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PY7020 > Skin conditions > Flashcards

Skin conditions Flashcards

1
Q

Eczema

A

Atopic - A group of conditions which consist of asthma, eczema and hay fever
Eczema/Dermatitis - Red, dry, itchy skin which can sometimes become weeping, blistered, crusty, scaling

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2
Q

Causes of eczema

A
  • Skin cells tightly held together allowing the penetration of allergens
  • Ingress of allergens causes inflammation
  • Increased loss of water and fat
  • Abnormal inflammatory or allergen response (IgE released)
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3
Q

Trigger factors

A

Materials (wool, synthetic fabrics)
Hormones, teething, sleep deprivation
Cow’s milk, eggs, food colouring
Inhalant allergens (Dust mite, mould, pollen, animal dander)

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4
Q

Symptoms of eczema

A

Intense itching, red and cracked, dry and flaky, undergoing lichenification, change in colour

During a flare up: Moist, weepy and crusting around edges, Small water blisters may develop on hands and feet, may result in sleep disturbance, tiredness and irritability

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5
Q

Lifestyle advice for eczema

A
  • Moisturise 2-3 times per day
  • Replace soap with emollient
  • Protective clothing
  • Avoid aggravating clothing
  • Avoid triggers
  • Keep cool
  • Do not scatch (pat skin dry not RUB)
  • Keep nails short
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6
Q

Emollients for eczema

A

OTC available
1st Line
Hydrates and soothes the skin
Apply frequently and liberally
Apply several times a day
Use daily even when there is no flare up
Apply to damp skin (during and after washing)
Replace soap with emollient
Most contain no API whereas some do (urea, lanolin, antiseptic)
Creams/lotions for red inflamed skin

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7
Q

Topical corticosteroids for eczema

A

2nd line
Reduces inflammation, redness and itching
Some lower strengths available OTC

Ointments preferred to creams
Apply thinly once or twice daily

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8
Q

Available topical corticosteroids OTC

A

Hydrocortisone 1% cream 15g (mild to moderate eczema in 10 years or older)
Clobetasone 0.05% cream 15g - over 12 years (eczema and dermatitis only)
Max treatment for 7 days

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9
Q

Referral for eczema

A
  • Under 10 years
  • Pregnant
  • Application to face, anogenital region
  • Broken skin
  • Infected skin (cold sores, acne, athlete’s foot)
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10
Q

Contact dermatitis

A

Inflammation of the skin when you come into contact with a particular substance
Irritant - A substance that directly damages the epidermis
Allergen - A substance that triggers the immune system to respond in a way that affects the skin

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11
Q

Symptoms of contact dermatitis

A

Most commonly affects hands and face
Redness, Itchy, Blistered, Dry and cracked, scaly

Irritant contact dermatitis - Stinging or burning sensation from one exposure to strong irritant or multiple exposure to weak irritant

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12
Q

Treatment for contact dermatitis

A

Avoid irritant or allergen
1st line: Emollient
2nd line: Topical corticosteroid
3rd line: Oral corticosteroid

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13
Q

Psoriasis

A

Common inflammatory skin disease that affects the skin, joints and nails
Caused by rapid replacement of skin cells leading to a build up of excess skin cells to form ‘raised’ plaques on the skin

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14
Q

Appearance of psoriasis

A

Inflamed areas of skin
Raised red and scaly patches/plaques in appearance
Scales are white/silvery
Itchy
Painful
Symmetrical patches
Pitted finger nails

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15
Q

Factors increasing psoriasis flare ups

A

Infections
Hormonal changes
Skin injury
Stress and anxiety
Alcohol
Smoking
Medications - beta blockers, lithium, antimalarials

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16
Q

Treatment for psoriasis

A

1st line: Emollient - reduces scale and relieves itching
2nd line: Topical corticosteroids - once stopped may cause rebound psoriasis
3rd line: Topical vitamin D preparations at max quantity to slow down rate of skin cell division

17
Q

Coal tar preparations for psoriasis

A

Helps to remove loose scales, slows down skin overgrowth
Messy to apply
Unpleasant smell
May stain clothing
Can cause light sensitivity

18
Q

Dithranol

A

Ideal for chronic, scaly psoriasis
Apply sparingly
Stains clothing
Messy to use

19
Q

Vitamin A analogues

A

i.e. Tazarotene
Not to be used on face or in skin folds

20
Q

Salicylic acid preparations

A

Reduces excessive scaling

21
Q

Moderate to severe psoriasis treatments

A
  1. Acitretin - hospital only
    It is a retinoid so avoid giving to child-bearing women
  2. Ciclosporin
    3-4 weeks until the benefit seen
  3. Methotrexate
    Slows down rapid division of skin cells and reduces inflammation
22
Q

Causes of acne vulgaris

A

Sebaceous glands form sebum (oil)
More sebum leads to greasy skin and worsens acne

23
Q

What worsens acne

A

Progesterone only pill
Hormonal changes
Picking or squeezing spots
Heavy sweating
Tight clothing
Medicines - phenytoin, steroid creams
Anabolic steroids

24
Q

Referral for acne

A

Moderate to severe condition
No response to OTC medicine after 8 weeks
Drug induced acne
Acne rosacea
Suspected carcinoma - raised edges

25
Q

Lifestyle advice for acne

A

Do not wash face more than twice a day
Avoid excessive washing, scrubbing and exfoliating
Use mild soap and lukewarm water
Use a soft wash cloth and fingers instead
Avoid oil rich moisturisers - can clog pores

26
Q

Benzoyl peroxide for acne

A

OTC for mild to moderate acne in strengths 2.5-10%
Apply to all affected area of skin, not just each spot
Start with lowest strength and titrate upwards - start OD then start BD if well tolerated
Apply 30 minutes after washing skin
Releasing oxygen when contact with skin so can bleach clothes, hair etc.

Side effects: skin dryness, irritation, burning sensation

27
Q

Azelaic acid for acne

A

Mild to moderate acne
Unplugs blocked pores
Less skin irritation than benzoyl peroxide
PGD required

28
Q

Topical antibacterials for acne

A

Clindamycin gel or erythromycin gel
Prescription required

29
Q

Moderate to severe acne treatments

A
  1. Oral antibiotics
    First choice: Oxytetracyline 500mg BD or tetracycline 500mg BD
    Second choice: Doxycycline OD or lymecycline OD
    Use for 3 months, switch if no improvement
  2. Hormone treatment
    Co-cyprindiol
    For women only
    Continue taking 3-4 weeks after acne has resolved
  3. Topical retinoids
    Adapalene (PGD)
30
Q

Topical retinoids counselling points

A

May develop skin redness and peeling - settles over time
Spots become a little worse before improving
Sensitive to light - use a suncream
Should not be pregnant or plan on getting pregnant

PY7020 (23 decks)

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