Mar 5 - Topical Tx's and Inflamm Skin Disease Flashcards
What is a corneocyte?
A skill cell from the top layer of the epidermis (stratum corneum)
Three ways topical drugs can be absorbed:
Passive Diffusion, Channels/Pores, Appendageal Structures
Topical absorption is directly proportional to _____?
The concentration of the active ingredient
Topical absorption is inversely proportional to _____?
Molecular size
What is the “vehicle” for topical medications?
The vehicle is what the active ingredient is suspended in
Cremes are a mixture of:
oil in water
Ointment is a mixture of:
water in oil
Gels are a mixture of:
semi-solid emulsions in an alcohol base
Which is the most potent delivery system: ointment, gel, lotion?
Ointment
Acne keloidalis
hypertrophic scarring over time due to chronic irritant exposure
1 FTU = _____g = ______ (surface area of the body)
1 FTU = 0.5 g = covering the front and back of one hand
Which is most potent: Hydrocortisone, Clobeasol Propionate, or Triamcinolone Acetonide?
Clobetasol Propionate (class 1)
What is our all-purpose topical steroid?
Triamcinolone Acetonide
What topical steroid should you use on an infant with a skin infection on the face?
Hydrocortisone
Some adverse effects of chronic topical steroid use?
Skin atrophy
In kids: adrenal suppression, Cushing’s Disease, growth retardation
Atopic dermatitis is often caused by a mutation in which gene?
The filaggrin gene
How to Dx Atopic Dermatitis?
Itchy skin + (onset before 2 y/o, dry skin, skin creases, family history of asthma/hay fever, scaley red cheeks with the cold)
xerosis =
dry skin
Is atopic dermatitis inflammatory or non-inflammatory?
Inflammatory and recurrent
Irritant Contact Dermatitis
Not immune-mediated; chronic exposure to irritant chemicals (ie soap, heat)
Itertrigo
Rashes in skin folds due to friction/trapped sweat. Can easily become secondarily infected (candidae)
Allergic Contact Dermatitis (ACD)
Delayed hypersensitivity with contact with the allergen. Blisters and epidermal changes 24-48 hours after exposure
Which cells recognize the MHC class II on allergy antigens?
Langerhans cells
Cellulitis vs Contact Dermatitis
Cellulitis = Dermis! Pain and warmth
Contact Dermatitis = Epidermis! Itchiness with red swelling
Neomycin (from Neosporin) will cross react / cross sensitize with ______
Vassotracen
Statis Dermatitis presentation
Itchy, swollen, brown/red skin caused by inadequate venous return from the lower limbs. Can lead to ulcers and open lesions.
Lipordermatosclerosis
Scarring due to dermatitis that can lead to thinning of the limb
Nummular Dermatitis
Due to a decrease in circulating NMF causing coin-like, red, scaley patches. Prevalent in older Pt’s
Suborrheic Dermatitis
Dandruff, in infants: cradle cap. Flaky yellow discharge from Malassezia furfur yeast consuming natural skin oils
How do you treat Suborrheic Dermatitis?
Ketoconazole and anti-fungal shampoos
Psoriasis
Thick, silvery, scaled rash on the trunk and extensor surfaces. Caused by an immune predisposition and an environmental trigger
Guttate Psoriais
Psoriasis associated with strep pyogenes - appears like psoriasis drops all over
What happens to your nails with psoriasis?
Nail pitting / separation of the nail from the nail bed
Psoriatic Arthritis
Arthritis secondary to psoriasis - can lead to nail changes, painful joints/bleeds, dactylitis
