Skin & Psoriasis & Dandruff Flashcards

1
Q

What questions might you consider when taking a dermatological history?

A
  1. Where did the problem first appear? certain type of conditions start from one area then spread
  2. Are there any other symptoms? - itch or pain
    mild itch - psoriasis/medicine eruptions
    severe itch - scabies, atopic/contact dermatitis
  3. occupational hx?
  4. General medical hx?
  5. Travel?
  6. Family and household contact hx -
  7. Pts thoughts on the cause of the problem
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2
Q

What is psoriasis?

A

chronic relapsing inflammatory disorder

immune-mediated disorder with a genetic influence

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3
Q

What are the symptoms of psoriasis?

A

Silvery-white scales associated with inflamed, red, patchy plaques on the extensor surfaces of the elbow and knee
pitting fingernails

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4
Q

What are symptoms triggered by?

A

Stress

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5
Q

What medicines can aggravate psoriasis?

A

Li, antimalarials, BB, ACEI, NSAIDS

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6
Q

When to refer a pt with psoriasis?

A

pts presenting with symptoms with no prior diagnosis should be referred.

pts with moderate to severe psoriasis may required tx under the supervision of a dermatologist

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7
Q

What tx is necessary for psoriasis?

A
  1. Emollients - keratolytics have been incorporated into emollients
  2. POM include vit D derivatives (calcipotriol), topical steroids, dithranol
  3. Coal tar preparations
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8
Q

What are side effects that can occur with these products?

A

possibility of skin sensitisation

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9
Q

What are some tar-based products?

A
Alphosyl 2 in 1 shampoo 
Capasal 
Cocois
Exorex 
Polytar, Polytar Plus 
Psoriderm 
SebCo 
T/Gel
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10
Q

What is Dandruff?

A

chronic, relapsing, non-inflammatory hyper-proliferative skin condition

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11
Q

What are symptoms of dandruff?

A

Greyish-white flakes or scales on the scalp which is often itchy
The scalp is the ONLY area affected unlike in seborrhoeic dermatitis
scalp is very dry, itchy, flaky

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12
Q

When to refer a pt with dandruff?

A
  • suspected psoriasis
  • Signs of infection
  • symptoms of unresponsive to tx
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13
Q

What tx is required for dandruff?

A
  • Ketoconazole 2% shampoo (Nizoral) is first line for moderate-severe dandruff - Use TWICE a week for 2-4 weeks after which used weekly or fortnightly as needed to prevent recurrence
  • Selenium sulphide 2.5% (Selsun) - cytostatic effect - reduces the cell turnover rate
    Used twice weekly for the first 2 weeks then weekly for the next 2 weeks and thereafter as required
  • Coal tar - least effective for tx of dandruff but may still be used as an alternative
  • Zinc pyrithione - head and shoulders
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14
Q

What side effects can occur with using these products for dandruff?

A

cause allergic or sensitisation reactions and coal tar can cause photosensitivity

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15
Q

Can all shampoos be used at any age?

A

All except Selsun only use in children >5 years

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16
Q

ANy counselling points for pts with dandruff and their use of tx?

A
  • Dandruff should start to improve within 12 weeks of initiating tx.
  • Tx should be applied to the scalp and left on for at least 5 minutes before rinsing for best effect