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Dermatology > Skin Therapeutics > Flashcards

Skin Therapeutics Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the advantages of topical treatments?

A

Direct application, reduced systemic effects

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2
Q

What are the disadvantages of topical treatments?

A

Time consuming, correct dosage can be difficult, messy

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3
Q

What are drugs used on the skin dissolved in?

A

Bases or vehicles

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4
Q

What are creams?

A

Semisolid emulsions of oil in water that contain emulsifier and preservative

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5
Q

What are some features of creams?

A

High water content cools and moistens skin, easy to apply, cosmetically acceptable

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6
Q

What are ointments?

A

Semisolid grease/oil (soft paraffin) without preservatives

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7
Q

What are some features of ointments?

A

Occlusive and emollient, restrict transepidermal water loss, greasy so less cosmetically acceptable

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8
Q

What are lotions?

A

Liquid formulations-suspension/solution of medication in water/alcohol/other liquids (may sting if alcoholic)

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9
Q

Where are lotions used to treat?

A

Hair bearing areas, the scalp

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10
Q

What are gels?

A

Thickened aqueous lotions-semisolids containing high molecular weight polymers (e.g methylcellulose)

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11
Q

Where are gels used to treat?

A

The scalp, hair bearing areas, the face

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12
Q

What are pastes?

A

Semisolids that contain finely powdered material (e.g ZNO)

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13
Q

What are some advantages and disadvantages of pastes?

A

Protective, occlusive and hydrating

Stiff, greasy and difficult to apply

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14
Q

When are pastes used?

A

Often used in cooling, drying, soothing bandages

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15
Q

What are foams?

A

Colloid with two/three phases-usually hydrophilic liquid in continuous phase with foaming agent dispersed in gaseous phase

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16
Q

What are some advantages of foams?

A

Increased penetration of active agents (e.g steroid, vitamin D), spread easily over large areas of skin, no greasy/oily film

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17
Q

What are the types of topical therapies?

A

Emollients, Anti-infective agents, Kerolytics, Topical steroids, Antipruritics, Psoriasis therapies

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18
Q

What do emollients do and what are they used for?

A

They enhance rehydration of epidermis; for all dry/scaly conditions (especially eczema)

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19
Q

How much of an emollient should be prescribed?

A

300-500g-needs frequent application

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20
Q

What can emollients be used as a substitute for?

A

Soap

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21
Q

What are some emollient prescribing tips?

A

Apply immediately after bathing, apply in direction of hair growth, make skin and surfaces slippery (hazard), use clean spoon/spatula to remove skin from tub (risk of bacterial contamination), fire risk if paraffin-based, avoid those containing SLS in “leave on” products

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22
Q

What is the cost of non-proprietary emollients?

A

Under £5/500g (e.g liquid paraffin, white-soft paraffin)

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23
Q

What is the cost of proprietary emollients?

A

Between £5 to > £30 (more cosmetically acceptable which is important for compliance)

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24
Q

When is wet wrap therapy used and what are some of its issues?

A

Used for very dry skin (xerotic skin); difficult and time consuming to apply

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25
Q

What are some properties of topical corticosteroids?

A

Vasoconstrictive, anti-inflammatory, anti-proliferative

26
Q

What is a side effect of topical corticosteroids?

A

Immune suppression

27
Q

What is an example of a mild topical corticosteroid?

A

Hydrocortisone (1%)

28
Q

What are some examples of moderate topical corticosteroids?

A

Modrasone, Clobetasone, Butyrate 0.05%

29
Q

What are some examples of potent topical corticosteroids?

A

Mometasone, Betamethasone, Valerate 0.1%

30
Q

What are some examples of very potent topical corticosteroids?

A

Clobetasol, Proprionate 0.05%

31
Q

What are some things that topical corticosteroids are used for?

A

Eczema, psoriasis (flexures, face, hairline, scalp), keloid scars (intralesional), other non-infective inflammatory dermatoses

32
Q

How much topical corticosteroid is needed to cover all of an adults body?

A

20-30g

33
Q

How much does 1 finger amount (1/2g) of topical corticosteroid cover?

A

2 hand areas

34
Q

What are some side effects of topical corticosteroids?

A

Thinning of skin, purpura, stretch marks, fixed telangectasia, steroid rosacea, perioral dermatitis, may worsen or mask infections, systemic absorption, tachyphylaxis, rebound flare of disease

35
Q

What are some effects of the systemic absorption of topical corticosteroids?

A

Adrenal suppression and Cushings syndrome

36
Q

What is tachyphylaxis?

A

A decrease in response to anti-inflammatory effects

37
Q

What condition in particular is associated with rebound flare caused by topical steroids?

A

Psoriasis

38
Q

What effects can antiseptics have?

A

Bacteriocidal and bacteriostatic

39
Q

What are some examples of antiseptics?

A

Povidone iodine (Betadine), skin cleanser, chlorhexidine (Hibitane, Savlon), triclosan (Aquasept, Sterzac), hydrogen peroxide (Crystacide)

40
Q

What are the clinical uses of antiseptics?

A

Recurrent infections, antibiotic resistance, wound irrigation, potassium permanganate rinse used in acute exudative eczema

41
Q

What are some conditions where antivirals are used in the treatment?

A 
Herpes simplex (cold sore)=topical antiviral
Eczema herpeticum=oral antiviral
Herpes zoster (shingles)=oral antiviral
42
Q

What are some of the antifungals used to treat Candida (thrush)?

A

Antiyeasts (e.g nystatin, clotrimazole)

43
Q

What are some examples of antifungals used to treat dermatophytes (ringworm)?

A

Clotrimazole, terbinafine cream

44
Q

What antifungal is used to treat Pityriasis versicolor?

A

Ketoconazole

45
Q

What are some examples of antipruritics?

A

Menthol, capsaicin, camphor/phenol, crotamiton (e.g Eurax cream)

46
Q

What is menthol used for?

A

Added to calamine and other lotions/creams to impart cooling sensation (e.g Dermacool)

47
Q

How does capsaicin work and what is it derived from?

A

Depletes substance P at nerve endings and reduces neurotransmission, effect gradually builds; from red chilli peppers

48
Q

What is camphor/phenol used to treat?

A

Pruritus ani

49
Q

When is crotamiton used?

A

After treatment of scabies to resolve residual itch

50
Q

What are keratolytics used for?

A

Used to soften keratin-removes keratin plaques on scalp

51
Q

What conditions are keratolytics used to treat?

A

Viral warts, hyperkeratotic eczema, psoriasis, corns, calluses

52
Q

How are warts treated?

A

Mechanical paring plus:

Keratolytics (e.g salicylic acid), formaldehyde, glutaraldehyde, silver nitrate, cryotherapy, podophyllin

53
Q

What chemical is usually used in the cryotherapy of warts?

A

Silver nitrate

54
Q

What kind of warts is podophyllin used to treat?

A

Genital warts

55
Q

What are some topical treatments for psoriasis?

A

Emollients plus choice of coal tar, vitamin D analogue, keratolytic, topical steroid or dithranol

56
Q

What are the treatments for stable chronic plague psoriasis?

A

Coal tar, vitamin D analogues, dithranol

57
Q

What are some features of coal tar?

A

Mild solutions up to strong crude coal tar used, messy, smelly

58
Q

What are some features of vitamin D analogues?

A

Clean, no smell, easy to apply, can be irritant, use limited to 100g weekly

59
Q

What are some features of dithranol?

A

Effective, difficult to use, irritant, stains normal skin

60
Q

What are the treatments used for scalp psoriasis?

A

Greasy ointments to soften scale, tar shampoo, steroids in alcohol base/shampoo, vitamin D analogues

61
Q

What are some examples of treatments for psoriasis of the axilla?

A

Topical steroids (face/flexures/groin/genitals), consider combination of antibacterial/antifungal, calcineurin inhibitors

62
Q

What are some side effects of topical treatments?

A

Burning, irritation, local/systemic toxicity, contact allergy dermatitis

Dermatology (31 decks)

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