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OTC meds > skin > Flashcards

skin Flashcards

1
Q

what are the symptoms of atopic eczema

A

itchy red rash usually in skin folds e.g elbows, behind knees

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2
Q

name some triggers of eczema

A
  • hormone changes in females
  • soaps
  • extremes of temperature
  • inhaled allergens e.g dust, mites
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3
Q

what is the main aim of eczema treatment

A

to control dryness, itching + reduce flare ups

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4
Q

describe how emollients should be used to manage eczema

A
  • applied frequently as part of the daily routine

- applied after bathing to prevent evaporative water loss

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5
Q

why may mildly potent OTC corticosteroids be used in eczema treatment?

name 2 examples of otc corticosteroids to be used

A

They can be used in adults and children over 10 years for acute flare-ups, applied once or twice daily for a maximum of one week.

examples: Hydrocortisone 1% and clobetasone butyrate 0.05% are both licensed for OTC use in eczema

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6
Q

when should you NOT recommend otc corticosteroids

A

in pregnancy, for the face or anogenital areas (anus + genitals)

examples of otc corticosteroids:
Hydrocortisone 1% and clobetasone butyrate 0.05%

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7
Q

name a commons side effect of topical corticosteroids

A

skin thinning, however this is more associated with more potent corticosteroids used over 4+ weeks

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8
Q

TRUE OR FALSE:

Topical corticosteroids may worsen acne and rosacea

A

true

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9
Q

what counselling advice can you give a patient on how to apply both a topical corticosteroid and an emollient

A

apply topical corticosteroid then wait 30 minutes after to apply emollient (this is to avoid diluting corticosteroid)

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10
Q

what lifestyle advice can you give to help reduce irritation of eczema

A
  • use gloves when handling irritants such as detergents
  • avoid extremes of temperature and humidity
  • use non-abrasive clothing fabrics, such as cotton
  • re-apply emollients after wetting the skin
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11
Q

what is atopic eczema

A

a chronic, relapsing, inflammatory skin condition characterised by an itchy red rash, which is often
found in skin creases such as the folds of the elbows or behind the knees

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12
Q

when would you refer a patient with eczema

A

if you suspect a secondary skin infection has occurred. This can present as impetigo or worsening of eczema as it will have increased redness + crusting

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13
Q

TRUE OR FALSE:

children will often grow out of having eczema

A

true

note routine emollients can reduce the itch and sleep disturbances whilst they are a child

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14
Q

what is contact dermatitis

A

a response to external irritants or allergens interacting with the skin.

It is an itchy rash often with crusting, scaling, cracking, or swelling of the skin

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15
Q

what is allergic contact dermatitis

A

a type IV hypersensitivity reaction that happens in predisposed individuals after sensitisation with an allergen

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16
Q

what is irritant contact dermatitis

A

more common, non-immune inflammatory

response to damage to the skin, usually caused by contact with external chemicals.

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17
Q

what are the symptoms of contact dermatitis

A

an itchy rash often with crusting, scaling, cracking, or swelling of the skin

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18
Q

which patients can use OTC topical corticosteroids

A
  • children over 10

- adults

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19
Q

what are the treatment options contact dermatitis

A
  • remove irritant if possible
  • Topical corticosteroids (Hydrocortisone 1% and clobetasone butyrate 0.05%) can be used to treat localised inflammation, as long as there is no broken skin or sign of infection. It should be used once or twice a
    day for up to seven days in adults and children over the age of 10 years.
  • emollients for dry skin
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20
Q

what is Seborrhoeic dermatitis

A

a skin condition that presents as red, sharply
marginated lesions with greasy looking scales or dry flaking dandruff or yellow greasy scaling. it typically occurs on areas with high sebaceous glands such as the scalp or eyebrows. In babies it is known as cradle cap

  • note it is thought to be caused by Malassezia
    (Pityrosporum) ovale which is a species of yeast that naturally lives on our skin*
21
Q

what are the signs of a secondary bacterial infection

A
  • increased redness
  • increased inflammation
  • crusting (increased crusting if crusting not already a symptom)
  • oozing
22
Q

when would you refer a patient with Seborrhoeic dermatitis

A
  • if they have signs of a secondary bacterial infection

- condition if impacting the person’s confidence + self esteem, especially if otc treatments have failed

23
Q

what are the symptoms of scalp ringworm (tinea capitis)

how would you treat it

A

infected areas of the scalp are red round or oval
patches, with hair loss or scaling

treatment: refer to gp for systemic antifungal treatment

24
Q

describe the OTC treatment options for Seborrhoeic dermatitis

A
  • first line treatment is: Ketoconazole 2% shampoo (e.g. Nizoral®). This can be used for both treatment and prophylaxis + it should be used max once every 3 days
  • second line: Selenium sulphide (Selsun®) . it just as effective as Nizoral but it is not as well tolerated
  • 3rd line: Pyrithione zinc containing shampoos (e.g. Head and Shoulders®) can be used to control mild cases. They can be used daily or every other day
25
Q

What are the treatment options for Seborrhoeic dermatitis in babies (also known as cradle cap)

A
  • an oil such as olive or arachis oil to soften the plaques, followed by shampooing with a gentle baby shampoo
  • shampoo such as Dentinox®
  • Metanium® a cradle cap cream (contains salicylic acid which helps remove outer layer of skin)
26
Q

what are the different types/ symptoms of psoriasis

A
  • chronic plaque psoriasis (red scaly patches with silver/white scales. patches may be itchy/crack/bleed). These are caused by cells multiplying too quickly or cells not maturing normally.
  • nail pitting + separation of the nail from the nail bed
  • guttate psoriasis - small plaques all over the body
  • scalp psoriasis (looks like severe dandruff)
27
Q

name some medications that can trigger psoriasis

A
  • beta blockers
  • NSAIDs
  • lithium salts
  • chloroquine
28
Q

name some triggers of psoriasis

A
  • family history of disease
  • physical trauma
  • acute infection
  • some medications (e.g beta blockers, NSAIDs, lithium salts and chloroquine)
  • stressful life events
  • smoking, alcohol
29
Q

how would you differentiate between Atopic eczema, seborrhoeic dermatitis, fungal nail infections if you suspect a patient may have psoriasis

A

would normally expect a previous diagnosis from the doctor that the patient has psoriasis

30
Q

what is the cure for psoriasis

A

there is no cure for psoriasis, treatment aim is to reduce flare ups (induce remission).

OTC meds can be used for acute flare ups

31
Q

why shouldn’t you use OTC topical corticosteroids in patients with psoriasis

A

because they may suppress the psoriasis short term, but long term they may worsen the condition once treatment has discontinued

32
Q

what are the OTC treatment options for psoriasis

A
  • emollients to soften scaling + reduce skin irritation
  • Tar-based preparations have anti-inflammatory and anti-scaling properties. A tar-based shampoo is first line for scalp psoriasis (e.g. Polytar®).
  • Keratolytic agents, such as salicylic acid, are useful where there is significant scaling
  • Dithranol is an effective treatment for chronic plaque psoriasis
  • note none of these should be used during inflammatory phase of psoriasis*
33
Q

what is the first-line treatment for scalp psoriasis

A

A tar-based shampoo is first line for scalp psoriasis (e.g. Polytar®). Tar-based preparations have anti-inflammatory and anti-scaling properties

34
Q

what are the counselling points for patients using Dithranol for psoriasis

A
  • It is extremely irritant, especially to flexures, and contact with normal skin must be avoided
  • it may cause staining, burning and severe blistering
  • It is not suitable for widespread small lesions or the face
35
Q

what is the only thing that should be used during the inflammatory phase of psoriasis

A

when frequent and generous emollient use

36
Q

when should you refer a patient with Urticaria (hives)

A
  • if they have a swollen tongue/throat, urgent referral or 999 as this may cause difficulty breathing
  • if they have had hives for more than 6 weeks (refer to GP)
37
Q

what is the first line treatment for Urticaria (hives)

A
  • oral antihistamines. non-sedating antihistamines (acrivastine, cetirizine, loratadine) preferred.
  • note that topical corticosteroids do not help treat hive*
38
Q

oral antihistamines should be avoided in pregnancy but if a pregnant patients needs to buy some, which should they buy

A

chlorphenamine (has the most experience of use in

pregnancy)

39
Q

when should you refer a patient with a wart

A

if the warts are on the face or anogenital area

40
Q

what causes warts

A

Warts are caused by the human papilloma virus (HPV).

They can be transmitted by contact and is particularly likely where the skin barrier and/or immune system is weakened

41
Q

what are the symptoms of hand, foot mouth disease

how do you treat it

A

symptoms: mouth ulcers + rash (on mouth/hands/feet), sore throat, temperature, not wanting to eat
treatment: it is self-limiting so will heal on its own within 2 weeks. only OTC meds are for pain relief

42
Q

do you need to treat a wart if it is not causing pain or problems

A

no, treatment may not be necessary

43
Q

what are the treatment options for warts

A
  • first line: preparations containing salicylic acid e.g Salactol®. Make sure to only apply to wart, use petroleum jelly to protect surrounding skin
  • glutaraldehyde (inactivates the warts virus HPV) and lactic acid (helps eliminate dead skin by increasing cell turnover). e.g Bazuka contains both. Use these for 3 months before considering alternative treatment
  • freezing the wart with liquid nitrogen
44
Q

why is it recommended to file a wart down with a pumice stone once a week

A

to remove dead, hardened skin and enable the treatment to penetrate to the ‘root’ of the wart

45
Q

which patients are salicylic acid products NOT suitable for

A

patients with:

  • diabetes
  • poor circulation e.g peripheral vascular disease
46
Q

name some things that can cause/ increase risk of foot ulcers/infections in diabetics

A
  • friction in ill-fitting/ new shoes
  • untreated or self treat callous
  • foot injuries (e.g trauma/ walking bare foot)
  • burns (e.g hot water bottles, hot radiators)
  • nail infections
  • foot deformities
  • heel friction (in patients confined to bed)
47
Q

what are the treatment options for nappy rash

A
  • Barrier creams: e.g zinc and castor oil (Sudocrem®), titanium (Metanium®) or dimethicone (Conotrane®)
  • topical antifungals: imidazoles: clotrimazole, econazole, miconazole) should be applied to limit the Candida infection
  • not do not apply too liberally as this prevents moisture absorption from nappy*
48
Q

when do you refer a patient with nappy rash

A
  • if standard treatments fail

- mild nappy rash persists (could be a sign of eczema)

OTC meds (5 decks)

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