OTC Skin Conditions Flashcards
What are symptoms of tines pedis?
Athletes foot
White, itchy, flaky, possibly macerated skin in web spaces between toes
What are the symptoms of tinea corporis?
Body ringworm
Flat, slightly raised circular rings with a distinctive red scaly border and can have a central clearing
What are the symptoms of tinea capatis?
Scalp ringworm
Distinctive ring shaped rash with associated hair loss
Refer as requires oral antifungal
What are the symptoms of tinea cruris?
Jock itch
Fungal groin infection
Red brown rash with well defined edge on inner thighs and buttocks
When do you refer fungal infections?
Facial or scalp involvement Toenails also affected in athletes foot Large area affected Broken skin Secondary bacterial infection Diabetic/immunocompromised OTC failure after 2 weeks
What are the topical imidazoles used in OTC fungal infections?
All ages clotrimazole (canesten), miconazole (daktarin/daktacort) Adults ketoconazole (daktarin GOLD, intensiv)
What is terbinafine used for OTC?
Lamisil 16+, lamisil once 18+
Spray, cream = jock itch and athletes
Gel = jock, itch, athletes foot, body ringworm
Cutaneous solution = athletes foot
Powders - prophylaxis for athletes foot
What is the advice for fungal infections?
Continue until at least 7 days after symptoms disappear
Contagious
Avoid sharing towels
Change socks regularly, dry skin thoroughly, wear flip flops in communal areas
What are the symptoms of acne?
Whiteheads
Blackheads
Spots
Pustules
When do you refer for acne?
Children under 12
Adults over 25 for the first time
Acne rosacea
Appears on back or chest or anywhere but face
Medication ADR - lithium, phenytoin, progestogens
OTC failure > 8 weeks
Moderate-severe
What are the OTC products for acne?
Benzoyl peroxide - acnecide, panoxyl - 2.5-10% OD to BD
Wash skin before applying
8 weeks improvement
Apply to whole area affected
What are the side effects of acnecide?
Bleaches clothes
Avoid direct sunlight, photosensitivity
Stinging, dry, burning, red, peeling skin especially in initial stages
Nicotinamide alternative
What is the advice for acne?
No evidence to suggest certain food or poor hygiene can cause acne
Use mild antibacterial soap
Do not overscrub
Do not squeeze spots
Avoid greasy or oil based cosmetics
What are the symptoms of corns and calluses?
Yellow hyperkeratinised skin
Can be painful
When do you refer corns and calluses?
Diabetics
Impaired circulation
Treatment failure
Soft corns
What are the OTC products for corns and calluses?
Padding or shielding
What is the advice for corns and calluses?
Wear well fitting shoes
Use a pumice stone to gently remove hard skin
Dry feet thoroughly after washing
What are the symptoms of eczema?
Sore and inflamed rash
Dry and flaky
Irritated and itchy
What are the symptoms of contact dermatitis?
Response to external factor
Substance directly damages outer layer of skin
Substance causes immune response
When do you refer eczema?
Infected Severe Broken skin Face Anogenital areas OTC failure > 7 days Undiagnosed eczema or unknown cause Symptoms > 2 weeks
What are the OTC products for eczema?
Emollients
Ointments
Soap substitutes
Bath additives
Hydrocortisone 10+ OD-BD
Clobetasone 12+
Max 15g, 7 days. Not in pregnancy or broken skin
Calamine/eurax
What is the advice for eczema?
Apply steroid sparingly
Apply emollient 30 mins before steroid
Soap substitutes
Eliminate aggravating factors
What are the symptoms of a fungal nail infection?
Dull, yellow opaque appearance
Nail thickens and distorts
Brittle and crumbles away
When do you refer nail infections?
Other fungal nail infections Nail breaking away Immunocompromised Peripheral circulatory disease Diabetes
What is used OTC for nail infections?
Amorolofine 18+ (curanail)
No more than 2 nails affected
Only beneath tips or sides of nails affected
Contraindicated in pregnancy and breastfeeding
What is the advice for fungal nail infections?
Keep using until all of the affected Mai, tissue grows out
Apply once weekly to affected nails
File down nail surface
Clean
Apply nail lacquer
What are the symptoms of psoriasis?
Plaque psoriasis
Red plaques
Well defined edges
Silvery scales
When do you refer psoriasis?
Undiagnosed
Moderate to severe
What are the OTC products for psoriasis?
Emollients
12+ coal tar solution
What is the advice for psoriasis?
Limit stress
Not contagious
Sun exposure - can improve psoriasis
What are the symptoms of cold sores?
Tingling sensation or irritation
Blisters on lips/around mouth
When should a cold sore be referred?
Painless Babies/young children Immunocompromised Uncertain diagnosis Eye affected Cold sores inside mouth Cold sores > 2 weeks Patients with atopic eczema
What are the OTC products for cold sores?
Aciclovir (zovirax) five times a day for at least 4 days. Max 10 days. Four hourly intervals
Penciclovir 12+ (fenistil) 8 times a day for 4 days
Hydrocolloid patch apply for 24 hours until it completely heals
Bland creams
What is the advice for cold sores?
Highly contagious No longer contagious after crusts for, Wash hands Transferable to eye Avoid kissing, oral sex, sharing cutlery Recurrent episodes
What are the symptoms of warts?
Flesh colour, raised cauliflower surface
What are the symptoms of verrucas?
Flat, occurs on sole of feet with black dots in the middle
What are the referral criteria for warts and verrucae?
Facial warts Multiple Anogenital Diabetic patients Immunocompromised Itching/bleeding A change in appearance OTC failure > 3 months
What are the OTC products for warts and verrucae?
Salicylic acid
Cryotherapy
Glutarol
Can take up to 12 weeks
Take steps to prevent spread
