A
Mild acne (not moderate or severe)
9
Q
Define mild acne.
A
A few non-inflamed blackheads or whiteheads or a moderate number of mildly irritate pimples.
10
Q
What hormone stimulates acne?
A
Dihydroxytestosterone
11
Q
Increased levels of testosterone increases activity of what 2 things?
A
Increased sebaceous gland activity and abnormal follicular desquamation
12
Q
What bacteria can colonize on the skin and lead to more inflammation and acne?
A
P. acnes
13
Q
What are some acne exacerbating factors?
A
Oil-based cosmetics, friction on face, excessive contact between face and hands, chlorine, drugs (steroids, lithium, phenytoin), hormones, prolonged sweating, high humidity, stress, and possible genetics and diet
14
Q
What are some medications that can exacerbate acne?
A
Steroids, lithium, and phenytoin
15
Q
T or F: There is a cure for acne.
A
False. There is no cure for acne
16
Q
What is the goal for OTC treatment of acne?
A
Reduce the frequency of the acne and severity of lesions and prevent scarring.
17
Q
What are the 4 exclusions for self-treatment for acne?
A
- moderate to severe acne
- comedogenic drug use
- possible rosacea
- no improvement afters 6 weeks of treatment (12 weeks with adapalene)
18
Q
What are some non-pharm options for acne treatment?
A
- eliminate exacerbating factors
- cleanse sin with mild soap 2 or less times per day
- limit high glycemic index foods
- pore strips (temporary usefulness)
19
Q
What are the 6 available OTC medications for acne?
A
- Adapalene 0.1% (Differin gel)
- Benzoyl peroxide 2.5-10%
- Azelaic acid 10-14%
- Salicylic acid 0.5-2%
- Sulfur 3-10%
- Sulfur + resorcinol 2-3%
20
Q
What are the two first-line option for OTC acne?
A
Adapalene 0.1% gel and Benzoyl Peroxide (2.5-10%)
21
Q
What is the brand name for adapalene 0.1% gel?
A
Differin gel
22
Q
What drug class is adapelene 0.1% gel?
A
Topical retinoid
23
Q
What is the MOA of adapelene 0.1% gel?
A
Regulates epithelial cell turnover and reduces inflammation
24
Q
T or F: Adapelene 0.1% gel bleaches things.
A
False. It does not bleach clothing.
25
How is adapelene gel dosed?
Thing layer applied to affected area once daily at bedtime
26
What are the 4 adverse effects of adapelene 0.1% gel?
Sun sensitivity, redness, dryness, and itching
27
How long does the it take for the full effect of adapalene gel?
8-12 weeks
28
Can adapelene gel be used in pregnancy?
No!!! Do not use retinoids in pregnancy
29
What are the two properties of benzoyl peroxide?
Keratolytics and antibacterial
30
What is the MOA of benzoyl peroxide?
Releases oxygen that kills C.acnes and has a mild peeling affect.
31
What is the dosing protocol for benzyl peroxide?
Apply to affected area once per day and then increasing to 2-3X per day. You can decease dose if irritation is too much.
32
T or F: Benzoyl Peroxide can bleach clothing.
True
33
What are the 3 adverse effects of benzoyl peroxide?
Sun sensitivity, itching, and allergic reaction
34
Even though it takes around _____-______ weeks for benzoyl peroxide to exert its full effects, the OTC maximum time for use of this medication is _________ weeks only.
8-12 weeks
6 weeks only
35
T or F: The 2.5% and the 10% benzoyl peroxide cream have the same antibacterial effects. The only difference between the concentrations is the amount of side effects.
True
36
What are the 3 second-line options for OTC acne treatment?
Sulfur 3-8% (resorcinol), Salicylic acid 0.5-2%, and azelaic acid 10-14%
37
What is the MOA of azelaic acid 10-14%?
Inhibits C.acnes and unclogs pores with gentle peeling
38
What is the dosing frequency for azelaic acid 10-14%?
Apply to affected area twice per day
39
What are the 3 adverse effects associated with azelaic acid 10-14%?
Burning, peeling, and dryness
40
What is unique about azelaic acid?
It is gentler than most other acne treatment options and it does not cause sunsensitivity.
41
It takes around ______ weeks for azelaic acid to take full effect.
4 weeks
42
What is unique about salicylic acid?
This medication can be systemically absorbed and interact with drugs like anticoagulants, methotrexate, corticosteroids, and glyburide.
43
T or F: Salicylic acid use is approved in pregnancy.
False. Do not use this medication in pregnancy.
44
What is the dosing frequency for salicylic acid?
Apply to affected area 1-3 times per day
45
What is the MOA of salicylic acid?
Comedolytic (these effects on dependent on the concentration of salicylic acid used)
46
What is the MOA of sulfur 3-8% (resorcinol)?
Keratolytics and antibacterial. It is also effective against existing comedoes but long-term use with increase comedos.
47
What are the 4 side effects associated with sulfur 3-8% use for OTC acne treatment?
Odor (sulfur smell), chalky consistency, yellow color, and dry skin
48
One unique effect of sulfur 3-8% is that continued use has a _____________ effect meaning it will increase the amount of comedos on the skin. That is why this medication is only indicated for short-term use.
Comedogenic
49
What is the dosing frequency for sulfur 3-8%?
Apply to affected area 1-3 times per day
50
T or F: Sulfur 3-8% should not be used in those with sulfa allergies.
True.
51
What is androgenetic hair loss?
Male or female pattern hair loss. It is a type of nonscarring alopecia
52
What is the only type of hair loss that can be treated OTC?
Androgenetic hair loss
53
What types of hair loss can not be treated OTC?
Autoimmune, patchy hair loss, chemotherapy hair loss, fungal hairloss, and scarring alopecia
54
What is the presentation of male androgenetic alopecia?
Crown hair loss (not a receding hairline)
55
What is the presentation of female androgenetic alopecia?
Thinning hair at the site of hair part.
56
Conversion of testosterone to _____________ via 5-alpha reductase shrinks hair follicules and causes androgenetic alopecia.
DHT
57
What are the 4 exclusions for self-treatment for androgenetic alopecia?
- Less than 18 yrs old
- Pregnant/ breastfeeding
- Scalp is red/inflamed/painful
- No family history of hair loss
58
What is the only FDA approved OTC treatment for hair loss?
Minoxidil 2-5% (Rogaine)
59
What is the brand name for Minoxidil?
Rogaine
60
What is the MOA of Minoxidil (Rogaine)?
It increase cutaneous blood flow and vascularization of the hair follicles.
61
What types of Minoxidil can women use?
2% solution and 5% foam 1x per day (no 5% solution use)
62
What types of Minoxidil can men use?
2% and 5% solutions and the 5% foam (2x per day for foam)
63
What are the 4 adverse effects associated with minoxidil use?
Itching, irritation, dryness, and hypertrichosis of the face
64
Results for minoxidil use should be evaluated after _______ months of use. If the medication is working, it needs to be used ___________.
4 months (12 weeks)
Indefinitely
65
The solution version of Minoxidil contains more ___________ which makes it more irritating than the foam version without this.
Alcohol
66
_________% of patients do not respond to minoxidil treatment.
60%
67
T or F: Increased hair loss may occur in the first few weeks of use with monoxidil.
True
68
T or F: Minoxidil is more effective if the hair loss presented years ago and not recently.
False. It works better the sooner used.
69
What is the key counseling point for application of minoxidil?
RUB IN 1ML OF SOLUTION and allow solution to penetrate scalp for 2-4 hours
70
Define scaly dermatoses.
Scaling of the epidermis with varying levels of inflammation. Levels of severity start with dandruff, then seborrheic dermatitis, and then psoriasis.
71
Rank scale dermatoses conditions from least to most severe.
Dandruff, Seborrheic dermatitis, then psoriasis
72
Define dandruff.
Excessive scalp scaling and flakes
73
Define seborrheic dermatitis.
Well demarcated, yellow, oily, scaly areas of reddened skin on the scalp, eyebrows, beard area, central back , or sternum of chest.
74
What is seborrheic dermatitis called in infants?
Cradle cap
75
Define psoriasis.
Small papules that become well demarcated plaques with silvery white scales. Psoriasis is a chronic inflammatory disease with remissions and exacerbations. It appears commonly on elbows, knees, back, trunk, and genital areas.
76
What is the origin of scaly dermatoses?
Yeast and fungi origin
77
What are the exclusions for self-treatment for dandruff?
Younger than 2 years old and worsening symptoms or no improvement after 2 weeks of use of OTC products.
77
Dandruff involves the yeast called __________. This yeast produces fatty acids and cytokines that cause the irritation seen in dandruff.
Malassezia
78
What are some non-pharm methods for dandruff?
Avoid UV light exposure, avoid cold temperatures due to its drying effects, and shampoo every 1-2 days.
79
What is the OTC treatment for dandruff?
Cytostatic containing shampoos like pyrithione zinc, selenium sulfide, ketoconazole, or coal tar shampoo.
80
What is the MOA of cytostatic containing shampoos for dandruff?
These shampoos inhibit cell growth and multiplication and suppresses replication of Malassezia yeast.
81
What is the dosing frequency for the cytostatic containing shampoos, pyrithione zinc and selenium sulfide?
QD for 1 week, 2-3x weekly for 2-3 weeks, and then once weekly for control
82
How should cytostatic containing shampoos be applied?
Massage these shampoos into the scalp and leave on for 3-5 minutes before rinsing. Use these shampoos daily for the 1st week, 2-3x weekly for 2-3 more weeks, and then once weekly for control.
83
What is the dosing frequency for the cytostatic containing shampoo, ketoconazole?
Use every 3-4 days for 4 weeks
84
Why does no one use coal tar anymore for dandruff treatment?
It discolors and stains things, has a bad odor, and causes sun sensitivity
85
Seborrheic dermatitis involves the yeast called __________.
Malassezia
86
What are the OTC treatments for Seborrheic dermatitis?
The exact same as those for dandruff.
87
Those with dandruff or seborrheic dermatitis need to be referred after ________ days of OTC treatment.
14 days
88
OTC treatment for dandruff is actually a _______ while OTC treatment for seborrheic dermatitis is ________ for the disease.
Cure
Control
89
What are the 3 goals associated with OTC treatment for seborrheic dermatitis?
- loose and remove scales with dandruff shampoo
- inhibit malassezia using dandruff shampoo
- stop itching and inflammation with 7 day course of hydrocortisone ointment
90
In addition to dandruff shampoos, what other medication can be used OTC to relieve symptoms of itchy and inflammation for seborrheic dermatitis?
Hydrocortisone ointment for maximum of 7 days
91
T or F: Psoriasis can be treated OTC.
False. No OTC treatment here, these patients need to be referred.
92
What are some non-pharm recommendations for those with psoriasis?
Avoid exacerbation triggers, gently rub scale with soft cloth after bathing to remove them, and daily lubrication of skin with emollients (hydrating lotions) after bathing.
93
Even though we can't treat psoriasis OTC, what can we recommend for itching and inflammation that may be associated with the condition?
Hydrocortisone 1% ointment. Only apply BID for up to 7 days.
94
How should hydrocortisone 1% ointment be applied for those with psoriasis?
Apply to affected area twice per day for 7 days. Wait to cover the plaques for 30 minutes after application.
95
Define dermatitis.
Nonspecific term for dermatological disorders characterized by erythema (redness) and inflammation
96
Define eczema.
Eczema encompasses inflammatory skin disorders of unknown etiology
97
T or F: Eczema is contagious.
False.
98
Out of the 7 different dematitisis discussed, which 2 can be treated OTC?
Atopic dermatitis and contact dermatitis
99
What is the typical presentation of atopic dermatitis in childhood?
It typically appears as erythema, scaling of the cheeks, crusts, and pustules can form after scratching.
100
Atopic dermatitis is a part of the ________ _______. This triad includes eczema, asthma, and allergies.
Allergic Triad
101
Atopic dermatitis in childhood continues into adulthood for around ______% of patients.
30%
102
What often triggers atopic dermatitis in the adult population?
Typically environmental triggers like chemicals or skin trauma.
103
What is the most common adverse effect of atopic dermatitis?
Itching
104
What is the hallmark sign of atopic dermatitis in adults?
Pruritus (itching). Scratching can lead to lichenification ( thickened, leathery skin) and excoriations (skin lesions caused by scratching or rubbing)
105
T or F: Infections are difficult to prevent in atopic dermatitis.
True. 90% of patient will exhibit colonization by staph. aureus and some herpes.
106
What are the 4 treatment goals for atopic dermatitis?
1. Stop the itch-scratch cycle
2. Maintain skin hydration and barrier function
3. Avoid triggers of the disorder
4. Prevent secondary infections
107
What are the 5 exclusions for self-treatment for atopic dermatitis?
- Moderate-severe condition with intense pruritus
- Large body area involved
- Less than 1 year old
- Skins appears to be infected
- Face or intertriginous area involved
108
What are some non-pharm ways to manage atopic dermatitis?
Avoid triggers of allergic skin reactions, wash hands before applying medications, take short baths and showers with lukewarm water and non-soap cleanser, use emollient or moisturizer within 3 minutes of washing, keep fingernails short and clean, and can apply topical hydrocortisone 1-2 times per day on dry lesions
109
Those with atopic dermatitis can use topical ______________ for maximum of 7 days.
Hydrocortisone
110
If someone is applying hydrocortisone and lotions, moisturizers, or oils, which should go first?
Apply to hydrocortisone before applying any other leave on product
111
What is the age cut-off for the use of topical hydrocortisone 0.5-1%?
No use in those less than 2 years old
112
Why is the maximum use for hydrocortisone creams only 7 days?
The concern is that the adrenals will stop producing endogenous steroids even though this is not typically seen with use of topical steroids.
113
What is the MOA of low-dose corticosteroids like 0.5-1% hydrocortisone cream?
Suppress cytokines involved in inflammation and itching.
114
What are the 5 adverse effects associated with topical hydrocortisone use?
Burning, pruritus, skin thinning or atrophy, secondary infections, and skin irritation
115
For those with atopic dermatitis, hydrocortisone should be applied to the affected area _______ per day.
Twice
116
Hydrocortisone _________ should be avoided in those with weeping atopic dermatitis lesions.
Ointments
117
What should be recommended for the treatment of dry skin (Xerosis)?
Recommend moisturizers including emollients or skin protectants. Humectant enhance hydration and include glycerin and occlusive form a thick coat that protects the skin and include petrolatum, mineral oil, and more. Short-term use of topical corticosteroids may be helpful as well.
117
Are ointments or lotions better for dry skin (Xerosis)?
Ointments are better as they have less water.q
118
Define contact dermatitis.
Skin disorder characterized by inflammation, redness, and possible vesicle or pustule formation. Symptoms may include itching, stinging, and burning.
119
________ ____________ is a major cause of workplace disability.
Contact dermatitis
120
What is the main difference between irritant contact dermatitis and allergic contact dermatitis?
Irritant CD is an inflammatory reaction typically caused by exposure to an irritant while allergic CD is an immunologic skin reaction caused by exposure to an allergic substance.
121
When does itching appear in irritant CD?
Later on after exposure.
122
Are vesicles and papules present in irritant contact dermatitis?
Rarely
122
When does itching appear in allergic CD?
Fairly early on after contact with allergen
123
Are vesicles and papules present in allergic contact dermatitis?
Yes
124
How soon do symptoms appear after exposure in irritant contact dermatitis?
On initial exposure or repeated exposure
125
How soon do symptoms appear after exposure in allergic contact dermatitis?
Delayed for the first exposure but will likely become faster will additional exposure.
126
What are some substances that can cause irritant contact dermatitis?
Water, urine, flour, detergents, hand sanitizers, soap, alkalis, acids, solvents, salts, surfactants, and oxidizers.
127
What are some substances that can cause allergic contact dermatitis?
Plants, fragrances, nickel, latex, benzocaine, neomycin, and leather
128
What two things should not be used in those with contact dermatitis?
Topical anesthetics and topical Benadryl
129
What is the age cut off for OTC treatment of contact dermatitis?
2 years old
130
What are the 12 exclusions for self-treatment for contact dermatitis (both irritant and allergic)?
- 2 years or younger
- Dermatitis present for 1 week or more
- chronic dermatitis
- symptoms develop after sun exposure
- Significant body area covered (irritant >10% and allergic >20%)
- Extreme itching, irritation, or vesicle formation
- Swelling of body or area around the eyes
- Involvement of mucus membranes like mouth, nose, anus
- Failure of self-treatment after 7 days
- Impairment of daily activities
- involvement of face, scalp, or neck
131
Those who have been treated OTC for _______ week or have had the irritant or allergic contact dermatitis for longer than ______ week, they need to be referred.
1 week
1 week
132
What are non-pharm ways to manage irritant contact dermatitis?
Avoid the skin irritant, changes clothes and gloves frequently, wash the affected area with lukewarm water and hypoallergenic soap.
133
What are non-pharm ways to manage allergic contact dermatitis?
Take measures to avoid/prevent poison ivy, oak, and sumac, take cold or lukewarm soapless showers to relieve itching, wash the affected area gently, apply cool water compresses for 20-30 minutes, and use hypoallergenic cosmetics and soapless cleansers.
134
For irritant contact dermatitis, the skin area should be soaked in _______ __________ to induce anti-inflammatory, anti-bacterial, and a cooling effect.
Burow's Solution
135
What is contained in Burow's solution?
Aluminum acetate
136
______ _________ should be avoided in those with irritant contact dermatitis.
Topical anesthetics.
137
In addition to Burow's solution for irritant contact dermatitis, what 3 other things can be used?
- colloidal oatmeal bath
- emollients or barrier cream to restore moisture
- topical corticosteroid
138
For cleansing and itching related to allergic contact dermatitis, what two things can be used?
- colloidal oatmeal bath
- oral first generation antihistamine for nighttime itching
138
Topical _________, ___________, and __________ should be avoided in those with allergic contact dermatitis.
Anesthetics, antihistamines, and antibiotics
139
For allergic contact dermatitis, ____________- containing products will produce a drying effect.
Calamine
140
In addition to colloidal oatmeal bath, first-gen antihistamine, and calamine products, what else can be used in those with allergic contact dermatitis?
Astringents to decrease edema, exudation, and inflammation and a topical corticosteroids
141
How often should topical corticosteroids be applied daily for allergic contact dermatitis?
3-4 times per day
142
What is urushiol-induced allergic contact dermatitis?
This is when the oil from the leaves of poison ivy, oak, or sumac touch the skin and cause allergic contact dermatitis.
143
What are some measures that protect people from urushiol-induced allergic contact dermatitis?
Wear protective clothing, if exposed, remove and wash clothes and shower, clip and clean fingernails, bathe pets if they are exposed.
144
What medication can be used for prevention of urushiol-induced allergic contact dermatitis?
Ivy block which contains Bentoquatam 5%
145
What chemical is contained in Ivy Block?
Bentoquatam 5%
146
What is the MOA of Ivy Block (Bentoquatam 5%)?
Bentoquatam serves as a barrier to block contact and absorption of the plant oils.
147
Ivy Block should be applied _________ minutes prior to suspected exposure. It should be reapplied every 4 hours.
15 minutes.
148
Is Ivy Block regulated by the FDA?
No
149
What is the medication known as Zanfel?
This is a poison ivy, oak, and sumac wash that contains nonoxynol-9 that can be used anytime after exposure to these oils.
150
What is the medication known as Tecnu?
This is a poison ivy, oak, and sumac cleanser/scrub that can be used up to 8 hours after exposure to the oils.
151
T or F: The eradication and removal of urushiol agent, Zanfel, can be used any time after exposure.
True.
152
T or F: Zanfel and Tecnu are not regulated by the FDA.
True
153
What is the indication for use of colloidal oatmeal?
It is used to sooth and cleanse areas of rash and to reduce itching.
154
What is the main counseling point associated with colloidal oatmeal use?
It makes the bath very slippery so do not slip and fall.
155
Calamine assists in _________.
Drying
156
T or F: Wounds should be kept dry to prevent infection.
False. Keep wounds moist at all times.
157
Which colored bottle of calamine should be recommended to patients with allergic contact dermatitis?
The pink bottle as that actually contains calamine. The clear/white bottle does not contain calamine.
158
Define a wound.
A wound is a break in skin that can be acute or chronic. Wounds include abrasions and lacerations.
159
Define abrasion.
Wound that results from rubbing or friction applied to epidermal layer of skin. This is a scrap.
160
Define laceration.
Wound that results from a sharp-edged object cutting through various layers. A cut or a puncture.
161
Define sunburn.
Overexposure to UVA and UVB rays from natural sunlight or tanning beds.
162
Define thermal burn.
Burn resulting from skin contact with flames, liquids, or hot objects.
163
Define electrical burn.
Burn that occurs when electricity flows through the body from an entry point to an exit point.
164
Define chemical burn.
Burn that occurs secondary to exposure to corrosive or reactive chemicals that causes tissue damage.
165
What types of wounds and burns can not be treated OTC and must be referred?
No OTC treatment for electrical burns, chemical burns, and chronic wounds like pressure sores, diabetic ulcers, more. Can not treat deep partial thickness wounds.
166
What is the only would type that can be treated OTC?
Superficial to partial thickness wound
167
For heat based burns, when must these patients be referred?
If the burn has blisters or is in a tight spot like hands, feet, genitals,etc.
168
With the rule-of-nines for burn BSA estimation, the body is divided into multiples of ________.
9
169
Why are we interested in the total body surface area that is burned?
The amount of skin that is impacted tells us about the level of dehydration the patient may experience.
170
If a skin wound or burn occurred within the last 3 hours, what should be done?
Irrigate the affected area with cool tap water for 20 minutes.
171
When caring for wounds and burns OTC, what 5 things does the patient need to be assessed on?
Cause, timing, depth, size, and fluid status
172
OTC treatment for burns and wounds can continue for _______ days before a referral is warranted.
7 days
173
What are the 14 exclusion factors for self-treatment for wounds and burns?
- Cuts longer than 1/2 inch (deepness too)
- Bleeding that does not stop after 10 minutes of pressure
- Chemical, electrical, or inhalation burns
- Wound secondary to animal or human bite
- Non-accidental injury (suicidial)
- signs of infection
- circumferential burns (worried about compartment syndrome)
- Pre-existing medical conditions like diabetes
- Wound containing foreign matter
- chronic wound (no healing in 30 days)
- wound on face, hand, feet, major joints, or genitals
- burn larger than 3 inches around
- Injury that does not heal or get better after 7 days of OTC TX
174
What are the 3 phases of wound healing?
1. Inflammatory phase
2. Proliferative phase
3. Maturation/remodeling phase
175
Explain the inflammatory phase of wound healing.
This is body's immediate response to the injury. It involves clot formation as well as debri and bacteria removal, collagen formation, and initial layer coverage. Occurs during the first 3-4 days following the injury.
176
Explain the proliferative phase of wound healing.
This is when new connective tissue begins to cover the new epithelium and there will be new connective tissue, capillaries, and inflammatory cells. Occurs from 3-4 days after injury to 3 weeks.
177
Explain the maturation/remodeling phase of wound healing.
Continual process of collagen synthesis and breakdown with replacement of weak collagen with high-tensile-strength collagen. Occurs 3 weeks to 60+ days after the wound occured.
178
What are these medications called BLEEDSTOP and QUIKCLOT?
These are marketed for people in the military, camping trips, etc that are not close to an ER. It is mainly just carbohydrates that when mixed with blood, forms a gel like substance.
179
What are some local factors that contribute to delayed or poor wound healing?
Inadequate tissue perfusion, inadequate moisture, presence of foreign bodies, necrotic tissue, infection
180
What bacteria are most likely to cause poor or delayed wound healing?
Staph or Strep
181
What are some systemic factors that contribute to delayed or poor wound healing?
Advanced age (60+), stress, poor nutrition, obesity and diabetes, cancer, smoking, alcoholism, and certain medications.
182
For burn cooling, remove the heat source and run under _______ ________ for _______ minutes.
Cool water
20 minutes
183
For wound cleansing, irrigate the infected area with ___________ ________ and mild _________.
Clean water and mild soap
184
_____________ can be cytotoxic to cells essential for wound healing and reduce the rate of healing.
Antiseptics
185
T or F: Any hanging or excess skin from a burn or wound should be cut off.
False. Do not do this
186
For dressing a wound, maintain a _________ wound environment to promote healing and prevent infection.
Moist
187
T or F: Topical antibiotics are required for wound treatment.
False. They are not always required.
188
T or F: Scabs are a very important part of the healing process and we need scabs to form to heal.
False. Scabs are not good and we do not want these. Keep the wound moist to prevent scabs.
189
How many times per day should wound dressings be changed?
It varies, but typically 1 time per day is recommended.
190
_________ and _________ protect that area from irritation caused by friction and rubbing and promote a moist environment for wound and burn care.
Emollients and moisturizers like vaseline, eucerin, aquaphor, cerave, etc.
191
When picking emollients and moisturizers what characteristics do we want?
No scent and no alcohol in it
192
For intact wounds, you can use an _______ or cream but for broken skin, use an ointment.
ointment
193
T or F: Skin protectants like emollients and moisturizers are more effective than antibiotic ointments.
True
194
Why are antiseptics no longer recommended for wound treatment?
Antiseptics can be cytotoxic to cells essential for wound healing
195
What is included in neosporin?
Bacitracin, Neomycin, and Polymyxin B
196
What is included in polysporin?
Bacitracin and Polymyxin B
197
What are the two topical antibiotics?
Neosporin and Polysporin
198
Topical antibiotics are only used to ______ infection.
Prevent
199
Which topical antibiotic is most likely to cause an allergic reaction in patients?
Neomycin
200
What is the dosing frequency for topical antibiotics?
Apply to the skin after cleansing and before applying a sterile dressing once daily to 3 times daily.
201
T or F: Drug resistance does not occur with topical antibiotics.
False. Drug resistance can occur with topical antibiotics.
202
T or F: Topical anesthetics should be used in open wounds.
False. This would be very painful, do not use this.
203
When are topical anesthetics typically used in wounds and burns?
Most used for sunburns.
204
What is Mederma?
This is a herbal medication derived from onions that can help get rid of scars. For new scars, it works in about 8 weeks while existing scars may take 3-6 months to recvoer.
205
What is the gold standard of scarring therapy?
ScarAway (Silicone therapy)
206
What is the generic name for Mederma?
Allantoin
207
What is the dosing frequency for ScarAway (silicone therapy)?
Use BID for 60-90 days
208
What are the two types of tetanus vaccines?
Boostrix and Adacel
209
When would you give a TDap vaccine for someone presenting with a minor and clean wound?
1 dose if it has been more than 10 years since the last dose of there is no record of the vaccine in the past.
210
When would you give a TDap vaccine for anyone presenting with a wound?
1 dose if it has been more than 5 years since the last vaccine. There is no harm to the patient if it is given even if they do not need it.
211
The TDap vaccine is given in pregnancy between _______-______ weeks.
27-36 weeks of pregnancy
212
What is the age cut-off for the use of chemical sunscreens?
6 months of age
213
What are the two types of ultraviolet light?
UVA and UVB
214
UVA light contributes to _________ while UVB light contributes to _______.
Aging
Burning
215
What is the most serious UV induced skin disorder?
Skin cancer
216
Define chemical sunscreen.
Sunscreen that absorbs and blocks transmission of UVR
217
Define physical sunscreen.
Reflects and scatters UVR.
218
SPF 15 sunscreen blocks _______% of the UVB.
93%
219
SPF 30 sunscreen blocks ______% of the UVB.
97%
220
SPF 50 sunscreen blocks ________% of the UVB.
98%
221
What are the 6 exclusions for self-treatment for sunburns?
- large areas of blistering
- fever
- extreme pain
- headache or confusion (sign of dehydration)
- lightheadedness or vision changes (sign of dehydration)
- severe swelling
- signs of infection
222
What is the ABCDEs of skin caner?
Asymmetry
Border
Color
Diameter
Evolving
223
What are the characteristics for sunscreens that are considered "Broad Spectrum Sunscreen"?
All products with an SPF of 15+ can claim to reduce the risk of skin cancer.
224
What characteristics must be included on a sunscreen label in order to be considered water resistant?
Indicate if the sunscreen remains effective for either 40 or 80 minutes during swimming or sweating.
225
How often should sunscreen be applied?
Apply about 1 ounce 15-30 minutes before exposure to sun and every 2 hour thereafter
226
T or F: Many sunscreen agents currently found OTC have not be formally evaluated for efficacy and safety.
True
227
What are the two physical sunscreens?
Zinc oxide and titanium dioxide
228
T or F: Physical sunscreens can be used for all ages, even young babies.
True
229
What is the American Academy of Pediatrics recommendation for sun protection for those under 6 months old?
Just stay out of the sun but parents can apply small amounts of sunscreen of spf 15+ to small areas of the face and back of hands likely with a physical sunscreen.
230
In a general sense, what are the 3 pharmacological OTC treatments for sunburns?
Apply skin protectant, use systemic analgesics, and can you topical anesthetics.
231
What are two complementary therapies that can be beneficial in a sunburn?
Honey and aloe vera
232
_____________ refers to dermatophyte infections (fungal infections).
Tinea
233
How are tinea fungal infections spread?
Spread via direct contact with people, animals, and soil
234
What are some risk factors for fungal infections?
- Ill-fitting or occlusive footwear
- sweating and wet clothing for long periods of times
- medical conditions like diabetes, autoimmune disease, obesity, and stress
- impaired ciruclation
- poor nutrition and hygiene
235
What are the 4 medical conditions that can increase the risk for fungal infections?
Diabetes, autoimmune disease, obesity, and stress
236
What is tinea pedis?
Foot fungus
237
What is tinea cruris?
Jock itch
238
What is tinea corporis?
Body worm
239
What is tinea capitis?
Head ring worm
240
What is tinea unguium?
Nail fungal infection
241
What are the only two fungal infections that can be treated OTC?
Tinea pedis (foot fungus) and tinea cruris (jock itch)
242
T or F: Fungal skin infections are not contagious.
False. These are very contagious.
243
What are the typical symptoms of skin fungal infections?
Itching and pain
244
What are the 10 exclusion factors for OTC treatment for fungal infections?
- nails or scalp involved
- unsuccessful initial treatment or worsening of condition
- face, mucous membranes, or genitalia involved
- Signs of possible secondary bacterial infection
- excessive and continuous exudation
- extensive, seriously inflamed, or debilitating
- diabetes, systemic infection, or immune deficiency
- fever, malaise, or both
245
In terms of non-pharm recommendations with fungal infections, what should patients be counseled on?
- do not share towels, clothes, personal articles, etc
- wash contaminated items with HOT water
- clean skin daily with soap and water
- keep area DRY
- wear protective footwear in community places
- place ordor-controlling insoles in shoes
246
Most antifungals will take _____-______ weeks to resolve the fungal infection.
2-6 weeks
247
