TreatmentBugsWarts

Question 1

Lice treatment 2years +

Answer 1

Over-the-counter pyrethrins (natural botanical)

Question 2

Use of OTC pyrethrins and risks

Answer 2

Topically to clean, dry hair for 10 minutes.
Pediculocidal. Re-treat at day 9. Or consider treatment on days 0,7 and 14.
Risks:
Potential allergic reaction in patients sensitive to chrysanthemums and ragweed.
+ Resistance

Question 3

Lice tx 2 months +

Answer 3

Permethrin 1% lotion

synthetic pyrethroid

Question 4

Use and risks of Permethrin 1% lotion

synthetic pyrethroid

Answer 4

Topically to clean, dry hair for 10 minutes.
Pediculocidal. Re-treat at day 9. Or consider treatment on days 0,7 and 14.
Risks:
+ Resistance

Question 5

Lice tx 6 years+

Answer 5

Malathion 0.5% lotion

prescription

Question 6

Use and risks of Malathion 0.5% lotion

prescription

Answer 6

Topically to clean, dry hair for 8-12 hours.
Pediculocidal AND ovicidal. A single application is usually effective. Reapply at day 9 if live lice are seen.
Risks:
alcohol base is flammable (avoid heat sources during use).
+ Resistance (UK formulation, less so in the US).

Question 7

Lice tx 6 months +

Answer 7

Benzyl alcohol 5%

prescription

Question 8

Use and risks of Benzyl alcohol 5%

prescription

Answer 8

Topically to clean, dry hair for 10 minutes.
Pediculocidal. Re-treat at day 9. Or consider treatment on days 0,7 and 14.
Risks:
-

Question 9

Scabies 1st line tx for pts over 2 months old (pregnancy cat B)

Answer 9

5% permethrin cream

Question 10

5% permethrin cream use and risks/ side effects

Answer 10

scabies tx
Topically overnight on days 0 and 7. Apply from neck down. Include scalp and face in infants and elderly. 
Risks:
Low systemic absorption, ~2%. 
May burn or sting on application.

Question 11

Scabies tx for children under 2 months old, safe in pregnancy

Answer 11

5-10% precipitated sulfur

Question 12

5-10% precipitated sulfur use and risks

Answer 12

Scabies tx
Apply overnight for three days, then wash off
Risks:
Greasy, strong odor, stains clothing

Question 13

Scabies tx most useful for immunocompromised pts

Answer 13

Oral ivermectin

Question 14

Oral ivermectin use and risks

Answer 14

Scabies tx
200mcg/kg by mouth, repeat dose two weeks later
Risks
Generally well-tolerated. May cause pruritus and rash. CNS toxicity is possible.
Pregnancy category C (generally not recommended in pregnancy). Safety data not established in children who weigh <33 lbs (15kg).

Question 15

wart treatment primarily irritating or destructive

Answer 15

Cryotherapy*
Salicyclic acid*
Tretinoin cream
Shave removal
Adhesive tape
Lasers
*= very common therapy, DCNB = dinitrochlorobenzene, IL=intralesional

Question 16

wart treatment orimarily immune-stimulating

Answer 16

Imiquimod
Candida antigen (IL)
Immunotherapy: Squaric acid or DCNB

Question 17

1st line tx for warts few on hands and foot

Answer 17

Cryotherapy
Salicylic acid
Adhesive tape
Laser

Question 18

1st line tx for warts many on hands and foot

Answer 18

Salicylic acid
Cryotherapy
Squaric acid or DNCB
Laser

Question 19

1st line tx for warts few on face

Answer 19

Cryotherapy

Shave (surgical) removal

Question 20

1st line tx for warts many on face

Answer 20

Cryotherapy

Tretinoin cream

Question 21

1st line tx for warts few on other sites on the body

Answer 21

Cryotherapy

Salicylic acid

Question 22

1st line tx for warts many on other sites on the body

Answer 22

Imiquimod
Tretinoin cream
Squaric acid or DCNB