L5 - Common skin conditions Flashcards
Macule (small) / patch (larger), flat, discolouration
Papule = ______ lumps, scratched across skin in a line, <1cm
Vesicle = ____ filled <1cm
Plaque of psoriasis >1cm
Nodule differs from papule via size >1cm
Bulla = _______, fluid filled >1cm
Macule (small) / patch (larger), flat, discolouration
Papule = little lumps, scratched across skin in a line, <1cm
Vesicle = fluid filled <1cm
Plaque of psoriasis >1cm
Nodule differs from papule via size >1cm
Bulla = blisters, fluid filled >1cm
Describe acute dermatitus
Inflammation of dermis, redness, itchy, oedema and weeping
Describe Chronic dermatitus
Skin thickening, discolour, hyper pigmented
3 types of dermatitis?
Atopic, contact irritant and contact allergic
Describe Atop dermatitis
Mutation in Filaggrin, important part of natural moisturising factor.
Good filigrin = good brick wall
Barrier damage = antigens enter skin = inflammation
Occupation important = break down barrier = defective barrier
Describe acute eczematic flare
red, scared, dry thickened skin
Describe Irritant contact dermatitis, give examples for causes
Due to contact with irritant, frequently over long period
e.g excessive moisture, hand washing or saliva (child licking lips)
Describe allergic contact dermatitis
Give an example of a a few triggers
Allergic reaction w/ allergen in contact w/skin
even when skin isn’t impaired = can still get dermatitis
e.g nickel. hair dye, adhesive in medical dressings, topical meds.
Rhus tree sap
GENERAL pharmacological treatments for eczema
Topical corticosteroids, barrier creams, emollients
Steroid ladder - potency
- Give pone example of each:
Mild:
Moderate:
Potent:
Ultrapotent:
Mild: 1% hydrocortisone
Moderate: Clobetasone butyrate
Potent: Betamethasone valerate
Ultrapotent: Clobetasol proprionate
Steroids: sensitive vs thick skin, what potency?
More potent for thick skin:
Less potent for thin skin:
Topical steroids
Finger tip, apply once daily as drug quickly builds ________ in skin. Also define steroid phobia
Reservoir
vague negative feelings and beliefs’ about topical steroids and may arise more from misinformation than irrationality.
Benefits of topical immunimodulators? Give two examples
No steriod side effects e.g thinning and resistance
Pimecrolimus - funded by pharmac, much mild
Tacrolimus, potent
Sites of psoriasis
Scalp, nails, umbilicus and axilla (throat)
Chronic plaque psoriasis
Plauqes, scaly and red, will bleed
Guttate psoriasis
After strep throat, raindrop red dots, can be life long
Localised pustular psoriasis
acute skin failure, peeling away, pustules can be local white milky
Erythrodermic psoriasis
Skin faliure, lose fluid, poor temp control, bugs get in
psoriasis worsened by
Stress, infection, systemic steriods, HIV, AIDS, Psoriatic arthritis
General treatment for psoriasis
Example of retinoid and immunimodulators?
Topical, salicylic acid, steriods, coal tar, retinoids e.g Calcipotriol or immunomodulaters for severe causes = MTX, cyclosprin
Systemic treatment for psoriasis?
Adverse effect of retinoids?
MTX, cyclosporin, Acitretin
Teratogenic
What is acne and it’s aetiology?
Chronic inflammation skin condition - disorder of pilosebasue grease gland
Caused by excess grease, comedone formation and colonisation of pilosebacous duct.
Comedones are:
Small flesh colored acne papules, ruptur e= inflamotry response = scaring.
Factors that modify acne
Hormones. medication (e.g steriods) and diet (weak evidence)
Acne vs Rosacea ?
Rosacea = no comedones, redness, flushing, papules, pustules. Differnt treatment
Treatment of mild acne?
Give examples.
Just topical treatment, mild
Benzoyl peroxide, Azelic acid, antibiotics and retinoids - 4 weeks
Treatment of moderate acne?
Give examples.
Topical + oral antibiotics
e.g Doxycyline, erythromycin, treat for 3 months
Treatment for sever acne?
Give example
Retinoids = isotretinoin.
Isotretinoin adverse effects
Highly teratogenic, dry sin, sensitivity, depression??
Woman need effective birth control
Bacterial infections: Impetigo (school sores). Clinical presentation?
Golden crust rash, caused by bug, children worlwide. DONT GIVE ANTIBIOTICS, antiseptics are good
Common fungal infections?
Tinea capitits/corporis = ringworm
Tinea pedis = athletes foot
Onchymycosis = fungal nail infection
Pityriasis versicolor = common skin infectoin
Piryriasis captis = dandruff
Tinea capitits/corporis = ringworm
Tinea pedis = athletes foot
Onchymycosis = fungal nail infection
Pityriasis versicolor = common skin infectoin
Piryriasis captis = dandruff
Tinea capitis can arise from ______ fungus. Can treat with ________
Animal fungus
Teat with antifungal
Ringworm, fungus grows in a ____ shape, Involves body, face, hands and groin.
Has ____ edge
Ring
Sharp
Athletes foot. Poorly treated with creams. Characterised by ___________. Web space gets soggy.
Macerated web spaces
With fungus + eczema, which do you treat first?
FUNGUS FIRST
Can get fungus and tinea, get scrape, establish diagnosis = get antifungal treatment first before treating the exam
Steroid on fungus = loves it, like fertilizer on fungus so treat fungus first.
Differential diagnosis of fungus?
Psoriasis and dermatitis
Nail infection clinical presentation + treatment?
white/yellow, thickened, crumbly.
Oral antifungal agents.
topical ineffective.
Nail infection differential diagnosis?
Onychogryphosis = fungal nail infection or psoriasis
Treatment of fungal infections?
Topical: Miconazole, clotrimazole, Terbinafine
Systemic: terbinafine and itraconazole
Yeast infection: red brown, pale patches, causes pigmentation in skin.
Treatments?
Ketaconazole shampoo
Creams: terbinafine and clotirmaxole/miconazole
Pityriasis Capitis/Seborrheic Dermatitis (Dandruff) = Chronic scaly scalp condition, reoccurring
Treatment?
Topical:
Miconazole-hydrocortison cream
Ketaconazole shampoo
Systemic:
Itraconazole
Herpes (cold sores)
Type 1 usaully causes ___ and facial infections
Type 2 usaully causes _____ and rectal infections
oral
genital
Herpes diagnosis and treatment?
discomfort and itch with no rash, then vesicles appear
vesicles on a red base, enlarged lymph nodes
Normally heal in 7-10 days no scar on own. If recurring = antiviral: acilovir and valaciclovir
Head lice, itchy, live off base of scalp. Heavy infestation can lead to ______ and secondary bacterial infection
dermatitis
Head lice treatment?
Shampoos, phenothrin
what scabies?
contagious, itchy, finger web scales, mite borrows underneath top layer of skin
Rash - hypershift to reaction to dead mites and poo, CRUSTED SCABIES = millions of mites in immunocompromised people
Treatment for scabies?
What’s good for resthome outbreaks?
Topical: permethrin cream
Oral: ivermectin (outbreaks in elderly)
Acute effects of UV radiation?
pain, swelling, blistering and erythema
Chronic effects of UV radiation?
Photoaging and dyspigmentation
Pharmacists role in skin cancer?
Educate patients about SS
Ensure people know how to properly use.
