Symptoms In Phamracy - Skin (w21)

Question 1

What is atopic eczema ?

Answer 1

• Chronic, itchy skin condition – common in children
• Often accompanies other “atopic” conditions
• Rash is dry, flaky and inflamed
• Aetiology unclear – trigger factors

Question 2

What is contact dermatitis ?

Answer 2

• Commonly on the hands
• Consider patient history and occupation
• Nappy rash is a type of contact dermatitis

Question 3

When would you refer someone with eczema or dermatitis ?

Answer 3

• Infected rashes, e.g. weeping from the rash
• Suspected ADR or unidentifiable cause
• Failed medication, e.g. >1 week of topical corticosteroid use
• Always consider meningitis / septicaemia

Question 4

What are the three main treatments advised for eczema and dermatitis ?

Answer 4

1) Emollients are the mainstay of treatment – they soothe the skin and can form a waterproof barrier to prevent drying
- May be applied to soothe the skin or used as soaps or bath additives
2) Topical corticosteroids, e.g. hydrocortisone 1% w/v, are available as P medicines. More potent corticosteroids are also available
3) Antipruritics to prevent itching are also available but generally not recommended

Question 5

What can be used to treat mild psoriasis ?

Answer 5

Typically topical agents
- Emollients
- Coal tar preparations
- Dithranol and salicylic acid
- Topical corticosteroids

Or phototherapy is an option for treatment

Question 6

List the 4 main fungal skin infections ….

Answer 6

1) Ringworm is a fungal infection thatpresents as a circular rash
- Spread by person-person / person-animal contact
2) Ringworm of the scalp is rare andshould be referred
3) Fungal nail infections should be referred as system antibiotics usuallyrequired
4) Athlete’s foot is a fungal foot infectionusually spread by person-person contact or from shared towels, changing rooms etc.

Question 7

When do you refer someone with a fungal skin infection ?

Answer 7

• Treatment failure (>2 weeks)
• Bacterial infection
• Diabetic patients (especially to do with infections surrounding nails)
• Involvement of the nail

Question 8

When do you refer a patient with herpes ?

Answer 8

• Eyes / genital regions affected
• Age of patient? (Zovirax® cream has no age restrictions)
• Painless, in the mouth or lasting >2 weeks
• Immunocompromised

Question 9

What is acne vulgaris ?

Answer 9

Common acne

Question 10

When do you refer a patient with acne ?

Answer 10

• Severe acne
• Treatment failure
• Suspected ADR
• ABCDE concerns
• Causing mental health issues

Question 11

When would you refer someone with scabies ?

Answer 11

• Age: young children and elderly
• Outbreaks suspected, e.g. in a school
• Crusted scabies (hyper-infection with mites)
• Infected rash
• Treatment failure
• Acquired through sexual activity?

Question 12

What are red flags in regards to skin infections ?

Answer 12

• Skin cancer (ABCDE)
• Meningitis – petechial rash
• Erythroderma (>90% of skin affected)
• Bullous disorders
  -Suspected ADR