Intertrigo / Contact Derm / Poison Ivy / Lice & Scabies Flashcards
Common causes of Allergic Contact Dermatitis?
-Nickel
-Poison Ivy
-Latex
-Food
-Fragrances
Common causes of Irritant Contact Dermatitis?
-Soaps
-Cleansers
-Water
-Detergents
-Oils
-Paints
-Hair Dyes
How might we go about identifying allergens that may trigger Allergic Contact Dermatitis?
Patch Tests
Most common medication agents that induce ACD?
Topical Antibiotics
What type of Contact Dermatitis is most commonly seen with BP-induced flareups in Acne treatment?
Irritant Contact Dermatitis (ACD extremely small % of population)
Chronic irritant exposure leads to what skin process?
Keratinization in & around affected area (protective measure put in place by the body).
Treatment of Acute Contact Dermatitis?
-Cool Wet Dressings QID x 20mins (to alleviate some of the discomfort associated with blistering).
Treatment of Sub-Acute Contact Dermatitis?
-Discontinuation of wet dressings
-Steroid Lotions / Creams
Treatment of Chronic Contact Dermatitis?
-Warm water soaks (to soften up keratinized skin)
-Dry skin creams
-Steroid Creams / Ointments
What is the difference between a “wet dressing” & a “water soak” as they pertain to CD treatment?
Dressing = Gauze or Facecloth + Cool Water.
Soak = Placement of AA in Warm Water… No Dressings.
What needs to supplement warm water soaks in CCD treatments?
-Follow up with a steroid cream or ointment… Dry, unmedicated skin cream for sure.
What does Intertrigo describe?
-Location!!! Problem itself can be a multitude of things (Psoriasis / Fungal / Bacterial Infection), but the basis of Intertrigo is contact between two skin folds.
What non-medical measures can be undertaken to combat Intertrigo?
i) Keeping AA’s as clean & dry as possible.
ii) Very tight-fitting clothing (to prevent two areas around skin folds from contacting each other).
What is the name of the resin that spreads an allergic rash in response to Poison Ivy exposure?
Urushiol (from broken / burned plants)
What does Poison Ivy look like?
-Burning, red rash within 12-48hrs of exposure
-Often see streaking
-Blistering
Can blisters spread Poison Ivy rash?
-No… Urushiol Oils do!
What can be used to alleviate redness / itchiness from Poison Ivy rash?
-Cool Compresses
-Calamine
-Topical Steroid
How long does it take mild rxn’s from Ivy exposure to subside?
7-10 days
Can plant oils secreted from Poison Ivy persist on clothing for years on end?
Yeppers!
If a Topical Steroid is chosen to treat Poison Ivy-Induced Rash, what product should we jump to?
-Spectro EczemaCare BID 2-3 days… HC 1% not strong enough of an agent (need something more potent).
What length of time is required for a Lice Nymph to emerge from their eggs?
6-10 days
How long do female lice survive for, & how many eggs / day do they usually lay?
1-3 months
5-10 eggs / day
How do Lice spread?
Head Contact (between two people)
Bedding / Towels / Hats
Combs & Brushes
DO NOT JUMP TO NEW HOSTS!!!
Do Lice discriminate who they target (ie. Clean vs. Dirty Hair)?
-Nope… Can survive showering & washing by closing their gills off.
If Lice are found in bedding or on towels, how viable are they? In hats?
-Not very… Probably in the process of dying, as they prefer the warmth of a human head.
-In hats, likely more viable b/c of the more frequented head contact.
Other name for lice eggs?
Nits
Do Nits wash out?
Nope
Where do Nits / Lice generally present themselves on the scalp?
Back of the scalp & around ear lobes
What lice product was taken off the market due to its seizural effects on kids taking it chronically for Scabies?
Kwellada
Why is GBH / Lindane safe for treating kids with lice & not for treating Scabies?
-Contact duration… 8-12hrs in every bodily crevice for Scabies (vs. 8mins of exposure in shampoos for lice treatment).
Name of the Pyrethrum compound in certain plants that acts as a natural insecticide?
Chrysanthemum
What product did Chrysanthemum ultimately make its way into?
R & C Shampoo
What additional agent is added to R & C Shampoos to enhance the potency of Pyrethrins (either via lasting longer or by increasing ability to enter lice bodies)?
Piperonyl Butoxide
What unique instructions should be followed when taking a Pyrethrin Shampoo for one’s lice?
-Application should be to dry (not wet) hair.
-Contact time = 10mins.
Is there a potential for lice resistance to Pyrethrin agents?
Potentially
Location (in terms of depth in/on the hair & scalp) of Louse & Nits?
Nits: Tightly attached to hair strands.
Lice: Crawl around on the scalp.
What use would a Pyrethrin product containing Lead have?
-For use on lice-infested garments / bedding / mattresses / furniture… NOT for use on humans or pets.
R & C II Spray
Permethrin 1% is a _______ ________ derivative.
synthetic pyrethroid
T or F: Permethrin has enhanced potency (relative to a classical Pyrethrin).
True.
T or F: Permethrin is extremely safe to use with children.
True.
Directions for Permethrin 1% usage?
1) Wash hair with shampoo
2) Creme rinse x 10mins
3) Rinse out
T or F: Lice resistance can be demonstrated with Permethrin products.
True… Is a possibility.
T or F: Permethrin & Pyrethrin products don’t require nit removal.
False… Must remove nits after treatments!
Brand name creme rinses containing Permethrin 1%?
Nix
Kwellada-P
“Physical Agents” that can be used for lice treatment?
Isopropyl Myristate
Coconut / Anise Oil
Dimethicone
SH-206 Shampoo
Isopropyl Myristate treatment regimen for lice?
10min contact time
Nit Pick
Repeat in 7d
Coconut / Anise Oil treatment regimen for lice?
15min contact time
Nit Pick
Repeat in 9 days
Dimethicone treatment regimen for lice?
30min Contact Time & Nit Combing with product in the hair
Overnight treatment = 8hrs contact
Nit Pick
Re-Apply prn
Why does persistent itch occur ~1wk after scalp infestation with lice?
-Lice secretes anticoagulant, which is the root cause of the itch.
1st line lice product?
NYDA Dimethicone
Utilization of heat (from hair straighteners or blow dryers) & bug-busting (combing with a lice comb w/o use of medicated shampoo) are two good lice treatment strategies.
-False… Both are not very effective.
What lice product was forced to be withdrawn from a Calgary feed shop that saw customers buying it for SARS-CoV2 treatment?
Ivermectin
What other products have been used as lice treatment strategies?
Dry-On Suffocation (Cetaphil Lotion)
Lice Electrocution
Tea Tree Oil (insecticidal, but to what capacity?)
Ulesfia
Natroba
Lice treatment expectations… When will itch go away, how fast do they work, when can my kids go back to school?
i) Few days & itch will go away
ii) ~10mins to work
iii) Next day
Why is nit comb dipping in vinegar discouraged when one is on a Permethrin product such as Nix?
-Vinegar reduces the residual effects of Permethrin!
-Secondarily; not enough contact time for Nit glue dissolving with simple dipping.
Is there a treatment for body lice?
-Nope… Only option is to treat clothing.
What product is officially indicated on its packaging for the treatment of pubic lice?
Pyrethrins (R & C Shampoo)
How do we treat pubic lice?
-Treat once with Pyrethrin product & shave the area.
-Note that other Physical Agents discussed priorly can (probably) be used for treating pubic lice, but Pyrethrins are officially indicated on their packaging.
Main transmission route of Scabies?
Person-to-Person contact
Secondary transmission route of Scabies?
Bedding & Clothing
Where are Scabies mites predominantly located?
Between fingers & on the wrists
What diagnostic sign indicates the potential location of Scabies mites?
-Blue dots where burrowing has taken place.
What makes Scabies treatment frustrating for patients?
-Must treat head-to-toe.
-Itch persists for a few weeks.
-Requires blind treatment of close contacts.
Product for Scabies treatment?
Permethrin 5% dermal cream / lotion
How do blind treatments for Scabies differ from Lice?
Scabies: 12hrs full body contact once, then follow-up treatment 7 days later.
Lice: Treat blindly every 7-9 days with safer current agents.
