Treatments

Question 1

What are ointments?

Answer 1

Suspensions or emulsions containing <20% water and volatiles but >50% hydrocarbons, waxes or polyethylene glycol

Question 2

What are pastes?

Answer 2

Stiff ointments which can be used as vehicles for insoluble powders

Question 3

What are creams?

Answer 3

Emulsion semisolids that contain >20% water and volatiles and <50% hydrocarbons, waxes or polyethylene glycol

Question 4

What are topical solutions?

Answer 4

Clear, homogeneous liquid dosage form for application to the skin

Question 5

What are topical suspensions?

Answer 5

A solid suspended in a liquid vehicle used as a liquid dosage form

Question 6

What are lotions?

Answer 6

An emulsion liquid dosage form

Question 7

What are gels?

Answer 7

Transparent semisolid emulsions that liquefy on contact with skin and dry to form a non-occlusive film

Question 8

What are foams?

Answer 8

Pressurised liquids added to a hydrocarbon propellant

Question 9

What are sprays?

Answer 9

Solution or suspension aerosols

Question 10

What is the first line treatment of psoriasis?

Answer 10

Emollient (reduce scale and itch)

Potent topical corticosteroid + topical vitamin D applied at different times

Question 11

What is the second line treatment of psoriasis?

Answer 11

Emollient (reduce scale and itch)

Stop topical corticosteroid and just apply topical vitamin D twice daily

Question 12

What is the third line treatment of psoriasis?

Answer 12

Emollient (reduce scale and itch)

Stop topical vitamin D and apply a potent topical corticosteroid twice a day

Question 13

When would coal tar preparations typically be used for psoriasis?

Answer 13

In patients with scalp psoriasis

Question 14

What are the two secondary care management options for psoriasis?

Answer 14

Phototherapy

Systemic therapy
(methotrexate or ciclosporin)

Question 15

When would UVB phototherapy be used in psoriasis patients?

Answer 15

Mainly guttate psoriasis

Also used for classic and plaque psoriasis

Question 16

What are the treatment options for seborrhoeic keratosis?

Answer 16

Cryotherapy

Curettage

Question 17

Give advantages of topical emollients?

Answer 17

Direct application

Reduced systemic effects

Question 18

Give disadvantages of topical emollients?

Answer 18

Time consuming

Messy to use, inconvenient

Correct dosing is difficult

Question 19

What are the types of topical emollients in dermatology?

Answer 19

Gels
Creams
Ointments
Pastes
Lotions
Foam

Question 20

What type of emollients have a fire risk associated with them?

Answer 20

Paraffin-based emollients

Question 21

Give some emollient application tips?

Answer 21

Apply after bathing
Apply in direction of hair growth
Be aware of slippery surfaces
Use a spatula to remove from tubs

Question 22

What are the three key actions of topical corticosteroids?

Answer 22

Vasoconstrictive

Anti-inflammatory

Antiproliferative properties

Question 23

What are topical corticosteroids used for in dermatology?

Answer 23

Eczema and psoriasis

Keloid scars
Non-infective inflammatory dermatoses (lichen planus etc)

Question 24

What can occur as a result of strong steroids / sudden steroid halting?

Answer 24

Rebound flare of disease

Note* mostly seen in psoriasis

Question 25

What is the fingertip rule?

Answer 25

One fingertip unit of topical steroid should cover the front and back of the hand Usually 1-2g

Question 26

List some side effects of topical steroids?

Answer 26

Rebound flare of disease Thinning of the skin Purpura Stretch marks Steroid rosacea Perioral dermatitis Fixed telangiectasia Tachyphylaxis Systemic absorption

Question 27

When are antiseptics used in dermatology?

Answer 27

Recurrent infection Skin cleansing Wound irrigation

Question 28

What are antibiotics used to treat in dermatology?

Answer 28

Acne and rosacea Skin infection Infected eczematous process

Question 29

What are antivirals used to treat in dermatology?

Answer 29

Herpes simplex Eczema herpeticum Herpes Zoster

Question 30

What are topical antifungals used to treat in dermatology?

Answer 30

Candida Dermatophytes Pityriasis versicolor

Question 31

Name some antipruritics?

Answer 31

Menthol Capsaicin Crotamiton Camphor / phenol

Question 32

What are keratolytics and what are they used to treat?

Answer 32

Drugs used to soften keratin Viral warts, hyperkeratotic eczema & psoriasis, corns, calluses etc.

Question 33

When area cytotoxic & antineoplastic therapies used in dermatology?

Answer 33

Solar damage Bowen's disease Superficial basal call carcinoma

Question 34

Give examples of cytotoxic & antineoplastic therapies?

Answer 34

Fluorouracil Imiquimod

Question 35

Give some side effects of topical therapies?

Answer 35

Burning and irritation Contact allergic dermatitis Local toxicity Systemic toxicity

Question 36

What are some systemic effects of topical therapies?

Answer 36

Salicylism Hypercalcaemia / hypercalciuria Suppression of pituitary - Cushingoid features

Question 37

What is used to treat actinic keratosis?

Answer 37

5-flurouracil cream

Question 38

What is used to treat bullous pemphigoid?

Answer 38

Highly potent topical steroids