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Minor Ailments > Skin conditions > Flashcards

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
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2
Q

Triggers for atopic eczema

A
  • Soap
  • Extremes of temperature
  • Stress
  • Hormone changes in women
  • House dust mites
  • Pollen
  • Pet dander
  • Moulds
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3
Q

Treatment options for atopic eczema

A
  1. Topical emollients should be applied frequently and after bathing. Lotions have lower patient acceptability so can use both lotions and cream.
  2. 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
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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
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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
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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
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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
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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
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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

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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
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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
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12
Q

Treatment options for psoriasis

A
  1. Emollients to soften scaling and reduce irritation
  2. Tar-based shampoo is first line for scalp psoriasis to reduce inflammation and scaling
  3. Salicylic acid when there is significant scaling
  4. Dithranol but avoid contact with normal skin as it can cause staining, burning and severe blistering
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13
Q

Urticaria

A
  • Itchy skin
  • Superficial swelling
  • Rash appears suddenly
  • Weal and flare rash
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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
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15
Q

Treatment options for urticaria

A
  1. 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
  2. Topical calamine lotion will relieve itch
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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
  1. 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
  2. Bazuka
    - Use for up to 3 months
  3. 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
  1. Barrier creams based on Zinc and castor oil (sudocream) or titanium (Metanium) protect the skin from faecal matter and excess moisture
  2. 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
  1. 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
  1. Pain relief such as paracetamol and ibuprofen
  2. 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
  1. Painkillers relieve the pain of sunburn
  2. Calamine and glycerin cream relieves itch and soreness
  3. Aftersun treatment which moisturises the skin
33
Q

Treatment options for insect bites

A
  1. Antihistamine creams
  2. Crotamiton cream or lotion to relieve itch
  3. Oral antihistamine for urticarial reactions
  4. Topical corticosteroids for inflammation
  5. 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

Minor Ailments (7 decks)

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