Sunburn Flashcards
What are the signs and symptoms of sunburn?
Painful erythema 2-6 hours after exposure, max severity in 24 hrs
Severe cases = malaise, nausea, vomiting
Resolution with peeling skin occurs over 4-7 days
Confused with photosensitive drug eruption = assess those who burn easily, esp children
Summarise key features of basal cell carcinomas
Most on head & neck
Rarely metastasise –> cause extensive localised damage
Slow growing
Grows visible BV with time that can break open and scab
Diagnosed by biopsy
What is the first line treatment of basal cell carcinoma?
Surgical removal (except superficial BCC)
What is the treatment for superficial BCC?
Cryotherapy, PDT
topical imiquimod = at night 5x/wk for 6 weeks –> wash off in morning
How is advanced BCC treated?
Vismodegib capsule = once daily
Pbs required
Summarise the key features of SCC
Heavily sun exposed areas = head, neck, back of hand, limbs
Tender lesion, appear suddenly + grow rapidly (more than BCC) OR grow slowly over months to weeks
Characteristic thick irregular appearance –> raised and firm (like wart) over time
More likely in damaged skin
What is the 1st line treatment for SCC?
Surgical treatment w/ 3-5 mm margin
Radiotherapy if surgery not appropriate
Summarise the key features of Melanoma
Malignant tumour from melanocyte (can arise w//in mole or freckle)
early detection is vital
several types and classifications
surgical removal
Outline the ABCDE rule of melanoma diagnosis
Asymmetry = one half different from the other
Border = usually irregular
Colour = varies within lesion, pigment may be largely or completely absent
Diameter = greater than 6 mm, can be diagnosed smaller (inc diameter is more important)
Evolution = changing or evolving
What are some organic chemicals (Absorbing agents) in sunscreen?
octyl salicylate
Disodium phenyl dibenzimidazole tetrasulfonate
*risk of allergic dermatitis
What are some inorganic substances (physical blockers) in sunscreen?
zinc oxide
titanium dioxide
Outline some key tips for sunscreen application
Apply to exposed site 15-30 mins before sun exposure when UV index >3
Degree of cloud cover doesn’t change sunscreen option
Use generous amount
Reapply every 2 hours and after vigorous activity
Don’t used expired ones
What drugs don’t really work to treat sunburn?
Anti-inflammatory drugs
oral and/or topical corticosteroids
List the treatments for sunburn
cool compress, cool damp cloth to area
Inc water intake
anaesthetic spray to relieve pain
After sun cream or gels
Cooling gels = water based
Aloe vera - clinical evidence limited
List the treatments (and their duration) for actinic keratosis
Fluorouracil = 1-2/day for 2-5 wks (face) or 3wks (arm/leg)
Imiquimod = 3x/week at night for 3-4wks OR apply 3x/week, for 16 weeks
Diclofenac 3% gel = apply bd for 60-90 days
Methylaminolevulinate/5-aminolevulinic acid = 1 session of photodynamic therapy, apply patch and then expose to PDT
Summarise key facts about fluorouracil in skin cancer treatment
Interfere with DNA synth
Cont treatment until marked inflam response
Therapy 3-4 wks, can be longer, face responds quicker (trunk, lower limb, hands, forearms
Avoid excessive/prolonged sun exposure
Use metal applicator or gloves when applying
only RPBS
Summarise key facts about imiquimod cream in skin cancer treatment
MOA = enhance immune response
Apply before bed (leave for 6-10 hrs) to clean area–> wash off w/ mild soap
2x dosing regimen
Avoid bathing/washing after application
Protect treated area from sun
Avoid contact with eyes, lips, nostrils
Summarise the key facts about diclofenac + hyaluronic acid in skin cancer treatment
MOA = proposed blocking of COX-2 –> dec angiogenesis and cellular proliferation
avoid contact w/ eyes and mouth, do not cover with occlusive dressing
Protected area from sunlight
Can take 30 days after finishing for lesion to heal
Not interchangeable with diclofenac gels for pain
consider potential for systemic absorption
Slip: What protective clothing should be worn in the sun?
Cover as much skin as possible = collared shirts w/ long sleeve
Some clothing may be poorer in ultraviolet protection
Slop: When/how often should sunscreen be applied?
Apply generous amounts to clean, dry skin = 20 mins before going outside
Reapply every 2 hours or after swimming or excessive sweating
Sunscreen = does not provide 100% protection
Slap: What kind of hat is best for sun safety?
Broad-brimmed, legionnaire or bucket style hat which shades face, nose, neck ears
Caps and visors are not enough
What is the sun safety acronym?
Slip
Slop
Slap
seek
slide