Skin disease

Question 1

What’s the typical treatment for wet and acutely inflamed skin lesions?

Answer 1

Cream based topical treatment

Topical steroids intermittently

Question 2

What’s the typical treatment for dry or lichenefied skin lesions

Answer 2

Oil-based topical ointment

Topical steroids intermittently

Question 3

What is typical management of eczema?

Answer 3

• Eliminate/avoid irritants or allergens
• Avoid soaps and wash with emollients
• Moisturize skin daily with emulsifying ointement or oil (e.g. coconut oil)
• Acute eczema = cream
• Dried/lichenified eczema = emollients
• Topical steroids using weakest effective steroids
• Weak steroid (1% hydrocortisone) to face
• Severe chronic eczema = coal tar ointment (2-10%) or cover with zinc oxide

Question 4

What is the clinical presentation/clues to Stevens Johnsons Syndrome and what is the management?

Answer 4

Stevens Johnsons Syndrome
* Recent change in drugs e.g. nevirapine in HIV+, sulfonamides
* Widespread erythema multiforme that involves hands
* Severe blistering of skin and mucosae including mouth, eyes, genitalia
* Nikolsky sign -> top skin is rubbed off with light pressure

Management
* Similar to burn patient and can be managed on burn ward
* Stop potential trigger drugs
* Fluids
* Prevention of infection

Question 5

What is typical management of psoriasis?

Answer 5

Psoriasis
* Emollients e.g. urea 10%, white soft parrafin
* Keratolytics e.g. salicylic acid
* Strong topical steroid - betamethasone
* Coal tar derivatives
* Severe - methotrexate