Treatments/Management For Stuff Flashcards
Staphylococcal scaled skin syndrome
- IV flucloxacillin (inhibits toxin synthesis) and topical fusidic acid (steroid antibiotic)
- Supportive care: fluid replacement, pain management, wound care
Psoriasis of the scalp
3% salicylic acid cream and tar-containing shampoo
Arterial ulcer
Reducing modifiable risks e.g. treating hypertension, prescribe a statin and an antiplatelet
Pyoderma gangrenosum
- Topical or systemic steroids
Plaque psoriasis
Potent topical corticosteroid + topical vitamin D
Pityriasis Roasea
Self-limiting- no treatment
But if it is itchy - Antihistamine, emollients, topical steroids
Erythema Nodosum
- NSAID to alleviate pain and inflammation
- Rest and leg elevation
- Potassium iodide or Colchicine - severe cases
- Corticosteroids used sparingly and reserved for severe, refractory cases
Pyoderma gangrenosum
- Systemic immunosuppression: high-dose oral corticosteroids (e.g. prednisolone) or other (e.g. cyclosporin, azathropine)
- Topical wound care
- Treat underlying cause e.g. IBD, RA or haematological malignancies (underlying inflammatory diseases)
- Pain management i.e. analgesia
Dermatofibroma
- Observation
- Surgical Excision: If necessary for cosmetic or symptomatic reasons. This is often performed by a dermatologist or dermatologic surgeon
- Cryotherapy: Freezing the dermatofibroma with liquid nitrogen
- Laser Therapy: minimize scarring
Scabies
- Topical permethrin 5%
- Crotamiton cream: to relieve the itching
- Malathion 0.5% should be used 2nd line as there is limited evidence for its effectiveness
- all contacts, included members from the same household, are treated on the same day
Folliculitis
- Topical antibiotics, with a suggested addition of antibacterial soaps (e.g. chlorhexidine-containing solutions like Hibiscrub).
- Oral antibiotics may also be required in more severe cases or cases that don’t respond to topical treatments.
- Special variants, such as Gram-negative folliculitis following prolonged antibiotic therapy for acne, or hot tub folliculitis (caused by Pseudomonas), may necessitate a different approach, tailored to the specific situation.
Vitiligo
Conservative measures:
- Avoidance of trauma.
- Use of cosmetic camouflage techniques.
- Sun-protection due to increased risk of sun-damage and spreading of vitiligo.
Pharmacological:
- Topical therapies e.g. steroids, calcineurin inhibitors, and janus kinase inhibitors.
- Phototherapy options e.g. narrow band UV-B and psoralen plus ultraviolet A (PUVA).
- Systemic treatments like oral steroids, methotrexate, ciclosporin, and mycophenolate may also be used.
Depigmentation therapy, which includes: cryotherapy, laser, or monobenzyl/hydroquinone, may be considered in severely affected dark-skinned individuals.
Steven Johnson Syndrome (SJS)
Mostly Supportive:
- Skin care and prevention of ocular complications
- Hospitilisation for fluid and electrolyte management
- Analgesia
- Treat any secondary infections
Dermatomyositosis
Immunosuppressive therapy:
First-line treatment - Oral Corticosteroids: managing symptoms and inflammation.
- Malignancy Screening: Dermatomyositis can be a para-neoplastic phenomenon, hence screening for underlying malignancy forms a crucial part of the management strategy.
Arterial ulcers
Address underlying condition to promote wound healing and improve arterial circulation
- lifestyle changes
- Medications i.e. antiplatelets (aspirin or clopidogrel), statins, antihypertensives
- Surgical interventions if severe i.e. angioplasty or bypass grafting
NOTE: compression socks contraindicated = worsen ischemia
