Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHRM 504 > Lecture 16: Dermatology I > Flashcards

Lecture 16: Dermatology I Flashcards

1
Q

Skin physiology 3 functional regions

A

Epidermis
Dermis
Hypodermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Epidermis

A

• Regulates water content of skin
• Controls drug transport into lower layers
-top of the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Dermis

A

• Nerve endings
• Vasculature
• Hair follicles
-2nd layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hypodermis

A

Provides nourishment and cushion

-3rd layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Skin Care – Basic Care of Skin

A
  • Avoid prolonged hot bathing/showering to prevent drying of skin
  • After bathing or showering, the skin should be lightly towel dried (pat to dry, avoid rubbing or brisk drying)
  • Use non-soap skin cleansers to avoid irritation/sensitivity
  • Minimize the use of astringents and alcohol-containing cosmetics or cleansing products
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Examples of low irritant products

A

Cetaphil Gentle Skin Cleanser, Free and Clear Liquid Cleanser, Dove, Neutrogena,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ointment characteristics

A

Semi solid, water free (or nearly), greasy, sticky, protective, occlusive; can be difficult to spread
Hydration: Moisturizing and emollient propeties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cream characteristics

A

Thicker than a lotion
thinner than an ointment
- more spreadable and less greasy than ointments
Hydration: Moisturizing and emollient properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lotion characteristics

A

Thinner than a cream, may contain oil and
water or alcohol; often provides cooling
effect
Hydration:Less hydrating than ointment of cream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Gel characteristics

A

Aqueous or alcoholic semisolid emulsion

Hydration: No emollient properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Solution characteristics

A

Water or alcoholic lotion containing a dissolved powder

-Hydration: Tends to be drying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Wet or oozy

Consideration

A

Creams, lotions and pastes are most suitable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dry and scaly

consideration

A

Ointments and oils are best

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Inflamed

Consideration

A

Use wet compresses and soaks, then creams or ointments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cracks and sores

Consideration

A

Avoid alcohol or acidic

preparations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Palms and soles

Consideration

A

Ointment or cream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Skin folds

Consideration

A

Cream or lotion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hairy areas

Consideration

A

Lotion, solution, gel or foam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mucosal surfaces

Consideration

A

Non-irritating formulations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Non-drug Topicals– Skin Protectants

A

Form a barrier on the skin to protect from moisture or irritants
• Lock in moisture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Examples of skin protectants

A 
• Zinc oxide
• Petrolatum
• Calamine
 - Absorptive, antiseptic, and antipruritic properties
• Dimethicone
- Repels water and soothes inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Non-drug Topicals – Moisturizers

A

Used to add moisture to the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Examples of moisturizers

A
  • Aveeno Moisture Cream
  • Cetaphil
  • Neutrogena Hand Cream
  • Vanicream
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Non-drug Topicals - Emollients

A

Used to soften the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Examples of emollients

A
  • Shea butter
  • Cocoa butter
  • Mineral oil
  • Lanolin
  • Beeswax
  • Olive oil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Major mechanism of drug absorption

A

Passive diffusion through stratum corneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Topical delivery of a drug from one of these vehicles depends on:

A
  • Relationship between the drug and the vehicle
  • Drug solubility in the vehicle
  • Diffusion coefficient from vehicle
  • Skin factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Skin factors that affect drug absorption

A

Hydration
• Wounds/burns
• Inflammation/dermatitis
• Age – pediatric patients absorb greater proportion of drug than adults → Ratio of surface area to body weight is 2-3x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Hydrocortisone

A 
OTC options are 1% or 0.5% = low potency steroid
- Low risk of local and systemic effects
• Safe short term
• Skin atrophy is possible but rare
• Caution face, eyelids, genitals
Apply before moisturizers
Avoid in children < 2 years of age 
DO NOT apply if skin in open or cracked
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hydrocortisone formulations

A

Ointment-Preferred on thick skin

Cream-less greasy, patients often prefer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Dermatologic Changes

A
  • Macules
  • Papules
  • Nodules
  • Vesicles and bullae
  • Plaques
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Macules

A
  • Circumscribed, flat lesions
  • Any shape or size
  • Differ from surrounding skin in color
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Papules

A
  • Small, solid, elevated lesions
  • Usually <1 cm in diameter
  • The major portion of a papule projects above the plane of the surrounding skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Nodules

A
  • Palpable, solid, round, or ellipsoidal lesions

* Not a papule – deeper or more palpable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Vesicles and Bulla

A
  • Technical terms for blisters
  • Vesicles are circumscribed lesions that contain fluids
  • Bullae are vesicles larger than 0.5 cm in diameter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Plaques

A
  • Mesa-like elevation

* Occupy a relatively large surface area compared with height above the skin surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Dermatitis

A
  • Inflammation of the skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Dermatoses

A

Skin disorder or disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Xerosis

A

Dry Skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Xerosis characteristics

A

Skins normally contains 10% to 20% water by weight
• If skin hydration drops below 10% the stratum corneum becomes brittle and may crack more easily
• Affects >50 % of older adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Xerosis risk factors

A
  • Environmental (i.e. hot showers)
  • Dehydration
  • Physical damage to skin
  • Malnutrition
  • Hypothyroidism
  • Advanced age - epidermis thins over time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Xerosis Clinical Presentation

A
  • Loss of moisture from skin à loss of elasticity à skin cracking
  • Roughness
  • Scaling
  • Loss of flexibility
  • Fissures
  • Inflammation
  • Pruritus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Moisturizing Skin

A

Moisturization = adding moisture + trapping moisture
• Baths are better than showers for moisturizing
• Moisturizers should be fragrance free
• There are no specific recommendations for quantity or frequency of moisturization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Moisturizer should be applied while

A

the skin is still moist or slightly damp (within 3 minutes of towel drying)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Xerosis Treatment

Nonpharmacologic therapy – moisturizing products

A
  • Emollients
  • Moisturizers
  • Glycerin containing cleansers
  • Bath oils
  • Increased room humidity
  • Hydration (oral)
46
Q

Xerosis Treatment

Pharmacologic therapy

A

Topical hydrocortisone (OTC)
• Short-term use (< 7 days)
• Often does not respond well
• May reduce erythema and pruritus

47
Q

Choosing a Moisturizing Product

A
  • Lotions may be used on the scalp and other hairy areas and for mild dryness on the face, trunk and limbs
  • Creams are more occlusive than lotions
  • Ointments are the most occlusive and can be used for drier, thicker, or more scaly areas
48
Q

Occlusive products are the best at moisturizing since

A

they capture trans-epidermal water loss by providing a layer of oil on the skin surface, increasing the moisture content of the stratum corneum

49
Q

Combining multiple formulations can help

A

(cleanser + bath oil + emollient)

50
Q

Atopic Dermatitis (AD)

A

Common inflammatory condition of the epidermis and dermis
• Affects children and adults
• Also known as atopic eczema
• 70% of AD cases have an atopic family history
• Characterized by episodic flares and periods of remission

51
Q

Atopic Dermatitis (AD) Pathophysiology

A
  • Inflammation with expression of cytokines and chemokines

* Decreased ability to retain moisture

52
Q

Atopic Dermatitis (AD) Clinical presentation for children

A
  • Often presents within first year of life
  • Erythema, scaling on cheeks and folds
  • Transitions to dry skin by age 2
53
Q

Atopic Dermatitis (AD) clinical presentation for adults

A
  • Often less severe plaque formation
  • Erythema, scaly, exudative, lichenified
  • Antecubital and popliteal fossae, hands, neck, forehead
  • Pruritus
  • Scratching and lichenification → excoriation
54
Q

Atopic Dermatitis (AD) common triggers

A
  • Food allergens (egg, milk, peanut, soy, wheat, nuts)
  • Aeroallergens (dust mites, cat dander, mold, grass, ragweed, pollen)
  • Stress
  • Airborne irritants (tobacco smoke, air pollution)
  • Cosmetics, fragrances
  • Temperature extremes
  • Electric blankets
  • Excessive hand washing
  • Soaps, detergents, scrubs
  • Dyes or preservatives
55
Q

Atopic Dermatitis (AD) Exclusions to self care

A
  • Moderate-severe condition with intense pruritus
  • Large area of body involvement
  • <1 year of age
  • Cutaneous infection
  • Face or intertriginous areas
56
Q

Atopic Dermatitis (AD) Goals

A
  • Stop itch-scratch cycle
  • Maintain skin hydration
  • Avoid triggers
  • Prevent infections
57
Q

Atopic Dermatitis (AD) Strategy

A
  • Identify and eliminate triggers
  • Skin hydration/barrier protection
  • Topical therapy (+/- systemic in refractory cases)
  • Refer if symptoms worsen or do not resolve within 7 days
58
Q

Atopic Dermatitis (AD) Non-Pharm management

A
  • Avoid triggers
  • Regular bathing
  • Short time, lukewarm water, mild cleansers (ex. Cetaphil), moisturize after
  • Avoid scratching
  • Keep nails short and clean
  • Cotton gloves at night
  • Topical emollients/ointments
  • Standard of care
  • Maintain skin hydration
  • Improves skin response rate in AD
  • Apply at least twice daily
59
Q

Atopic Dermatitis (AD) Pharm management

A

Hydrocortisone (HCT)
• Apply 1-2 times per day during flare-ups
• Refractory conditions should be referred for prescription agents

60
Q

Atopic Dermatitis (AD) Diagnosis by clinical criteria

A
  • Essential features = pruritus + eczema

* May have elevated IgE or eosinophils

61
Q

Atopic Dermatitis (AD) Diagnosis by grading criteria

A
  • Erythema
  • Edema
  • Papulation
  • Excoriations
  • Dryness
  • Scaling and crusting
62
Q

Atopic Dermatitis (AD) Diagnosis by atopic tria

A
  • Asthma
  • Allergic rhinitis
  • Atopic dermatitis
63
Q

Diaper Dermatitis

A

Acute inflammation of skin in perineum, buttocks, inner thighs, and abdomen
• Can occur in any population with incontinence
• Most common in infancy (thinner skin than adults)

64
Q

Diaper Dermatitis Pathophysiology

A
  • Skin compromise due to occlusion, moisture, microbes or friction
  • Urine and feces break down skin
  • Ammonia in urine raises skin pH which makes it more prone to breakdown
65
Q

Diaper Dermatitis Clinical presentation

A

• Bight red, wet-looking patches and lesions

66
Q

Diaper Dermatitis Exclusions to self-care

A
  • Lesions present >/= 7 days or have not improved in 7 days despite treatment
  • Secondary skin infection or symptoms of UTI
  • Diaper dermatitis outside diaper region
  • Presence of broken skin, including oozing, blood, or pus
  • Chronic or frequently recurring lesions
  • Systemic infection symptoms
  • Behavioral changes
  • Immunocompromised condition
67
Q

Diaper Dermatitis goals

A
  • Relieve symptoms
  • Rid the patient of rash
  • Discourage infection
  • Prevent recurrences
68
Q

Diaper Dermatitis Approach

A
  • Determine whether self-care is appropriate
  • Recommend OTC protectants for up to 7 days
  • Refer if symptoms worsen or do not resolve within 7 days
69
Q

Diaper Dermatitis Non-pharm treatment

A
  • Increase diaper changes
  • Gentle wiping with baby wipes
  • Use of disposable diapers
  • Prevention is key!
  • Change diapers immediately
  • Keep diaper area clean and dry
70
Q

Diaper Dermatitis Non-pharm treatment pt 2

A
  • Skin protectants - serve as a lubricant and physical barrier
  • Topical talc and cornstarch powders
  • Apply products liberally as needed
  • Hydrocortisone is contraindicated!
71
Q

Irritant Contact Dermatitis (ICD)

A
  • Inflammatory skin reaction caused by an irritant

* Most cases related to occupation

72
Q

Irritant Contact Dermatitis (ICD) Pathophysiology

A
  • Often occurs on exposed skin surfaces
  • Disruption of skin barrier
  • Changes in epidermis
  • Release of proinflammatory cytokines
  • Many factors affect magnitude of skin response
  • Existing skin conditions
  • Quantity and concentration of substance
  • Chemicals, acids, bases are more severe
  • Contact time with irritant
73
Q

Irritant Contact Dermatitis (ICD) Clinical presentation

A
  • Symptoms are often delayed
  • Inflammation and swelling
  • Erythematous
  • Itching and burning
  • Dry, painful, cracked skin
  • Generally resolves in several days after irritant removed
  • Chronic exposure to irritant:
  • Skin remains inflamed
  • Fissures or scales may develop
  • Skin may be hypo- or hyperpigmented
  • Leathery thickening of skin
  • Lichenification
74
Q

Irritant Contact Dermatitis (ICD) Common substances associated with ICD

A
  • Acids, alkalis
  • Detergents, soaps, hand sanitizers
  • Epoxy resin
  • Ethylene oxide
  • Fiberglass
  • Flour
  • Oils
  • Oxidants, plasticizers and activators in athletic shoes
  • Solvents
  • Urine/feces
  • Water
  • Wood dust and products
75
Q

Irritant Contact Dermatitis (ICD) Treatment goals and approach

A

• Remove the irritant
• Prevent further exposure to irritant
• Relieve inflammation, irritation and tenderness (non-pharm and pharm
options)

76
Q

Irritant Contact Dermatitis (ICD)

A 
● Avoid further irritant exposure
● Wash area of initial irritant exposure
• Warm water and mild soap
• Reduces contact time with irritant
• Helps localize symptoms
● Protective clothing and equipment
Skin protectants/ointments
● Colloidal oatmeal baths
● Topical corticosteroids - not recommended
77
Q

Irritant Contact Dermatitis (ICD)- Wash area of initial irritant exposure

A
  • Warm water and mild soap
  • Reduces contact time with irritant
  • Helps localize symptoms
78
Q

Irritant Contact Dermatitis (ICD) Skin protectants/ointments Steps

A

Apply to the affected area
• Helps restore moisture to stratum corneum
• Protectant from further exposure
• Dimethicone containing products help repair epidermal barrier

79
Q

ICD - Colloidal oatmeal baths

A

May help relieve itching

*Topical corticosteroids - not recommended

80
Q

Allergic Contact Dermatitis (ACD)

A

Inflammatory dermal reaction after exposure to allergen

81
Q

Allergic Contact Dermatitis (ACD) Common causes

A
  • Poison ivy, oak, sumac
  • Nickel (jewelry)
  • Latex (gloves, healthcare workers)
  • Cosmetics and fragrances
  • Benzocaine
  • Neomycin sulfate
82
Q

Allergic Contact Dermatitis (ACD)- Urshiol induced ACD

A

Toxicodendron plants
• “Leaves of 3, let it be”
• Urushiol is the antigen released by direct damage to the plant
• Allergic response occurs within 10 minutes of contact
• Unwashed contaminated hands can transfer urushiol to other body surfaces and other individuals
• ~80% of those in the US are estimated to be sensitive to urushiol
• Reduced sensitivity in elderly

83
Q

Allergic Contact Dermatitis (ACD) Clinical presentation

A
  • Papules
  • Small vesicles
  • Pruritus
  • Erythema (streaky/patchy)
  • Inflammation
  • Lichenification
  • Affected area eventually crusts and dries
  • Presentation varies based on severity
  • Typically resolves in 10-21 days
84
Q

Allergic Contact Dermatitis (ACD) Exclusions to self-care

A
  • <2 years old
  • ACD present >2 weeks
  • Involvement of >20% of skin surface
  • Extreme itching, irritation, or severe vesicle and bulla formation
  • Swelling of the body or extremities
  • Swollen eyes or eyelids swelling shut
  • Discomfort in genitalia d/t itching, irritation, swelling
  • Involvement/itching of the mucous members of the mouth, eyes, nose, anus
  • Signs of infection
  • Failure of self-care after 7 days
  • Impairment of daily activities
85
Q

Allergic Contact Dermatitis (ACD) Non-Pharm treatment

Education and prevention

A
  • Protective clothing
  • Barrier products block urushiol from absorbing into skin (IvyBlock- FDA approved)
  • Plant eradication
  • Urushiol is inactivated by wet conditions
  • Remains active within dead plants or innate objects
  • Cold showers with hypoallergenic cleansers
86
Q

Allergic Contact Dermatitis (ACD) Non- Pharm Treatment

• Remove the known antigen ASAP

A
  • May reduce chance and severity of reaction
  • Wash are with soap and water (10 minutes)
  • Nonprescription wash to prevent or relieve rash
  • Zanfel
  • Technu Outdoor Skin Cleanser
  • Similar efficacy to soap – consider costs
87
Q

Allergic Contact Dermatitis (ACD) Pathophysiology

A
  • Allergen activates sensitized T cells after initial contact
  • Next time allergen has contact:
  • T cells migrate to site of contact
  • Release inflammatory mediators
  • Type IV delayed hypersensitivity reaction
  • Cell-mediated immune reaction
  • Can take 24 hours to 21 days to develop
  • If previously sensitized → rash and symptoms usually develop 24-48 hours after exposure
88
Q

Allergic Contact Dermatitis (ACD) Pharm treatment: Itching

A

Oral diphenhydramine (NOT topical)

89
Q

Allergic Contact Dermatitis (ACD) Pharm treatment:Weeping

A 
Astringents: Decrease edema and exudation
• Aluminum acetate/Burrow’s solution
• 1 tablet to 1 pint of water
• Soak area 15-30 mins 2-4x day
• Calamine lotion
90
Q

Allergic Contact Dermatitis (ACD) Pharm treatment: Inflammation

A
  • Hydrocortisone
  • Most effective for mild-moderate ACD
  • Cream preferred to ointment
  • Allows weeping lesions to dry
91
Q

Dandruff

A

Chronic, mildly inflammatory scalp disorder

92
Q

Dandruff Clinical presentation

A

diffuse scaling at crown of

head +/- pruritus

93
Q

Dandruff Pathophysiology

A

Hyperproliferative epidermal disorder
• Shedding of large, white scales
• Role of Malassezia yeast species?

94
Q

Dandruff Treatment Goals

A

Reduce epidermal turnover rate
• Minimize cosmetic concerns
• Minimize itch

95
Q

Dandruff Treatment Approach

A

• Regular non-medicated shampoo typical is sufficient for mild/moderate dandruff
• Nonprescription medicated shampoos suppress replication of Malassezia species
and reduce yeast count in the scalp and skin
• Refer to PCP if dandruff persists after 4-8 weeks with medicated shampoo

96
Q

Dandruff Pharmacologic Treatment

A 
Nonprescription medicated shampoos
• Pyrithione zinc (Head and Shoulders shampoo)
• Selenium sulfide (Selsun Blue)
• Ketoconazole
• Coal tar shampoo
97
Q

Ketoconazole shampoo for dandruff

A

Anti-fungal shampoo with anti-Malassezia activity

98
Q

Coal tar shampoo for dandruff

A
  • Decrease rate of epidermal replication
  • Second-line
  • Limited efficacy
  • Discolor light hair and clothing
99
Q

• Shampoo Directions for dandruff

A

Wash hair and scalp daily or every other day for one week, then taper down
• Contact time is key to effectiveness
• Massage shampoo into scalp and leave for 3-5 minutes before rinsing
• Repeat rinsing to ensure residual is removed

100
Q

Seborrheic Dermatitis

A

Inflammatory condition primarily near sebaceous gland

101
Q

Seborrheic Dermatitis Pathophysiology

A
  • Accelerated epidermal proliferation caused by elevated levels of Malassezia
  • Epidermal cell turnover is 9-10 days compared to 25-30 days normally
102
Q

Seborrheic Dermatitis Clincal presentation

A
  • Dull, yellowish, oily, scaly areas on red skin
  • Pruritus is common
  • Common locations: Scalp, eyebrows, eyelids, cheeks, paranasal areas, beard area, sternum, central back, around ears, intertriginous areas
  • Infantile form
  • Cradle cap
  • Usually clears without treatment by 8-12 months
  • Adult stages
  • Yellow, greasy scales on scalp to face
103
Q

Seborrheic Dermatitis Treatment Goals

A
  • Reduce inflammation and epidermal turnover
  • Minimize or eliminate erythema, scaling, and pruritus
  • Educate about chronic condition – control symptoms, not cure
104
Q

Seborrheic Dermatitis Treatment Approach: Infants

A

Infants
• Usually self-limited with time
• Use non-medicated shampoos
• Gently massage scalp with baby

105
Q

Seborrheic Dermatitis Treatment Approach: Adults

A

Shampooing is the foundation of treatment REGARDLESS of skin lesion location
• Medicated shampoos: Pyrithione zinc, Selenium sulfide, Ketoconazole
• Topical corticosteroids may be useful to treat inflammation in seborrheic dermatitis
• NOT typically useful in treating dandruff
• 7 day maximum use before refer

106
Q

Psoriasis

A

Chronic inflammatory disease
• Plaque psoriasis most common
• Remissions and exacerbations are unpredictable
• Lesions may clear spontaneously

107
Q

Psoriasis Pathophysiology

A
  • Accelerated epidermal proliferation
  • Excessive scaling on raised plaques
  • Lesions may last a lifetime or disappear
  • May leave skin hyper- or hypo-pigmented
108
Q

Psoriasis Clinical Presentation

A
  • Lesions start as small papules and unite to form plaques
  • Well-circumscribed, sharply demarcated
  • Overlying thick white scales
  • Most common sites
  • Exterior surfaces of elbows and knees
  • Lumbar region of back
  • Scalp
  • Posterior auricular area
  • Inflammation and itching
109
Q

Psoriasis Triggers

A
  • Environmental
  • Physical, chemical
  • Infections and immune status
  • Certain drugs and corticosteroid withdrawal
  • Ex: beta-blockers, lithium
  • Psychological stress and hormones
  • Obesity
  • Use of alcohol and tobacco
110
Q

Psoriasis Treatment Goals

A
  • Control or eliminate signs/symptoms

* Prevent or minimize flare-ups

111
Q

Psoriasis Treatment Approach

A
  • Only mild cases can be self-treated
  • Up to a few isolated lesions, no larger than a quarter
  • Bathing will help remove loose scales which disrupts plaque formation
  • Emollients to moisturize/soften skin
  • Apply liberally with gentle rubbing 4x daily
  • Hydrocortisone (OTC)
  • Most effective for acute bright red flare lesions
  • Refer to dermatologist for moderate to severe cases over large areas
112
Q

Dermatoses Exclusions to Self Care

A

Less than 2 years of age
• Worsening or no improvement after 1-2 weeks of proper
use of OTC medication options
• >5% body surface area involvement for psoriasis

PHRM 504 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions