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PHAR 153 > Intro Dermatology > Flashcards

Intro Dermatology Flashcards

1
Q

What are some properties of skin?

A

Amazing protective properties(thin as paper, but impressive protection)

As cells move up, they die (proliferated)

moisture determines pliability

The skin is slightly acidic, called the “acid mantle”

It is the site of Vitamin D synthesis

Photo reactions to drug therapy

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2
Q

What is included in the dermis?

A

Hair follicles, sebaceous and sweat glands

sensations of itch, stinging, pain

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3
Q

What is included hypodermis?

A

subcutaneous, connective, and adipose tissue

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4
Q

What are some issues with nails?

A

Hangnails, fungal infections, psoriasis(pits in nail)

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5
Q

What are some factors that affect drug absorption into the skin?

A

Skin hydration (more hydrated = more absorption)
pH of drug and vehicle
Thickness of application (thinner layers = more effective per unit of drug used)
Temperature of skin
Damaged skin (increased absorption)

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6
Q

What is difference between dosage forms?

A

The following are listed with the highest efficacy first

Ointments (more effective), creams, and lotions (less effective)

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7
Q

What is a FTU (fingertip unit)?

A

One fingertip unitis the amount of topical drug that is squeezed out from a standard tube along a adults fingertip.

One FTU is enough to treat an area of skin twice the size of the flat of an adult’s hand with the fingers together

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8
Q

What are the different types of blisters?

A

Vesicles (less exaggerated blister)
Blistering (classic blister)
Bullae (exaggerated version of blister)

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9
Q

What are some lesions that may indicate the process of inflammation and infection?

A

Erythema (red patch, often is deodourant reaction)

Wheal (found commonly in allergy tests)

Papule (small bump on skin, found in acne)

Pustule, nodules, and cysts are worsening types of lesions found in acne

Abcess (foliculitis, pus filled)

Crusting (reaction to earrings, thickened skin)

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10
Q

What are some lesions that are characteristic of chronic skin issues?

A

Scales (raised above the surrounding skin)

Plaque (raised, white, thickened skin)

Patch (a large macule, vitiligo)

This process is called lichenification

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11
Q

What type of skin lesions is caused by mechanical irritation?

A

Excoriation (can be caused by repetitive motions, top layers of skin are removed)

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12
Q

Why do we have to worry about skin conditions in people with diabetes?

A

Glucose toxicity can limit sensation to the point where individuals do not feel ulcers on the bottom of their feet

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13
Q

What is a macule?

A

A macule is a flat, distinct, discoloured area of skin less than 1 cm wide, It doesn’t involve any change in the thickness or texture of the skin

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14
Q

What are some common actions pharmacists take in response to a patient asking about a rash?

A

1) Unmedicated soothing lotion
2) antibiotic/antifungal
3) do nothing? (a valid option, it helps us see progression. This can help pin point exact diagnosis)

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15
Q

What are some characteristics of dry skin?

A

The legs, hands, forearms, face, shoulders/back are common areas

Ranges from annoying to being painful (cracks can appear)

Often associated with itch

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16
Q

What are some factors that can cause dry skin?

A

Excessive bathing/showering (dial down the temperature)

Low humidity (winter)

aging (more oil production in youth)

sun damage

agressive soaps

mechanical rubbing

medical conditions (diabetes, hypthyroid, and others)

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17
Q

What is the Itch-Scratch Cycle?

A

1) Itching leads to scratching
2) Scartching damages the skin
3) Causes eczema to worsen
4) This leads to more itching

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18
Q

What makes a dry skin product ‘eczema grade’

A

it is unscented, non-allergenic, gentle/soapless, no added colours

19
Q

What are some non-drug measures that control dry skin?

A

Cut back on frequent hot showers.
Pat dry rather than rub dry.
Apply cream/lotion while skin is still damp

20
Q

What is the value of colloidal oatmeal as a dry skin product?

A

Oatmeal components (protective/water-holding, slight anti-inflammatory action, anti-itch)

21
Q

What are some standard pharmaceutical ingredients used in dry skin products?

A

petrolatum(vaseline), dimethicone(silicone-derivative), fatty acids, etc.

22
Q

Rank product efficacy by dosage form from highest efficacy first

A

Petrolatum
Ointments
Creams
Lotions
Bath oils

23
Q

Is ceramide in dry skin products efective?

A

Although ceramides are found in our skin, but it is best utlilized when it is delivered below the skin. Ceramide in topical creams has no specific action besides being a lipid

24
Q

If a patient has acne, should we give them a lotion or cream?

A

A lotion has lower lipid content, a quality that is important for people with acne

25
Q

What is the concept behind humectants?

A

Gimicky product

Used to attract water from the atmosphere (likely a high ask)

26
Q

What are keratin softening agents?

A

These are stronger agents, and more clinical. Used on hardened skin, don’t use everywhere

ex. AHA and urea

27
Q

What is the effect of salicylic acid in dry skin products?

A

This is a keratolytic, not for regular dry skin

28
Q

Do any topical vitamins have any significant clinical value

A

Not really, the only exception is niacinamide for its anti-oxidant properties

29
Q

What is the difference between dry skin products?

A

They are actually extremely similar (share 80% of ingredients)

Beneficial effects largely due to unglamourous glycerin, dimethacone, and petrolatum

30
Q

What are age spots?

A

Regions of hyper-pigmentation(also known as liver spots)

31
Q

What can be used to even out differential pigmentation?

A

Tretinoin (mostly used for acne, also used to even out skin tone)

Hydroquinone

32
Q

What factors determine your complexion?

A

Heredity

Sun exposure/occupation

Smoking (makes you look older)

33
Q

What are some common causes for itch?

A

Very different etiologies = diverse treatment options, therefore itch can be complex

Dry skin
Tinea (fungal)
Athlete’s Foot (fungal)
Chicken Pox (found in unvaxxed kids)
Food allergy
Hives

34
Q

How can we help dry skin?

A

Assure normal hydration, fewer hot showers, and use regular dry skin products

35
Q

What is the use of Calamine as a an anti-itch product?

A

This product is not good for dry skin (stringent)

This used to dry skin around an insect bite or poison ivy. This gives relief from itching

36
Q

Why is menthol used as a an anti-itch products?

A

Use as a counter-irritant
2-3% of menthol is applied on the skin, it irritates the skin. If there is pain in the deeper tissues, irritation of skin is suggested to ‘fool’ the brain into percieving pain less intensely (do not use this on dry skin)

Use as an anti-pruritic
below 1%, menthol helps with dry skin directly

37
Q

How are local anesthetics used in anti-itch products?

A

Pramoxine and benzocaine is found in hemmorhoid crem, used to anesthetize these areas

great for insect bites, not so much for cuts and burns

38
Q

How are antihistamines useful in anti-itch products?

A

Topical benadryl is not liked by medical professionals for use in rashes.

We should determine what is causing the rash in the first place, and them provide individualized care for primary issue.

The value of benadryl is overstated by patients. Second generation antihistamines are much better (helps with itch related to hives)

It is likely more irritating than soothing for itchy skin (limited use)

Do not use on blistered, raw, oozing areas (chicken pox)

39
Q

What are some characteristics of topical steroids?

A

Anti-inflammatory

Steroids help with minor irritations, rashes, insect bites, poison ivy, allergic reactions

ex. 0.5% and 1% hydrocortisone (potency 7), clobetasol (potency 4)

40
Q

How do cold packs help with itch?

A

They are great for burns and insect bites.

41
Q

How to tell if a patient’s itch is systemic?

A

If there is no rash, but there is itchiness, they have systemic factors causing itchiness

ex. use of drugs that cause pruritis (opiates)

42
Q

Is itch commonly ignored by doctors?

A

Itch is often ignored as attention is given to more serious conditions.

Itchiness can be debilitating and the pharmacy reason for reduced quality of life

43
Q

Is there something special in anti-itch products for diabetes patients?

A

Nothing in the products marketed to help diabetes related skin issues have unique clinical effects. They are just another moisturizer/dry skin product

PHAR 153 (20 decks)

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