Treatment Update Flashcards
1st-line treatment
Guttate Psoriasis for everyone
Heals itself over 3-4 months
1st-line treatment
Venous Leg Ulcer for everyone
Compression
1st-line treatment
Eczema Herpeticum for everyone
IV aciclovir
1st-line treatment
TEN/SJS first-line treatment for everyone
Remove medication
1st-line treatment
Erythema Multiforme for everyone
Heals itself over a few weeks
1st-line treatment
Alopecia Areata with evidence of hair regrowth first-line treatment for everyone
nothing
1st-line treatment
Alopecia Areata no hair regrowth and the person has less than 50% hair loss first-line treatment for everyone
watch and wait
1st-line treatment for
Alopecia Areata no hair regrowth and the person has more than 50% hair loss, or treatment is preferred first-line treatment for everyone
topical corticosteroid
Vitiligo 1st-line treatment for everyone
Cosmetic
SCC 1st-line treatment for everyone
Surgical Excision
Actinic Keratosis 1st-line treatment for everyone
Fluorouracil cream twice a week
Solar Keratosis 1st-line treatment for everyone
Fluorouracil cream twice a week
Seborrhoeic keratosis 1st-line treatment for everyone
Cryotherapy or curettage for warts
Malignant Melanoma 1st-line treatment for everyone
Excision Biopsy according to Breslow thickness
Bowens Disease 1st-line treatment for everyone
A single freeze-thaw cycle with liquid nitrogen for 20-30 seconds and topical fluorouracil or
Stage 0 basal cell carcinoma 1st-line treatment for everyone
imiquimod topical
Stage 1 basal cell carcinoma 1st-line treatment for everyone
excision + 1cm margin
Stage 2 basal cell carcinoma 1st-line treatment for everyone
excision + 2cm margin
rapidly developing angiodema 1st-line treatment for everyone
Give slow intravenous (IV) or intramuscular (IM) chlorphenamine and hydrocortisone
Erythroderma 1st-line treatment for everyone
Same day referral to dermatologist
Bullous Pemphigoid 1st-line treatment for everyone
referral to dermatologist + corticosteroid
Pemphigus vulgaris 1st-line treatment for everyone
No cure use corticosteroids to manage
Pemphigus foliaceus 1st-line treatment for everyone
referral to dermatologist + potent or higher strength topical steroid
Comedonal Acne first-line treatment for everyone except pregnant women
Topical Retinoid Cream such as adapalene
Comedonal Acne second-line treatment for everyone
Topical Azelaic acid Cream
1st Treatment of mild to moderate papular for all people
Topical Epiduo Gel (Adapalene + benzyl peroxide)
2nd line Treatment of mild to moderate papular for all people
Topical Duac Gel@ (clindamycin + benzyl peroxide)
3rd Line treatment if 1st and 2nd line dont work?
Add an antibiotic tablet to the topical therapy such as tetracycline: limecycline
Antibiotic tablet - limecycline max duration before you should stop
3 months
Mild moderate acne in pregnant women 1st line treatment
Topical benzyl peroxide
Severe acne in any person
Early referral to dermatologist for specialist treatment with the aim of preventing scarring
Small atrophic scars
dermal filler to lift the indentation
Keloid scars
try medical treatment first with topical steroid trial for 2 weeks
If that fails can consider laser resurfacing
Tinea corporis, fungal ringworm infection first-line treatment
First try topical antifungal agents - drugs that end with zole in this case ITRACONAZOLE or terbinafine
Tinea corporis, fungal ringworm infection back up if first line treatment fails
Oral antifungal agents such as TERBINAFINE or ITRACONAZOLE
Oral thrush first-line treatment
Nystatin
Canesten Thrush Oral 150mg capsules
Candida Oesophagitis first-line treatment
Nystatin
Herpes Zoster Shingles first-line treatment
Aciclovir
Herpes Simplex infection around the mouth first-line treatment for everyone
Start treatment ASAP with Aciclovir
Varicella-Zoster Chicken Pox first line treatment for everyone
No treatment can recommend calamine for itching
Flexural Psoriasis first-line short term treatment
Underboob
short-term use of a mild or moderate potency topical corticosteroid
Scalp Psoriasis first line treatment for everyone
tar based shampoo applied generously and left on for an hour
Flexural Psoriasis first-line long term treatment
Underboob
Calcitriol or tacalcitol
Flexural Psoriasis backup short term treatment if first line fails to work
(Underboob)
topical tacrolimus cream under specialist supervision
Erythrodermic psoriasis initial management until specialist dermatoligical assessment?
Generous quantities of emollients
Severe psoriasis that is resistant to initial topical treatments first line management?
Systemic therapy, methotrexate, ciclosporin, acitretin,
Chronic stable psoriasis being managed with emollients, other treatment measures
UVB phototherapy
Seborrhoeic dermatitis
(Eyebrow Dandruff)
(Nose dandruff)
Name 2 creams that can be used to relieve symptoms
Topical steroid cream and topical tacrolimus cream
Scabies
(Infestation by Sarcoptes scabiei mite)
Name a topical treatment and give instructions on how to use
Topical treatment
Permethrin 5% (insecticide)
- left on for 24 hours
- applied to neck down
- reapplied to hands after washing
- repeated after 1 week
Genital Warts
(HPV 6/11 infection)
Name two creams
Name a treatment option if the cream does not work
First Line Treatment
Creams
• Podophyllotoxin 0.15%
• Imiquimod 5%
Second Line Treatment
• Cryotherapy
Nec Fasc first line antibiotics after debridement
Metronidazole, Clindamycin, Tazocin, Gentamicin
NOTIFIABLE disease
Diphtheria overgrowth in the soft palate and on the skin first line treatment for this medical emergency.
If person not vaccinated advise to apply clindamycin cream to affected area. For the systemic problems including toxins give erythromycin orally
NOTIFIABLE disease
Scarlet fever first line treatment
Oral course of penicillin antibiotics or erythromycin for those with allergies
