Sunburn and Dermatitis (Bellanger) Flashcards
A chronic, recurring inflammatory skin disorder (Type 1 hypersensitivity reaction). Does not have a cure and is not contagious, the goal is to ____ and ____ it,
Atopic dermatitis (AD) aka eczema (allergic dermatitis) prevent; control
The atopic triad consists of ____, ____ and ____.
It [is/is not] all inclusive.
eczema, allergic rhinitis, asthma;
is not
The following symptoms are indicative of…?
- -xerosis
- -pruritus
- -red, inflamed skin
- -vesicles and papules
- -recurring rash/flare ups
- -lichenification
Atopic dermatitis (AD) aka eczema (allergic dermatitis)
AD locations?
Older children and adults: hands, neck, inner elbows, back of knees and ankles
Younger children: face, elbows, knees
AD triggers?
- -Irritants
- -Infections
- -Allergens
- -Environment
Some causes of dry skin:
- -an insufficient ____ or ____
- -____ and essential fatty acid deficiency
- -____ diseases
- -____ insufficiency
- -diuretics
- -malignancies
- -diet; malabsorption
- -zinc
- -systemic
- -kidney
AD diagnosis criteria is an itchy skin condition, plus ___ or more of the following:
- -onset of age <__ y.o.
- -personal history of other atopic disease
- -visible ____ dermatitis
3
- -2
- -10
- -flexural
AD self-treatment exclusions:
- ____ condition with intense ____
- involvement of ____ area of body
- <__ y.o.
- skin appears to be ____
- -severe; pruritus
- -large
- -2
- -infected
AD treatment goals:
- -eliminate ____
- -control the ____
- -prevent future flare ups and maintain skin ____
- -prevent secondary infections -minimize drug ____ ____
- -triggers
- -itching
- -hydration
- -adverse reactions
AD treatment
- -first line?
- -standard of care?
- -not on the ____ or children <__ y.o.
- -emollients
- -topical steroids (Rx or OTC)
- -face; 2
Adjunct AD treatment
- -for patients with allergic rhinitis?
- -for oozing, weeping lesions
- oral antihistamine (sedating antihistamine for sleep relief)
- astringents
What are some examples of…
- -emollients/moisturizers?
- -urea?
- -lactic acid?
- -Aquaphor, Eucerin, Lubriderm
- -Carmol, Lac-Hydrin
- -AmLactin
Topical steroids of ____ to ____ potency are commonly used until flare-ups are ____. Are usually used no longer than ___ to ___ weeks at a time for self-care.
low; medium; controlled; 3; 4
Topical calcineurin inhibitors (Rx) are ___ line agents for patients who have had ____ to steroids, for diseases that are ____ to steroids, or there is a large ____ of disease.
2nd; ADEs; unresponsive; BSA
Calcineurin inhibitor mechanism of action
immunomodulator: inhibits calcineurin in the skin; blocks T-cell activation and release of cytokines leading to decreased inflammation
*will not be asked?
Calcineurin inhibitors are applied ____ daily before ____. Should see benefits in 8 days - 6 weeks. ADEs include skin ____ and ____.
twice; moisturizer; irritation; burning
Topical calcineurin inhibitors: (2)
pimecrolimus (Elidel) - for mild-moderate eczema; cream tacrolimus (Protopic) - for moderate-severe eczema; ointment
You should avoid topical calcineurin inhibitors on ____ or ____ skin conditions (eg, cutaneous T-cell lymphoma) and should be used for short-term and intermittent treatment using the ____ amount. Use ____!
malignant; premalignant; minimum; sunscreen
AD follow-up: consult a physician if…
- -it does not improve or worsens after __-__ days of ____ treatment
- -____ of the skin occurs while using the topical steroid
- -2-3; medicated
- -atrophy
Skin condition that results when the skin comes into contact with chemicals or metals. The affected skin becomes red, itchy and inflamed or in severe cases, blisters and weeping sores may form.
contact dermatitis
Contact dermatitis treatment
- -remove and avoid the ____/____
- -may use ____ potency topical ____
- -in rare instances, ____ dressings to relieve redness and itching
- -allergen/irritant
- -low; corticosteroid
- -wet
Diaper dermatitis signs and symptoms may include: (2)
- -erythema in patches (buttocks, upper thighs, abdomen, genital region)
- -shiny, beefy-red erythema
Diaper dermatitis treatment goals:
- -relieve the ____
- -get rid of the ____
- -prevent ____
- -prevent it from happening again
- -symptoms
- -rash
- -infection
Diaper dermatitis treatment
- -many topical products can lead to ____ side effects if applied
- -use a ____ cream
- -do not use topical ____, ____, ____, or ____
- -systemic
- -barrier
- -antifungals, antibacterials, anesthetics, hydrocortisone
Diaper dermatitis skin protectants:
- -____ ____ 1-40% and ____ 30-100% (examples: Desitin, A & D Ointment, Boudreaux’s Butt Paste…)
- -apply liberally to skin in diaper area every ____ ____
- -can continue use after rash heals for prevent recurrence
- -zinc oxide; petrolatum
- -diaper change
Diaper dermatitis follow-up
- -____ until healed if it improved after 7 days
- -____ if it has not healed/improved or worsened after 7 days
- -continue
- -refer
Sunscreen exclusions: (3)
- -xeroderma pigmentosum
- -allergy to all sunscreen ingredients
- -<6 months of age
Sunscreen selection:
- -pick a ____ ____ sunscreen
- -greater than or equal to ___ SPF
- -for patients with sensitive skin or are allergic, avoid ____, consider ____ sunscreen, consider ____ chemical sunscreen
- -broad spectrum
- -15
- -aminobenzoic acid (PABA); physical; avobenzone
Sunscreen application:
- -apply ___-___ minutes prior to UV exposure
- -____ after exposure to ____ or towel drying
- -reapply at least every ___ hours
- -15-30
- -reapply; moisture
- -2
Peripheral vasodilation in the epidermis from UV light; inflammatory reaction; erythema peaks at 12-24 hours.
sunburn
Superficial burns:
- -____ only
- -brief exposure to low heat or sunburn
- -usually no ____
- -____ can be managed by self-care
- -heal within ___-___ days
- -epidermis
- -vesicles
- -most
- -3-6
Superficial partial-thickness burns:
- -epidermis and top layer of ____
- -more heat or longer exposure
- -painful ____, ____, ____
- -____ burns (1-2% BSA) can be managed through self-care
- -heal in ___-___ weeks
- -dermis
- -blistering, moisture, weeping
- -small
- -2-3
Self-treatment of burns exclusions:
- -burn to BSA of __% or more for superficial partial-thickness
- -burns involving eyes, ears, ____, hands, feet or ____
- -deep partial thickness burns
- -full thickness burns
- -chemical burns
- -electrical burns
- -____ or multiple medical conditions
- -____ patients
- -2
- -face; perineum
- -diabetes
- -immunocompromised
Sunburn treatment goals: (4)
- -relieve pain
- -provide physical protection
- -reduce chances of infection or scarring
- -minimize medication ADEs
Sunburn treatment plan:
- initial treatment is ____ (if burn occurred in the past ___ minutes, immerse in cool water)
- can be any ____ of indicated OTC products dependent on symptoms and patient preference
- non-drug, 20
- combination
Sunburn treatment: systemic analgesics
- -prefer one with ____ properties
- -longer duration of action than ____ anesthetics
- -use for the first ___-___ days
- -anti-inflammatory
- -topical
- -1-2
Sunburn treatment: topical anesthetics ____ might be less painful
sprays
Sunburn treatment: skin protectants
- -help with ____ and skin irritation
- -examples (2)
- -apply ____
- -wait until after ___ hours to start using
- -rehydration
- -cocoa butter, petrolatum
- -PRN
- -24
Sunburn alternative treatment?
It may decrease pain by inhibiting ____ and inflammatory process. Avoid use on broken skin and avoid internal use.
aloe vera
bradykinin
Burn follow-up:
see physician if burn has ____ or worsened; if it has not healed in ___ days
progressed; 7
