skin Flashcards
patient presents with fungal infection of the scalp where hair is falling out
refer to gp
patient presents with new acne. she is 40. what do you suggest
refer acne if it has appeared first time in someone other than teenager
2 possible causes of dandruff
dry skin
overgrowth of fungus
mild dandruff can be treated easily by shampoos containing selenium, salicyclic acid, coal tar, zinc. These two dont smell nice and can also cause irritation in some people though
selenium
coal tar
male pattern baldness and certain types of hair loss in women can be treated OTC with minodixidil. Which strengths are available how how long does it need to be used to see effect?
2% solution
5% solution and foam
needs at least 2 months continuous use before any effect is seen
any new hair that grows could shed 3-4 months after stopping
most common cause of itchy scalp
esp in children
head lice
white egg cases = nits
Freederm gel preparations contain nicotinamide.
What is it
anti inflammatory
reduces selling and redness of acne
cause of warts
HPV
what do verruccas look like
warts on soles of feet
have tiny black dots on them
name the 2 steroids available OTC
HC
clobetasone
what is HC 1% OTC available for
allergic contact dermatitis
irritant dermatitis
insect bite reactions
mild to moderate eczema
what is clobetasone butyrate available for OTC
reduce inflammation, itching and dryness of skin during eczema and dermatitis flare ups
Restrictions to HC sale - age
Nobody under 10
Nobody pregnant or BF
Not on broken or infected skin
Not on face or around anal/genital areas
Thin application only as it can thin the skin
Not suitable for large areas of skin
Max 7 days
Age restriction for clobetasone OTC
nobody under 12
do not use on face, around groins, genitals or between toes
what is a fingertip measure
tip of adult index finger to first crease
this is enough cream to cover an area that is twice that of an adult palm
what is scabies caused by
mite infestation
they get under epidermis of skin and cause itchy rash to appear up to 8 weeks after pt infected
what is this
scabies
scabies is passed on how?
long periods of skin to skin contact with an infected person as well as sexual intercourse and sharing of clothes, towels and bedding
if one person has scabies, does everyone need to be treated
yes all close contacts and household members at the same time whether they have the rash or not to avoid re-infecting the treated people
what areas to treat in scabies
everywhere below neck needs to be treated in scabies including anal/genital areas, wrists, armpits, breats, soles of feet, in between toes and fingers
particular attention to between fingers and toes and under fingernails
what areas to treat for scabies in children under 2 and the elderly
everywhere including scalp, face and ears
avoid eyes and mouth
which insecticides are recommended to kill mites in scabies
malathion
permethrin
true or false - apply insecticides e.g. malathion, permethrin to skin for scabies after a hot bath
false. needs to be applied to cool, dry skin.
scabies - how long to leave malathion on the body
24h
scabies - how long to leave permehtrin on the body
8-12 hours
does scabies treatment need to be repeated
yes after 7 days to ensure any recently hatched mites are eliminated
treatment of scabies in pregnant women and children under 2
refer to GP
on the day of scabies treatment application, what else should they be advised to do
Wash their clothes, towels and bedding at over 50°C. Items that can not be washed, can be placed in a plastic bag for 72 hours. This will kill any remaining mites and prevent re-infection.
patient has used permethrin (8-12 hour application) twice now (repeated after 7 days to ensure any eggs that hatched also killed). But, they say they are still itching and would like some more treatment.
Can you supply?
no
itching and rash associated with scabies infestation can persist for up to a month after treatment for the associated itching to settle down and longer for genital lesions to resolve
meningitis symptoms are similar to flu. what are some common symptoms that require urgent referral
Headache, neck or back stiffness, dislike of bright light, nausea and vomiting and irritability or drowsiness. There is usually a skin rash (which may appear purple in colour) that does not disappear when a glass is pressed on it.
