Skin therapeutics/ topical therapy Flashcards

1
Q

What are the advantages and disadvantages of topical treatments ?

A

Advantages:

  • Direct application
  • Reduced systemic effects

Disadvantages:

  • Time consuming
  • Correct dosage can be difficult
  • Messy to use
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2
Q

Describe some of the features of creams

A
  • Semisolid emulsion of oil in water
  • Contain emulsifier & preservative
  • High water content
  • Cool & moisturise
  • Non greasy
  • Easy to apply
  • Cosmetically acceptable
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3
Q

Describe some of the features of ointments

A
  • Semisolid grease/oil (soft paraffin)
  • No preservative
  • Occlusive and emollient
  • Restrict transepidermal water loss
  • Greasy - less cosmetically attractive
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4
Q

Describe some of the features of lotions and the areas of skin they are used to treat

A
  • Liquid formulation - Suspension or solution of medication in water, alcohol or other liquids
  • Treat scalp, hair-bearing areas
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5
Q

Describe some of the features of gels and the areas of skin they are used to treat

A
  • Thickened aqueous lotions (semi-solid)
  • Treat scalp, hair bearing areas, face
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6
Q

Describe some of the features of pastes and what some of the treatments they are often used in

A
  • Semisolids
  • Contain finely powdered material eg ZNO
  • Stiff, greasy,difficult to apply
  • Protective,occlusive,hydrating
  • Often used in cooling, drying, soothing bandages
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7
Q

Give some examples of bases/vehicles drugs used on the skin are often dissolved in

A
  • Gels
  • Creams
  • Ointments
  • Pastes
  • Lotions
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8
Q

Give some examples of the different types of topical therapies

A
  • Emollients
  • Topical steroids
  • Antinfective agents - antiseptics, antibiotics, antivirals, antifungals
  • Antipruritics
  • Keratolytics
  • Psoriasis therapies
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9
Q

What are the features/function of emollients and what type of skin diseases are they mainly used in ?

A
  • They Enhance rehydration of epidermis
  • Require frequent application
  • Used for all dry/scaly conditions esp. eczema
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10
Q

What are the two main types of emollients and what differs the two from each other

A

Two main types are proprietary and non-proprietary

Proprietary costs more but is more cosmetically acceptbale hence better complicance

Examples of non-proprietary is soft paraffin, emulsifying ointment (can be used as a replacement for soap)

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11
Q

What are wet wraps used to treat?

A

They are used for very dry (xerotic) skin

e.g. xerotic eczema - a form of eczema that is characterized by changes that occur when skin becomes abnormally dry, itchy, and cracked

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12
Q

Are wet wraps effective to use for xerotic skin ?

A

Very effective but also very time consuming to put on

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13
Q

What are the 3 main modes of action of corticosteroids ?

A
  • Vasoconstrictive
  • Anti-proliferative
  • Anti-inflammatory
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14
Q

Put the following topical steroids in order of increasing potency:

  • Hydrocortisone
  • Clobetasol, Proprionate
  • Modrasone, Clobetasone, Butyrate
  • Mometasone, Betamethasone, Valerate
A
  • Mild - Hydrocortisone
  • Moderate - Modrasone, Clobetasone, Butyrate
  • Potent - Mometasone, Betamethasone, Valerate
  • Very Potent - Clobetasol, Proprionate
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15
Q

List some of the skin diseases topical steroids are used in

A
  • Eczema (dermatitis)
  • Psoriasis
  • Other non-infective inflammatory dermatoses e.g. lichen planus
  • Keloid scars (a tough heaped-up scar that rises quite abruptly above the rest of the skin. It usually has a smooth top and a pink or purple color.)
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16
Q

What are some of the side effects of topical steroids ?

A

Thinning of the skin, purpura and stetch marks

Also steroid rosacea, fixed telangectasia, Perioral dermatitis

17
Q

The pic below shows some of the other side effects of steroids:

A
  1. Steroid rosacea (a condition in which certain facial blood vessels enlarge, giving the cheeks and nose a flushed appearance.)
  2. Fixed telangectasia
  3. Perioral dermaitis
18
Q

What is the action of antiseptics and give some examples of antiseptics

A

They either have bacteriostatic or bacteriocidal effects

some examples:

  • Povidone iodine (Betadine) skin cleanser
  • Chlorhexidine (Hibitane, Savlon)
  • Triclosan (Aquasept, Sterzac)
  • Hydrogen peroxide (Crystacide)
19
Q

What are some of the clinical uses of antiseptics ?

A
  • Recurrent infections
  • Antibiotic resisistance
  • Wound irrigation
20
Q

What is the topical antibiotic used to treat rosacea ?

A

Metronidazole

21
Q

What are some of the topical antibiotics used in the treatment of acne ?

A

clindamycin, erythromycin, tetracycline

22
Q

What are some of the topical antibiotics used in the treatment of impetigo ?

A

mupirocin, fusidic acid

23
Q

What is the topical antibiotic treatment of infected eczema ?

A

combined corticosteroid/ antibacterial (short-term)

24
Q

What are anti-puritics used to relieve ?

25
Give some examples of anti-puritics
* Menthol: added to calamine & other lotions & creams to impart cooling sensation. (Dermacool) * Capsaicin: from red chilli peppers - depletes substance P at nerve endings and reduces neurotransmission, effect gradually builds * Camphor / phenol – for pruritus ani * Crotamiton: e.g Eurax cream
26
What is the aim of treatment with keratolytics ?
Keratolytic therapy is treatment to remove warts and other lesions in which the epidermis produces excess skin.
27
List some of the different conditions keratolytics are used to help treat and give and example of a keratolytic drug
* Viral warts * Hyperkeratotic eczema & psoriasis * Corns and calluses * To remove keratin plaques in scalp e.g. Salcylic acid
28
What are the different treatment options for warts ?
* Keratolytics e.g.Salicylic acid * Formaldehyde * Glutaraldehyde * Silver nitrate * Cryotherapy (usually liquid nitrogen) * Podophyllin (genital warts)
29
What are the different treatment options for psoriasis ?
Emollients and choice of: * Coal tar * Vitamin D analogue * Keratolytic * Topical steroid * Dithranol
30
What is the disadvantage of using coal tar ?
Messy and smelly
31
What are the advantages and disadvantages of using vitamin D analogue ?
* Clean, no smell * Easy to apply * BUT can be irritant
32
What are the advantages and disadvantages of using dithranol?
Its effective but difficult to use and irrtiates/stains nromal skin
33
What is imiquimod and what is it lincensed to treat?
* Immune response modulator * Enhances innate & cell-mediated immunity * Anti-viral, anti-tumour effects * Licensed for use in genital warts,superficial BCC (basal cell carcinoma)
34
What is the slightly different treatment options for scalp psoriasis ?
* Greasy ointments to soften scale * Tar shampoo * Steroids in alcohol base or shampoo * Vitamin D analogues
35
What is the action of Calicneurin Inhibitors?
The block lymphocyte activation - e.g. T cells aren't activated
36
Give a couple examples of Calicneurin Inhibitors and what they are used to treat along with the potential side effects they may cause
* Tacrolimus, pimecrolimus * Topical treatment of atopic eczema (esp face,children) * May cause burning sensation on application * ?risk of cutaneous infections,??risk of skin cancer
37
What is cosmetic camouflage and give an example of a disease it is used to help treat
Make up used to cover up skin disease e.g. vitiligo