SM Dermatology Flashcards
1
Q
A patient presents with cold sores. Is this HSV 1 or HSV 2?
A
HSV 1
2
Q
When must HSV 1 be treated with antivirals?
A
Within 48-72 hours of sx onset
3
Q
What is an antiviral used to treat HSV 1?
A
Acyclovir
4
Q
Chronic ulcerative stomatitis
-characteristics
-how long does it take to resolve?
-resistant to what?
A
-autoimmune; large size, many sores/ulcers in mouth
-weeks to months
-topical steroids
5
Q
Chronic ulcerative stomatitis
-treatment of choice after topical applications fail
A
hydroxychloroquine (Plaqueril)
6
Q
what derm issue is seen mainly in children - bumps on skin?
A
keratosis pilaris
7
Q
treatment for keratosis pilaris
A
emollients, moisturizers
8
Q
what are the two types of impetigo?
A
Bollous and nonbollous
9
Q
what are the characteristics of bollous impetigo?
A
no honey crust; bullae erupt
10
Q
what are the characteristics of nonbollous impetigo?
A
more common; honey crusted
11
Q
what is the treatment for nonbollous impetigo?
A
mupirocin ointment (bactroban)
12
Q
what is the treatment for bollous impetigo?
A
oral abx based on underlying bacteria
-typically cephalexin or dicloxacillin
-if underlying bacteria is MRSA, treat with doxy
13
Q
what two main types of bacteria are responsible for impetigo?
A
- strep pyogenes
- staph aureus
14
Q
what characteristics describe pityriasis rosea?
A
-starts with herald patch, then full distribution of “rash” (usually to back or abd)
15
Q
what is a herald patch? what disease is this a sx of?
A
-scaly, oval, or round skin patch that appears before a widespread rash known as pityriasis rosea
16
Q
tx for pityriasis rosea?
A
goes away on its own; can last weeks to months before resolving
17
Q
how long does it take for pityriasis rosea to resolve?
A
weeks to months
18
Q
what are the characteristics of a brown recluse spider bite?
A
spot is tender, turned deep purple in color; possible white halo around it
-possible systemic symptoms
19
Q
what two diagnoses can occur from tick bite?
A
- rocky mountain spotted fever
- Lyme disease (erythema migrans)
20
Q
what sx occur with rocky mountain spotted fever?
A
rash 3-5 days after sx onset; rash on palms of hands and soles of feet initially
21
Q
what is the biggest issue with rocky mountain spotted fever?
A
high mortality rate if untreated!
22
Q
what is the treatment for rocky mountain spotted fever?
A
doxy
-no matter what - doesn’t matter age or if pregnant; benefit outweighs risk
23
Q
sx of lyme disease
A
tick bite can have bullseye/target lesion (erythema migrans)
24
Q
the rash of lyme disease is called what early on?
A
erythema migrans
25
tx for lyme disease
-doxycycline, no matter the age
-amox if pregnant
26
sx of measles
fever, cough, congestion, conjunctivitis; eventual rash (3-5 days after initial sx)
27
when does the rash occur with measles?
3-5 days after initial sx
28
what is another name for measles?
rubeola
29
what is a common/well-known symptoms of measles?
Koplik spots (in mouth)
-tiny grain-like lesions (of white sand) surrounded by erythematous halo on buccal mucosa
30
how to prevent measles?
MMR vaccine
31
when is MMR vaccine given to children? why?
12MO; live vaccine
-normally receive passive immunity in utero
32
when do you give MMR vaccine early?
when infant is traveling internationally and under 12MO
33
what is the most well-known symptom of mumps?
noticeable parotid gland swelling
34
what diseases have the characteristic sx of swollen parotid glands?
mumps
bulimia nervosa d/t repetitive vomiting
35
what is the dx for a mass under chin that occurs whenever pt eats any sort of meal?
salivary gland stone
36
what is another name for salivary gland stone?
sialolithiasis
37
tx for sialolithiasis?
surgical removal if stone is present
38
sx of actinic keratosis
dry scaly lesions on sun-exposed area; pink/yellow/tan/pale/brown
39
treatment for actinic keratosis
topical 5-FU or cryotherapy
40
should AK be treated right away or is it okay to wait?
yes, right away
41
why should AK be treated right away?
precursor to squamous cell carcinoma
42
squamous cell carcinoma sx
-how is it dx?
-slow growing, scaly ulceration that is very red and bleeds easily
*cancer
-biopsy
43
-characteristics of cafe au lait spots?
-benign or tx needed?
-hyperpigmentation of skin
-benign, no further intervention; however; >6, may indicate underlying disorder: neurofibromatosis
44
if patient has >6 cafe au lait spots, what are they at risk for?
neurofibromatosis
45
what is intertrigo?
rash present in skin folds (under breasts, abd folds)
46
treatment for intertrigo
minimize moisture and friction to area + antifungal (one of the azoles) (+ occasionally topical steroids)
47
ABCDEs of malignant melanoma
A - asymmetry
B - border irregularity
C - color variation
D - diameter >6mm
E - evolution of lesion
48
what does a brown or black line under fingernail w/o trauma indicate?
melanoma or splinter hemorrhage (associated with endocarditits)
49
treatment for brown or black line under fingernail
REFER (possibly melanoma)
50
sx of seborrheic keratosis
pasted on lesions; "stuck on"
51
do we treat seborrheic keratosis?
No, benign; does not need removal
52
basal cell carcinoma sx
lesion is shiny, waxy or pearly + telangiectasias
53
what are telangiectasis and what skin condition is this sx usually found in?
visible blood vessels across the lesion; basal cell carcinoma
54
what is the most common type of skin cancer?
basal cell carcinoma
55
how is basal cell carcinoma diagnosed?
biopsy
56
treatment for basal cell carcinoma?
REFER to derm before removal
57
what skin condition is usually located on flexor surfaces (creases) of body?
atopic dermatitis (eczema)
58
sx of atopic dermatitis
pruritic --> itch, scratch, itch cycle; usually located on flexor surfaces (creases) of the body
59
what are the three A's?
1. atopic dermatitis
2. asthma
3. allergies
60
treatment for atopic dermatitis
emollients, topical steroids
61
what is nummular eczema?
simple, round-shaped eczema lesion often resembling a coin
62
where is nummular eczema usually found on the body?
arms and legs
63
what is nummular eczema typically related to?
underlying atopic dermatitis, but can be idiopathic
64
treatment for nummular eczema and for how long?
high-potency steroids for several weeks
65
sx of plaque psoriasis
thick, silvery scales
66
tx of plaque psoriasis (within primary care)
topical steroids, emollients or coal tar can be used as adjunct therapy
67
tx of plaque psoriasis when not controlled within primary care setting
REFER to derm
68
what are the two signs to be aware of related to plaque psoriasis?
1. auspite sign
2. koebner phenomenon
69
what is the auspite sign?
-what disease is this related to?
-plaques are scratched or removed, and pinpoint bleeding occurs
-plaque psoriasis
70
what is the koebner phenomenon?
-what disease is this related to?
-trauma to the skin which leads to a plaque forming
-plaque psoriasis
71
sx of contact dermatitis
immediate rxn to irritant; typically linear pattern; localized
72
tx of contact dermatitis
topical steroids and avoid irritant
73
sx of shingles
vesicular, follows a dermatome
74
what is shingles proceeded by?
burning, tingling at site before rash appears; new pain on one side of body
75
how is singles prevented?
vaccine - shingrix
76
at what age is shingrix given?
age 50; though, adults 18yrs and older may receive shingrix if immunocompromised
77
is shingrix vaccine activated or inactivated?
inactivated
78
can patients receive antivirals with shingles dx? if so, when?
-yes
-within 48 hours of sx onset
79
when must a shingles patient be referred?
if shingles rash is close to eye(s)
-ophthalmology
80
if shingles rash gets too close to eye, what is patient at risk for?
permanent corneal scarring and blindness
81
what are the characteristics of pressure injuries stage I?
intact, non-blanchable
82
what is the treatment for stage I pressure ulcer?
foam dressings to prevent further damage; use of pressure relief ankle foot orthosis (PRAFO) boot; frequent position changes
83
what is considered an unstageable pressure injury?
cannot see wound bed d/t presence of slough (unstageable until we can see the wound bed)
84
should a stable eschar be removed/soaked?
NO - seals out bacteria
85
characteristics of scabies
intensely pruritic; occurs btw fingers/toes; others in household have similar sx
86
tx for scabies
permethrin cream and wash everything in HOT water
-usually treat these patients twice
87
how would you describe the rash associated with varicella?
rash presenting in various stages of healing
88
when can varicella vaccine be given to children?
>12MO; live vaccine
89
when can children return to school/daycare after chicken pox diagnosis?
when all lesions have crusted over
90
sx of lice
incessant pruritis of scalp; contagious; occurs at any age
91
treatment for lice
permethrin = Nix
-only kills live lice; must comb out knits/eggs; may need second tx + wash everything in HOT water
92
sx of molluscum contagiousum
umbilicated lesion/dimpling; flush colored and highly contagious
93
tx of molluscum contagiosum
usually resolve on their own over time
94
sx of skin anthrax lesion
ulcerated, black lesion; painless (w/o systemic involvement)
95
common population who acquire skin anthrax?
cattle farmers
96
tx for skin anthrax lesions w/o signs of systemic involvement
1. fluoroquinolone, typically ciprofloxacin
2. tetracycline, typically doxycycline as alternative tx
97
sx of hidradenitis suppurativa
recurrent issue; comes and goes frequently
-can lead to several noudles, pustules, or even abscesses in the sweat glands
-often affects groin, thights, axilla, and under the breasts
98
R/F of hidradenitis suppurativa
-obesity
-smoking
99
is hidradenitis suppurativa related to poor hygiene?
NO; closely linked to genetics
100
tx for hidradenitis suppurativa
NSAIDs for pain management initially
-mild cases: skin compresses (wamr), skin care, topical clindamycin
-severe cases: I&D, wound culture; typically requires abx for long term (>couple of weeks)
101
is hidradenitis suppurativa an acute or chronic condition?
chronic condition
102
what conditions may require an I&D?
cysts
boils (furuncle)
hidradenitis suppurativa
103
sx of folliculitis
skin infection of hair follicles and surrounding tissues
104
does folliculitis resolve on its own?
usually, yes; warm compresses help
105
tx of folliculitis
mupirocin (similar tx as impetigo)
-if severe, oral abx: PCN or cephalexin (Keflex)
106
what oral antibiotics are commonly used for skin infections?
-PCN
-Cephalexin (Keflex)
107
sx associated with rosacea
erythematous facial rash that doesn't spare the nose or nasolabial folds
108
what skin condition is an erythematous facial rash that doesn't spare the nose or nasolabial folds?
rosacea
109
tx for mild rosacea
behavioral modification ie sun protection measures
110
tx for rosacea (pharmacological measures)
metronidazole or Flagyl gel (most helpful for inflammatory type of rosacea that consists of papules or pustules)
111
sx of lupus (SLE)
rash that does spare nasolabial folds = malar rash ("butterfly rash")
112
what skin condition is an erythematous facial rash that spares the nasolabial folds?
lupus (SLE)
113
what is a malar rash? what skin condition is it associated with?
-"butterfly rash"; rash that spares nasolabial folds
-lupus (SLE) and Sjogren's syndrome
114
sx of Sjogren's syndrome (that differentiate it from lupus)
-very dry eyes, very dry mouth
-also has malar rash
115
what two skin conditions present with malar rash?
SLE
Sjogren's syndrome
116
sx of erysipelas
sharply defined, well demarcated borders; superficial and red = superficial cellulitis
117
tx for erysipelas
PCN or cephalexin
118
what are the two types of cellulitis?
1. purulent
2. non-purulent
119
treatment for purulent cellulitis
BCD (esp with possibility of MRSA)
bactrim
clindamycin
doxycycline
120
treatment for non-purulent cellulitis
keflex or PCN
121
first line tx for acne
topical applications - tries to dry excess oil/bacteria
-benzoyl peroxide wash or cream
122
second line tx for acne
topical abx (clindamycin) OR tretinoin (retinoic acid) - helps skin cells turn over while helping to keep pores open/stops clogging up
123
third line tx for acne
oral abx
-doxycycline --> educate against sun exposure
124
last case scenario for acne tx
referral to derm
-may prescribe isotretinoin (Accutane)
125
what is the BBW for accutane associated with?
teratogenic to pregnancy
126
what must patients do who take accutane?
have two forms of birth control
127
can any provider prescribe accutane?
NO; federally regulated and need special certification
128
what brings about geographic tongue sx?
spicy or hot foods tend to proceed geographic tongue
129
is geographic tongue bad?
NO, benign
130
sx of leukoplakia
hairy tongue; cannot scape off
131
tx of leukoplakia
REFER to dentist - seen in pts with HIV (immunocompromised population); detrimental to enamel
132
oral candidiasis - can you scape off tongue?
YES
133
sx of fifth disease
slapped-cheek rash; lacy net-like rash
134
what causes fifth disease?
viral infection
135
sx of fifth disease?
starts with fever, leads to slapped-cheek rash/very reddened cheeks as well as lacy net-like rash across body
136
when does fifth disease stop being contagious?
when rash appears (slapped-cheek rash; lacy net-like rash)
137
tx for fifth disease
self-limiting
138
who should patients with fifth disease stay away from?
those who are pregnant; can cause miscarriage
139
what is the preferred medication class for fungal infections?
antifungals; typically fluconazole
140
how do you decide topical vs oral in fungal infections?
based on severity
141
when to use oral antifungal
severe, recurrent, unresolved yeast infections or vaginal yeast infection
142
what diseases are treated with fluconazole?
tinea
intertrigo
143
how to treat tinea vesicolor
antifungal creams, lotions, shampoos
144
sx of enterobiasis
genital area is intensely pruritic at night
145
what is enterobiasis
pinworm
146
how to diagnose enterobiasis
scotch tape test early in AM
147
tx of enterobiasis
mebendazole or albendazole
148
what is mebendazole or albendazole used to treat?
enterobiasis (pinworm)
149
what oral abx is used to treat dog/cat bite?
Augmentin
150
do we suture a dog bite?
NO; do not use dermabond either - increases risk for infection
151
what disease is linked to chronic ulcerative stomatitis?
lichen planus
152
what other immune disorders can be associated with lichen planus?
UC, vitiligo, myasthenia gravis, alopecia areata
153
what can exacerbate lichen planus?
stress, infection
154
where on the body does lichen planus occur?
flexor surfaces of the limbs, but also mouth, sin, genitals
155
how does lichen planus present?
red/purple flat top bumps, intensely pruritic
-some lesions are lacy/white when located on mucous membranes = wickham striae
156
what is wickham striae?
seen in lichen planus
-lesions that are more lacy/white when located on mucous membranes
157
how long does it take for lichen planus to resolve?
about 6MO; self-limiting
158
tx for lichen planus (mild)
simple topical steroids; antihistamines
159
where is lichen simplex chronicus seen on the body?
arms, legs, neck, upper trunk, genital region
160
what does lichenification mean?
skin becomes leathery/rubbery in appearance d/t repetitive scratching/rubbing
161
what can lead to lichenification?
atopic dermatitis (allergies, asthma)
162
tx for lichen simplex chronicus
topical steroids; antihistamines
-utilize moisturizers to help with prevention
163
how does lichen sclerosus appear on the skin?
almost always white in appearance
164
where is lichen sclerosus typically found?
genitalia; on postmenopausal women, typically locaed on vulva
165
what population is most commonly diagnosed with lichen sclerosus?
postmenopausal women
166
is lichen sclerosus contagious?
NO
167
sx of lichen sclerosus
very itchy; painful intercourse, tearing and bleeding; tends to reoccur often
168
treatment for lichen sclerosus
topical steroids --> potent topical steroids
**this is the only dx that warrants potent topical steroids on genitalia
-clobetasol
169
patients diagnosed with lichen sclerosus are at higher risk to develop what?
squamous cell carcinoma
170
-what layer of skin is impacted by first degree burn?
-does it blister as SE?
-tx
-epidermis
-no
-OTC aloe vera
171
-what layer of skin is impacted by second degree burn?
-sx
-tx
-epidermis and dermis
-red, blistered, painful (educate pt not to pop blisters)
-topical applications of silver sulfadiazine cream or abx ointment if concerned about infection
172
what is silver sulfadiazine used to treat?
2nd degree skin burn
173
-what kind of burn occurs in 3rd and 4th degree burns?
-emergency or can treat in primary care?
-what must be completed during initial assessment?
-full thickness burn; involves full epidermis and dermis
-need emergency care
-initial assessment must include airway assessment in relation to smoke inhalation
174
Rule of 9's: Adult
percent of BSA - head and neck
9%
175
Rule of 9's: Adult
percent of BSA - upper limbs
9% each (front and back = 9%)
176
Rule of 9's: Adult
percent of BSA - trunk
36%
177
Rule of 9's: Adult
percent of BSA - chest above navel
9%
178
Rule of 9's: Adult
percent of BSA - upper back
9%
179
Rule of 9's: Adult
percent of BSA - stomach/abd
9%
180
Rule of 9's: Adult
percent of BSA - lower back
9%
181
when do you refer a burn patient to the ED?
-when burned BSA is >10%
-burn involves face, hands, genitals, feet
-any electrical or chemical burns
-any burn >2nd degree
182
Rule of 9's: Child
percent of BSA - head
18% (front and back)
183
Rule of 9's: Child
percent of BSA - anterior trunk
18%
184
Rule of 9's: Child
percent of BSA - posterior trunk
18%
185
Rule of 9's: Child
percent of BSA - arm
9%
186
Rule of 9's: Child
percent of BSA - leg
14%
187
Guess this exanthem:
high fever, cough, nasal congestion, pink/watery eyes, white spots in mouth + rash
rubeola (measles)
188
what are koplik spots?
sx of rubeola (measles)
-white cluster spots on gums, small; present 2-3d after measle sx start
-present on buccal mucosa, near molars specifically
-seen/presents before measles rash occurs
189
what are the 3 C's of sx associated with rubeola?
cough
congestion (coryza)
conjunctivitis
190
-is rubeola contagious?
-does it lead to serious complications?
-tx
-very contagious
-yes: pneumonia and encephalitis
-symptomatic tx; MMR vaccine prevents
191
timeline of rubeola virus
1. exposure
2. 1 wk later = contagious
3. Day 10: sx start (3 C's, fever)
4. Day 12-13: koplic spots (before rash)
5. Day 15: fever subsides; rash appears
6. Day 22-24: rash resolves; measles resolves
192
when are patients contagious with rubeola?
3-4d before rash starts until 4d after rash appears; expect high fever, 3 C's
193
what is the hallmark sx of measles (rubeola)?
rash; starts on face and spreads downward and outward to rest of body
194
what are the two types of measles?
rubeola
rubella
195
Guess this exanthem:
4YO girl; fever, bilateral swelling on face just in front of ears for last 2d
-bilateral swelling of face just in front of ears
Mumps
-parotic gland swelling
196
-is mumps contagious?
-how is it transmitted/spread?
-sx
-Yes, very contagious
-respiratory droplets, direct contact, contaminated clothes, furniture (usually spread by individuals living in close contact ie college dorms)
-fever, HA, malaise, swelling of parotid glands
197
Guess this exanthem:
Rash for 2d, mild fever, cervical lymphadenopathy; child seems well overall
-rash started on face and spread across rest of body
Rubella (German Measles)
-more mild than rubeola
198
what other "nickname" does rubella have?
"3 day measles"
199
-do patients have complications with/after rubella?
-distinguishing sx
-tx
-far fewer complications
-mild sx; pink rash; lymphadenopathy
-symptomatic tx: hydration, rest, OTC Motrin/Tyl.; MMR vaccine prevents!
200
-are we concerned if a pregnant woman is exposed to rubeola?
-are we concerned if a pregnant woman is exposed to rubella?
-no
-yes
201
at what age can MMR vaccine be given? why?
-who can this vaccine not be given to?
12MO; live attenuated vaccine
-pregnant women; immunocompromised
*do not get pregnant w/i 4 weeks of receiving this vaccine
202
Guess this exanthem:
high fever (103F) for 3-4d; fever broke this AM but new rash appeared
-rash is rose/pink in appearance and started on trunk
-blanchable rash; spreading to neck, arms, face, legs
Roseola
203
what is another name for roseola?
sixth disease
204
what is roseola commonly caused by?
2 strains of human herpes virus or adnovirus (among others)
205
in roseola, what comes first - rash or fever?
fever, then rash
206
distinguishing sx of roseola
rose colored, blanchable papule rash
-high fever, then rash appears (typically starts on trunk)
207
when does roseola stop being contagious?
once rash appears
208
-tx for roseola
-is there a vaccine?
-symptomatic tx
-no
209
Guess this exanthem:
Mild cold sx for few days; after 1 wk from sx onset, patient developed rash on cheeks
-across trunk, developed lacy and net-like rash that continue to spread
-rash is mildly itchy, esp at soles of feet
Fifths disease
210
What is another name for Fifths disease?
erythema infectiosum
211
what is Fifths disease caused by? (what virus)
strain of parvovirus B19
212
what are the distinguishing sx of Fifths disease?
"slapped cheeks," lacy, net like appearance to the rash
213
-Tx for Fifths Disease
-any long-term complications?
-concerned if pregnant patient exposed?
-symptomatic tx
-not typically long term complications
-yes, can cause pregnancy complications --> severe anemia in fetus (order titer if pt has been exposed)
*many people are immune d/t previous exposure
214
Guess this exanthem:
Fever for 1-2d, sore throat, painful sores started in mouth
-rash now on hands and feet as well
-some spots are vesicles; skin on top of toes is starting to peel
HFM
215
-what virus causes HFM?
-where does rash start on the body?
-tx
-is there a vaccine?
-coxsackie virus
-mouth and spreads to hands/feet; can see peeling after rash has occurred
-symptomatic tx
-no
216
what is the order of potency in topical steroids?
ointments
creams
lotions
solutions
217
does potency = level os absorption into the skin?
no
218
what type of topical steroid medium is best absorbed by skin?
cream
219
what is the most commonly prescribed potency topical steroid prescribed in primary care?
-class III
-class IV
220
can we prescribe class I topical steroid in primary care?
NO
-can lead to adrenal suppression, smother other SE
221
what potency topical steroid can be used on the face?
low potency or none
222
what potency topical steroid can be used on arms/legs/trunk?
medium potency
223
what potency topical steroid can be used on hands/feet?
high potency
224
can you apply topical steroid to genitalia?
Overall no, except in Lichen Sclerosis --> use high potency for short term (clobetasol)
225
what is the most important factor to consider when prescribing topical steroid?
potency (and area of body steroid will go)
226
Mupirocin
-what is this the primary tx for?
-effective against gram + or - bacteria?
-when should improvement be seen with use?
-if no improvement, then what?
-nonbollous impetigo
-gram + bacteria ie staph aureus and strep pyogenes
-in 3-5 days
-if lingering, reassess pt
227
Antivirals
-what are antivirals used to tx?
-what routes are antiviral medications?
-what do these medications end in?
-shingles, HSV1 and HSV2
-oral, topical, etc.
-"-cyclovir" --> acyclovir (zovirax), valacyclovir (valtrex)
228
Antivirals
-what organ system do antivirals impact? what can it lead to? how can the patient avoid this?
-when must these medications be started to be effective?
-kidneys; can lead to AKI; stay hydrated
-started w/i 48 hours; can wait up to 72hrs, but not as effective
229
Antivirals
-what are sx of viral skin infections?
-are these used as spot tx or maintenance tx?
-burning, tingling at site prior to lesion
-can be utilized as spot tx or maintenance therapy doses
230
Triazoles
-what kind of medication class is this?
-what is this used to treat?
-what do these medications end in?
-antifungal
-vaginal yeast, tinea versicolor, ringworm
-"-azoles"
231
Triazoles
-are these medications fungistatic or fungicidal?
-are these medications teratogenic?
-what organ system can these medications negatively impact?
-fungistatic: limits ability of fungus to reproduce
-yes
-liver
232
Selenium sulfide
-what type of medication is this?
-what makes this medication helpful?
-what is this medication used for?
-antifungal and antiinfective
-it is in shampoo form and OTC; slows growth of yeast
-tx of tinea versicolor, tinea capitis, common dandruff of scalp
233
What is used to treat pinworms?
Mebendazole (Vermox) or Albendazole (Albenza)
234
what is the medication regiment for pinworm treatment?
prescribe 1 dose at diagnosis, the 1 dose 2 weeks later (mebendazole or albendazole)
235
-are pinworms contagious?
-what is the significance of prior question?
-yes
-must treat everyone in household
236
what is the OTC medication option to tx pinworms?
Pyrantel Pamoate (not as effective)
237
Terbinafine
-what kind of medication is this?
-what does this treat?
-length of time for treatment
-what organ system should be monitored?
-antifungal
-tinea capitis and fungal infection of nail beds (onychomycosis)
-tinea capitis = 2-4 wk; onychomycosis = 6-12 wks
-monitor liver prior to prescribing
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Griseofulvin
-what kind of medication is this?
-what does this treat?
-length of time for treatment
-how should this medication be taken?
-antifungal
-tinea capitis (slightly more effective than terbinafine, but comparable)
-6-8 week tx
-take with fatty meal
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what two medications can be used to treat tinea capitis?
1. Terbinafine
2. Griseofulvin (slightly more effective, but comparable)
240
what is permethrin (elimite) used to treat?
lice, scabies, ticks, mites, fleas
241
how to use permethrin (elimite) to treat scabies
-apply to entire body from neck down before bedtime; wash off 12 hours later
-repeat in 1 week
-daily showers and laundering (hot water) decrease recurrence
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how to use permethrin (elimite) to treat lice
-apply to head and remove immediately after
-kills active lice, but not unhatched eggs = needs second tx; knits need to be combed out of hair
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Acne Tx
-initial treatment
-solo tx or adjunct tx?
-how does it work?
-benzoyl peroxide (salicylic acid prior)
-solo tx or adjunct tx
-dries and peels skin on face so acne bacteria will be shed off; kills bacteria under skin and cleans out pores
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Acne Tx
-secondary tx
-how does it work?
-example of topical retinoid and how it works
-topical retinoids and/or abx cream
-stops overgrowing of bacteria on skin
-tretinoin (Retin-A); irritate skin = dissolves old/dead skin = pores unclog; skin heals itself
245
Acne Tx
-tertiary tx
oral abx
-tetracyclines (start thinking of referring to derm)
246
Acne Tx
-fourth option for tx
Accutane (isotretinoin)
-prescribed by derm
-need reliable form of birth control; med can cause numerous birth defects
