Skin conditions Flashcards
1
Q
Atopic eczema
A
- Chronic, relapsing, inflammatory skin condition
- Itchy red rash
- Often found in creases i.e. behind the knees and folds of the elbows
- Increased water loss from skin causing dry skin
- Lower resistance to irritant substances
2
Q
Triggers for atopic eczema
A
- Soap
- Extremes of temperature
- Stress
- Hormone changes in women
- House dust mites
- Pollen
- Pet dander
- Moulds
3
Q
Treatment options for atopic eczema
A
- Topical emollients should be applied frequently and after bathing. Lotions have lower patient acceptability so can use both lotions and cream.
- A mildly potent corticosteroid i.e. Hydrocortisone 1% and Clobetasone butyrate 0.05%
- For adults and children over 10 years for acute flare ups
- Apply once or twice daily for a maximum of 7 days
- Not recommended in pregnancy or for use on the face and anogenital areas
- May worsen acne and rosacea
- Wait 30 minutes before applying emollient to prevent diluting the corticosteroid
4
Q
Practical tips for atopic eczema
A
- Use gloves when handling irritants such as detergants
- Avoid extremes of temperatures and humidity
- Use non-abrasive clothing such as cotton
- Reapply emollient after wetting the skin
5
Q
Contact dermatitis
A
- Response to irritants or allergen interacting with the skin
- Type IV hypersensitivity reaction
- Itchy rash often with crusting, scaling, redness, swelling
6
Q
Danger symptoms for contact dermatitis
A
- Secondary bacterial infection if the skin is broken by scratching and is seen as red, oozing and inflamed area
7
Q
Treatment options for contact dermatitis
A
- Emollient for dry skin
- Topical corticosteroid if there is no broken skin for adults and children over the age of 10 (Max use 7 days) for inflammation
8
Q
Cradle cap
A
- Red, sharply marginated lesions
- Greasy looking scales
- On the scalp or eyebrows
- Appears as dry, flaking skin
- Does not cause discomfort or harm and usually resolves by around 8 months
9
Q
Treatment options for cradle cap
A
- Ketoconazole 2% shampoo OTC for use once every 3 days
- Selenium sulphide is second-line
- Pyrithione zinc containing shampoos (Head and shoulders) used every day or every other day
- Tar shampoos (T/Gel)
For babies:
- Dentinox cradle cap shampoo
- Metanium cradle cap cream
10
Q
Practical tips
A
- Use baby oil to soften up the plaques followed by gentle baby shampoo
- Gentle brush with baby brush after shampooing
11
Q
Psoriasis
A
- Scaly red patches
- Covered with silver, white scales
- Patches may be itchy and can crack and bleed
- Nail pitting and separation of the nail from the nail bed in some
- Refer for treatment failure
12
Q
Treatment options for psoriasis
A
- Emollients to soften scaling and reduce irritation
- Tar-based shampoo is first line for scalp psoriasis to reduce inflammation and scaling
- Salicylic acid when there is significant scaling
- Dithranol but avoid contact with normal skin as it can cause staining, burning and severe blistering
13
Q
Urticaria
A
- Itchy skin
- Superficial swelling
- Rash appears suddenly
- Weal and flare rash
14
Q
Danger symptoms of urticaria
A
- If the swelling affects the tongue or throat call 999 as this may cause breathing difficulty
- If urticaria persists for more than 6 weeks, refer
15
Q
Treatment options for urticaria
A
- Oral anti-histamines are the first line - non sedating are preferred (acrivastine, loratadine, cetirizine)
- Avoid in pregnancy particularly, in the first trimester
- If needed, chlorphenamine is the most suitable in pregnancy - Topical calamine lotion will relieve itch
16
Q
Practical tips for urticaria
A
- A cool bath or shower will relieve the symptoms
- Avoid aspirin or codeine, they may aggravate the symptoms
- Avoid causative factors such as stress, overheating, tight clothing
- Keep a food diary to identify particular food causes
17
Q
Warts and Verrucas
A
- Caused by human papilloma virus
- Affects hands, feet and anogenital areas
- Transmitted by contact
- Likely where there is a weak skin barrier or immunocompromised
- Common warts appear as firm, raised, rough papules with a cauliflower-like surface and a tiny black dot on the surface
- Verrucas appear in pressure areas such as the soles of the feet growing inwards and appearing as a small area of horny, rough skin
18
Q
Danger symptoms for warts and verrucas
A
- Routine referral if they are on the face and anogenital area
- Diabetic patients
19
Q
Treatment options for warts and verrucas
A
- Salicylic acid based products i.e Salactol are first-line OTC
- Protect healthy skin by applying petroleum jelly or plaster with a hole cut in it
- Apply daily - Bazuka
- Use for up to 3 months - Wartner
20
Q
Practical tips
A
- Warts are contagious so preventing their spread is important
- Waterproof plaster or sock should be worn to cover verrucas if swimming
- The wart should be filed using an emery board once weekly to remove dead, hardened skin and to allow the treatment to penetrate to the root
21
Q
Nappy rash treatment options
A
- Barrier creams based on Zinc and castor oil (sudocream) or titanium (Metanium) protect the skin from faecal matter and excess moisture
- Topical imidazole (Clotrimazole, econazole, miconazole) applied 2-3 times daily for 7-10 days after the rash has cleared
22
Q
Practical tips for nappy rash
A
- Increase the frequency of nappy rashes
- Allowing the child to have time without the nappy, exposing skin to fresh air
23
Q
Treatment options for acne vulgaris
A
- Topical benzyl peroxide starting off with lower strengths and slowly working your way up
24
Q
Practical tips for acne vulgaris
A
- Wash with mild soap and lukewarm water no more than two times a day and avoid vigorous scrubbing
- Squeezing the pimples or spots will increase scarring so do not pick at them
- Use a water-based moisturiser as greasy and oily products can clog the pores
25
Q
First aid for thermal burns
A
- Immerse the affected area in cold water for 20-30 minutes
- Chemical burns require irrigation and removal of contaminated clothing
- Treat with wound dressing
- Creams should not be applied to a burn
26
Q
Danger symptoms for burns and scalds
A
- If burn is greater than the size of patient’s hand = urgent referral to A&E
- Deep burn, heavy blistered, or painful = urgent referral to A&E
- Shortness of breath or respiratory problems following a chemical burn = urgent referral to A&E
27
Q
Treatment options for burns and scalds
A
- Pain relief such as paracetamol and ibuprofen
- Dressings i.e. alginate, paraffin gauze, clear film dressings
28
Q
Practical tips for burns and scalds
A
- Remove jewellery from affected area to avoid discomfort
- Do not pull of clothes stuck to the skin
- Blisters should be kept intact
- Keep pan handles turned inwards
- Bath water should be tested for children and elderly
29
Q
Sunburn
A
- Skin overheats becoming red and painful
- May peel or blister
- Swelling of the skin and fever
- Symptoms of heatstrokes such as dizziness, headaches and nausea
30
Q
Danger symptoms for sunburn
A
- Severe sunburns or sunburns in babies and children will need GP referral
- Suspected melanomas need GP referral
31
Q
Practical tips for sunburn
A
- Cover up in the sun
- Seek shade
- Use a suncream with a suitable SPF
- If affected by sunburn, stay out of the sun and drink plenty of fluids and avoid alcohol
32
Q
Treatment options for sunburn
A
- Painkillers relieve the pain of sunburn
- Calamine and glycerin cream relieves itch and soreness
- Aftersun treatment which moisturises the skin
33
Q
Treatment options for insect bites
A
- Antihistamine creams
- Crotamiton cream or lotion to relieve itch
- Oral antihistamine for urticarial reactions
- Topical corticosteroids for inflammation
- Local anaesthetics
34
Q
Danger symptoms for insect bites
A
- Cellulitis from bacterial entry at the punctured site. Feels hot and painful. May cause fever and vomiting and should be referred
- Signs of Lyme disease 4 weeks after where the site gets bigger and has a pale centre
- Stings by wasps or bees can cause anaphylactic shock. Urgent referral for adrenaline.
35
Q
Practical tips for insect bites
A
- Use insect repellants
- Wear loose clothing with long sleeves and legs
- To avoid tick bites, avoid walking in long grassland
- If there is a bee or wasp sting, the sting should be carefully removed by scraping it out
- Cold compress can reduce swelling and relieve pain
