skin

Question 1

treatment of mild eczema?

Answer 1

Emollients

Mild potency topical steroid

Question 2

treatment for moderate eczema?

Answer 2

Emollients
Moderate potency topical steroid
Non-sedating antihistamine
Topical calcineurin inhibitor
Bandages – sometimes used to help manage the symptoms

Question 3

treatment for severe eczema?

Answer 3

Emollients
Potent topical steroid
Sedating/non-sedating antihist
Topical calcineurin inhibitor
Bandages
Oral Steroids
Phototherapy

Question 4

topical treatment for trunk and limb psorasis?

Answer 4

Potent corticosteroid AND vitamin D analogue (calcipotriol).

Coal tar if above not effective

Question 5

topical treatment for scalp psorasis?

Answer 5

Potent corticosteroid.
If not effective try a different formulation and/or salicylic acid/emollients.

Combine steroid with calcipotriol or use vitamin D analogue alone if not effective/tolerated

Question 6

topical treatment for face, genital or flexure psoroasis?

Answer 6

Mild-moderate steroid
Short term treatment

If not effective/long term treatment needed, use calcineurin inhibitor

Question 7

treatment for mild psorasis?

Answer 7

Emollients
Topical corticosteroid alone or with topical vitamin D analogue
Calcineurin inhibitor (tacrolimus)
Coal tar or dithranol

Question 8

treatment for moderate psorasis?

Answer 8

Phototherapy plus topical treatments
Oral methotrexate or ciclosporin plus topical
Oral acitretin plus topical
t

Question 9

treatment for severe psorasis?

Answer 9

Add biological agent

Question 10

mild to mod treatment of acne?

Answer 10

Topical retinoid (adapaline 0.1% gel/cream, isotretinoin)
Benzoyl peroxide (BPO - 4% cream or 5% gel/wash) 
Azelaic acid (20% cream, 15% gel)
Milder action not as potent but causes less skin irritation
Topical antibiotic (clindamycin 1%) always with BPO

Combination products seen
Emollients to combat dry skin (oil free/non-comedogenic)
Continue treatment for 6-8 weeks, if no improvement refer to GP

Question 11

mod to severe acne treatment?

Answer 11

Oral antibiotic and topical retinoid combination
Doxycline, azithromycin but has more resistance
Can add BPO - helps to reduce incidence of resistance
Treat for 6-8 weeks and can repeat causes but not for long term use

Question 12

risks of isoretoninin?

Answer 12

TERATOGENIC (pregnancy prevention programme, PPP)
Effective contraception 1 month before treatment starts and 1 month after e.g. COC and condoms
Cannot donate blood before, during or after
Depression, anxiety, suicidal ideation
Psychiatric history needed; STOP and refer to psychiatrist if mental health deteriorates on treatment
Impaired night vision
Inform DVLA if affected; do not drive at night
Pilots cannot take this
Dry skin and mucous membranes, joint pains common
Makes skin very fragile
Need UV protection in summer – SPF 50
NO wax epilation, dermabrasion or laser treatments during or

Question 13

risks of acirectin?

Answer 13

Contraception in women of child-bearing potential for 3 years after taking
(pregnancy prevention programme, PPP)
Hyperlipidaemia
cardiovascular risk assessment needed
monitoring of lipid profile
Hepatotoxic
Monitor liver function every 3/12 during treatment (more frequently at start)
Do not drink alcohol or keep to absolute minimum and for 2 months after
Increases serum level concentration

Question 14

risks of methotrexate?

Answer 14

Can cause liver cirrhosis
Liver function tests every month initially
Can cause blood disorders
Thrombocytopaenia, leucopaenia, anaemia
Full blood count every week then monthly
GI symptoms; stomatitis, nausea
5mg folic acid weekly
Other considerations
Alopecia, family planning (teratogen), infection risk, avoid live vaccines but make sure they have prevention against these illness
May mask your symptoms for illness so make sure to report every thing you feel
Interactions with NSAIDs