OTC scalp

Question 1

Symptoms for referral of dandruf

Answer 1

Doubt of diagnosis
Scaling on other parts of the body - indicating seborrhoeic dermatitis, eczema, psoriasis
Sidedness tendency to flaking or seborrhoeic dermatitis for the first time in middle age may be due to HIV

Question 2

5 treatment ingredients for dandruff/ seborrhoeic dermatitis
How often to use?

Answer 2

Pyrithione zinc 2-3x weekly
Selenium sulphide 2x weekly for 2/52 then 1x
Ketoconazole 2x weekly then weekly or fortnight
Coal tar
Salicylic acid

Use regularly - at least twice weekly

Question 3

Caution with selenium sulphide

Answer 3

Highly toxic if ingested orally

Question 4

Pyrithione zinc and selenium sulphide mode of action

Answer 4

Cytostatic - reducing cell turnover

Question 5

Can to use selenium in preg/ BF/ children

Answer 5

Not in first trimester of pregnancy or children under five

Question 6

Gap required between selenium use and dying hair

Answer 6

48 hours

Question 7

Which treatment of dandruff is usually for more severe or persistent ?

Answer 7

Ketoconazole 2%

Question 8

Disadvantage of ointment preparations over shampoo

Answer 8

An absolute mess

Question 9

Seborrhoeic dermatitis in infants is called

Answer 9

Cradle cap

Question 10

Different features between seborrhoeic dermatitis and dandruff

Answer 10

Greasy scales and pruritis

Question 11

Referral for seborrhoeic dermatitis

Answer 11

Severe should be diagnosed and managed by a doctor

Persist yellow greedy scales extending over face or eyebrows or nose or anywhere else

Question 12

Timeframe of cradle cap

Answer 12

Three months of life to a year

Question 13

Appearance of cradle cap

Answer 13

Scaling or scrutiny of the scalp in infants

Question 14

Referral for cradle cap

Answer 14

Anywhere else on the body

Acute erythematous scaling of scalp, nappy area or other parts of body may indicate atopic eczema or generalised infantile seborrhoeic dermatitis

Question 15

Treatment for cradle cap

Answer 15

Olive oil or coconut oil followed by shampooing

There are shampoos avail but these are probably no more effective

Question 16

Signs of scalp psoriasis

Answer 16

Raised defined erythematous and scaly, salmon pink, silvery easily removed scales that may lead to capillary bleeding

Itching - not always
Scaly border extending just bellow hairline

Question 17

Treatment for scalp psoriasis

Answer 17

Should be under dermatologist - refer

Tar based and Salicylic acid preparations (as directed by specialist)
Potent topical corticosteroid or calcipipitrol preparations (Pom)

Question 18

Scalp ringworm is also called

Answer 18

Tinea capitis

Question 19

Scaling ringworm is often acquired from

In whole does it usually occur

Answer 19

Dogs and cats

Almost exclusively in children

Question 20

Signs of scalp ringworm

Answer 20

Tiny bald patches with broken hairs around them

Little or no itching

Question 21

Treatment for scalp ringworm (2)

Answer 21

POM PO antifungals (griseofulvin or terbinifine)

Question 22

Referral symptoms for tinea capitis

Answer 22

Always refer as treatment is POM

Also there maybe lymph swelling, alopecia, bacterial infection, kerion ( swollen puss filled mass)