RTS - SKIN PART 2 Flashcards
What is acne vulgarisms?
chronic skin condition - blockage/inflammation of hair follicles accompanying sebaceous glands
Present with non inflammatory, inflammatory lesions or a mixture
what are the symptoms of acne? i.e the different types of spots (6)
Blackheads (open comedones) - follicles that have a wide opening, filled with plugs of sebum
- White heads (closed comedones)- smaller opening and have same materials as blackheads, white
- Papules - small red bumps - sore
- Pastules - white tip at centre caused by build up of pus
- Nodules - large hard lumps hat build up beneath surface
- cysts- most severe type of spot- large puss filled lumps- greatest risk of scarring
Treatments for acne
- topical
- POM treatments e.g topical retinoids, topical antibiotics, azelaic acid, combined pill, antibiotic tabs
- Benzoyl peroxide - Quinoderm 10
describe benzoyl peroxide as treatment for acne
Include cautions & SE
prevents dead skin clogging up hair follicles, kills bacteria on the skin
- cream/gel
- apply one or twice daily 20 mins after washing face
Cautions - apply sparingly, use UV protection, has a bleaching effect
SE - dry sin, burning, itching, stinging, redness, skin peeling
Name and describe the 3 types of acne scars
- Ice pick - small deep holes that looks like skin is punctured
- Rolling scars - bands of scar tissue form under the skin - uneven appearance
- boxcar scars - round or oval depressions or craters
Lifestyle advice for acne
- wash affected areas with mild cleanser and Luke warm water
- dont squeeze
- avoid too much make up and use water based products described as ‘non comedogenic’
- remove stress factors
- if dry skin- fragrance free moisturisers, water based emollient
- Wash hair regularly, keep off face
what is rosacea?
relapsing condition, exact cause unknown. Affects people with fair skin and generally ages 30-50
symptoms of rosacea?
flushing, facial redness, visible blood vessels, thickened skin sensitive - burn, itching papules an dpastules raised red patches swelling
common triggers of rosacea
exposure to sunlight stress hot or cold weather foods e.g spicy medication - corticosteroids, amidarone
treatments of rosacea
No treatment is available OTC.
(a) self care
(b) medications - can get oral antibiotics or topical metronidazole, azelaic acid
lifestyle advice for patients with rosacea
(a) sun - always wear sunscreen min spf30, UVA and UVB
(b) stress - relaxation, exercise
(c) foods - stop alcohol an spicy foods, and see what causes skin to flare up in a food diary
(d) cold weather- protect face, e.g scarf
Also use skincare techniques like acne
what is a cold sore?
Small blisters form around lips/mouth and caused by herpes simplex virus, clears up without treatment in 7-10 days. It is very contagious
symptoms of cold sores/
Initially asymptomatic but then in recurring infections there is initial tingling, burning, followed by fluid filled sores, pain, oozing, scabbing
they grow in size
lifestyle advice for cold sores
wash hands avoid touching eyes, kissing, oral - avoid picking the scabs - avoid sharing medicaiton/cutlery etc - change cosmetics - remove the trigger
Red flags for cold sores
- treatment failure
- patients with weakened immune system
- dehydration, especially children
- spread of infection to mouth, eyes or genitals
- > 10 days
- large numbers of them
- babies /young
treatments for cold sores
(a) do nothing - OTc for cold sores and additional symptoms - many go away on own
(b) antiviral - acyclovir (Zovirax) - helps speed healing time,, apply at first signs of cold sore and stops it spreading
(c) for the pain - para/ibu
DO NOT APPLY ANTI ITCH
What is impetigo?
Common and contagious. Causes sores and blisters. 2 types
(1) - non bullous - skin around nose and mouth, sores burst leaving a yellow brown crust
(2) bullous - skin on the trunk, fluid filled blisters, they burst leaving a yellow crust
what are causes of impetigo?
skin becomes infected with - staphylococcus aureus, streptococcus pyogenes
- A break in the skin (primary impetigo) - stings,bites, cuts
- Skin Damaged by another condition (secondary)- head lice, scabies, eczema
who is at risk of impetigo?
Child diabetics carrier of staph.aureus warm weather weak immune s
Symptoms of impetigo
Most people - non bullous.
- red sores
- sores burst- thick crusts
- red marks where crusts dry
- itchy
Referral for impetigo?
Most cases heal within 14-21 days without treatment, however always must see the GP.
This is because the infection is easily spread and treatments can resolve it quicker
What is athletes foot?
Tinea pedis. It loves warm, moist, airless conditions - anyone can get it but more common in people who sweat more, wear shoes and socks that make their feet sweatier
- it is passed on from person to person
- once a small patch develops - spreads
Symptoms of athletes foot
rash, itchiness, cracks, scaling, sore, dry
what are treatments for athletes foot (5 types)
Topical antifungals (lots of preparations) - continue for 14 days after rash has gone in some cases to prevent re-infection and ensure its fully healed
- azoles - clotrimazole, ketoocnazole, micronazole - canesten, daktarin
- Terbinafine - lamisil
- tolnaftate - mycil
- griseofulvin - grisol
- corticosteroids - canestro HC (own license - anti fungal with steroid hydrocortisone)
Red flags for athlete foot
- treatment failure
- diabetics - any foot or hand complaint for any diabetic refer
- signs of bacterial infection - ooze, puss
- nails infected
- pregnancy//BF
causes of nail infections
- fungal infection
- damage to nail
- fungal infections e.g athletes foot, not fully healed?
- wet hands, diabetes, psoriasis, nail biting, weak immune system,humidity, artificial nails
symptoms of nail infections
nail thickened and discoloured, pain, brittle, skin is inflamed, patches on nailbed
treatments for nail infections
may not be necessary but GP must decide. Could just use self care and OTC methods.
- Nail paints can penetrate the nail but this treatment is SLOW - 6-12 months but toes can be 9-12 months.
- Treatment application is dependent on product- some are once weekly
- examples: Scholl, canespro, curanail
red flags for nail infections
treatment failure - but remember the timeframe diabetic immunocompromised pregnancy/bf more than 2 nails infected
lifestyle advice for nail infections
- keep feet cool and dry, clean socks
- avoid trainers
- treat other infections
- keep nails short, use separate clippers
- well fitting shoes that mould feet
- good hygiene
- see a podiatrist
what are warts/veruccas? causes?
small lumps that develop on the skin of the body caused by human papilloma virus
caused by excess keratin on top skin layers producing hard texture, via close skin to skin contact, contaminated pools/ towels, scratching, knocking, biting
symptoms of veruccas
On soles of the feet, white patch on skin
black dot in centre
flat
painful
Symptoms of warts
Knuckles, fingers, knees round raised rough irregular surface 1mm-10mm
Treatments for warts and veruccas?
(a) can do nothing - can clear up alone but may take up to.2 years or more
- No single treatment is 100% effective-
- salicylic acid
- cryotherapy
- treatment is long can take up to 12 weeks if adhere
red flags of warts and veruccas
treatment failure many of them on face, genitals immunocompromised diabetic preg bf
describe salicylic acid treatment in warts and veruccas
it Is the active ingredient in most preparations.
it can damage health skin so ensure protection via petroleum jelly or corn plaster.
- Before 1st application, soak wart in water for 5 mins
- use energy board/pumice stone to fit down the area
- Soak for 2-3 mins
- Apply directly
- Allow to dry, don’t cover
Next day, peel off the white patch from the area and reapply. Once every week file down and reapply
how is cryotherapy used for warts and v?
e. g bazuka sub zero.
- liquid nitrogen is applied for a few seconds
- freeze and destroy the affected skin cells
- freezing can cause pain so think about the patient
- riskier due to contact time
disadvantages of cryotherapy for warts
riskier - contact time
painful, can cause blistering
skin pigmentation
change in nail shape./structure
What is lifestyle advice for preventing warts ?
- don’t touch other peoples warts
- don’t share stuff
- no scratching etc
- reduce shaving
- moisturiser
lifestyle advice for someone who already has a wart
protection - plasters etc
cover up during activities
hands - gloves in gym,
feet- flip flops, s wim socks
what are corns and calluses?
areas of hard thickened skin due to excessive pressure
usually on feet and hands
pain
what are corns?
small circles, on feet mainly e.g soles, sides
could be due to poor fitting shoes
occurs on bony feet dur to lack of natural cushion
also develop as a result of other foot conditions
what is a callus?
Hard, rough areas of skin, yellow colour
In heel area and on plasma of hands
larger than corns
treatment for corns and calluses
remove cause of pressure, friction
remove thick skin
also foot care products
foto care products for corns and calluses
- rehydration creams
- hard skin softening creams e.g scholl
- foam insoles
- wedges placed in between toes to relieve
- silicone wedges change position of toes to redistribute pressure
- salicylic acid
lifestyle advice for corns and calluses
- dry feet thoroughly
- apply foot cream
- pumice stone
- comfortable footwear and protection when doing repetitive tasks
