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MPharm 2 - PH2107 > Unit 2 - Dermatology 1 > Flashcards

Unit 2 - Dermatology 1 Flashcards

1
Q

What type of acne can be managed by the pharmacist?

A

Mild acne

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2
Q

What type of acne should be referred to the GP?

A

Moderate to severe acne

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3
Q

What will the treatment of acne be dictated by?

A

The type of lesions

  • inflammatory
  • non-inflammatory
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4
Q

What are the BNF treatments for acne?

A 
Topical benzoyl peroxide / azelaic acid
Topical antibacterials
- clindamycin
- erythromycin
Topical retinoids
- adapalene
- tretinoin
- isotretinoin
Oral antibiotics
- oxytetracycline
Oral anti-androgens
- co-cyprindiol
Oral retinoids
- isotretoin
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5
Q

What are the BNF treatments for eczema?

A 
Emollients - mainstay of treatment
Topical corticosteroids
Topical calcineurin inhibitors
- pimecrolimus cream
- tacrolimus ointment
Oral immunomodulation
- ciclosporin
- azathioprine (unlicensed)
- systemic corticosteroids
Miscellaneous
- wrapping
- sometimes coal tar
- alitretinoin (severe chronic hand eczema (NICE))
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6
Q

How is clear eczema treated?

A

Emollients

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7
Q

How is mild eczema treated?

A

Emollients

Mild topical corticosteroids

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8
Q

How is moderate eczema treated?

A 
Emollients
Topical corticosteroids
- moderate body vs mild face/neck
Topical calcineurin inhibitors (pimecrolimus)
- body vs face/neck
Bandages
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9
Q

How is severe eczema treated?

A 
Emollients
Topical corticosteroids
- potent body vs moderate face/neck
Topical tacrolimus
Bandages
Phototherapy
Systemic therapy
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10
Q

What can be used to treat concurrent skin infections?

A

Topical antibacterials
Topical antibacterias in emollients
Topical antibiotics?
Oral antibiotics?

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11
Q

What is seborrhoeic eczema?

A

Common pattern of scaly eruption on scalp and around eyebrows, nose and ears

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12
Q

Which sex has a higher incidence of seborrhoeic eczema?

A

Adult form more common in males

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13
Q

When does seborrhoeic eczema usually first appear?

A

Puberty

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14
Q

What can seborrhoeic eczema resemble?

A

Dandruff

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15
Q

What can cause seborrhoeic eczema?

A

Pityrosporum ovale (yeast)

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16
Q

What should a pharmacist do with a patient if they suspect seborrhoeic eczema?

A

Refer to the GP

17
Q

What can be used to treat seborrhoeic eczema?

A

Antifungal creams/shampoos

Mild corticosteroids

18
Q

Describe discoid eczema

A

Well defined coin-like lesions
Scaly plaques
Very itchy

19
Q

Who is more likely to suffer from discoid eczema?

A

Middle aged men

20
Q

What should a pharmacist do with a patient if they suspect discoid eczema?

A

Refer to GP

21
Q

What can be used to treat discoid eczema?

A

Topical corticosteroids

22
Q

Describe pompholyx

A

Localised to palms of hands and soles of feet
Vesicles and blisters
Symmetrical presentation

23
Q

What should a pharmacist do with a patient if they suspect pompholyx?

A

Refer to GP

24
Q

What can be used to treat pompholyx?

A

Topical corticosteroids (moderate potency)

25
Q

Describe psoriasis

A 
Chronic inflammatory skin condition
Affects 2-3% of the population
80 million sufferers worldwide
Occurs commonly in second and sixth decades of life
May be a lifelong condition
Spontaneous exacerbations and remissions
26
Q

What are the six different types of psoriasis?

A
  1. Chronic plaque psoriasis (most common - > 80%)
  2. Guttate psoriasis - acute form
  3. Pustular psoriasis
  4. Erythrodermic psoriasis
  5. Flexural psoriasis
  6. Palmoplantar pustular psoriasis
27
Q

Describe chronic plaque psoriasis

A
  • well defined, thickened red, symmetrical plaques ( > 2cm)
  • silvery scales (hyperproliferation)
  • scalp, extensor of limbs (elbows, knees, shins)
  • flexures
  • hands and feet
  • itching can occur in up to 50%
  • scalp involved in 80% of cases
  • nails involved in 50% of cases
28
Q

What are the major concerns with psoriasis?

A 
Disfigurement and psychological morbidity
Significant social implications
- quality of life
- jobs
- social life
- hobbies
Infection risk
Risk of co-morbidities
- skin cancer
- cardiovascular complications
29
Q

What are the BNF treatments for psoriasis?

A 
Topical
- emollients including olive oil
- topical corticosteroids
- topical Vitamin D analogues
- coal tar
- tazarotene
- salicylic acid (scalp) often combined with coal tar
- dithranol
Phototherapy
Chemotherapy
Systemic
- methotrexate
- ciclosporin
30
Q

What is the mainstay of psoriasis treatment on the trunk and limbs?

A

Vitamin D analogues
Potent corticosteroids

Initial treatment is both treatments

  • one in morning
  • one in evening
31
Q

What is the first line treatment of psoriasis on the face, flexures, scalp and genitals?

A

Mild/moderate corticosteroid

32
Q

What is the second line treatment of psoriasis on the face, flexures, scalp and genitals?

A

Vitamin D analogues

Coal tar preparations

33
Q

What is the role of pharmacists in the treatment of psoriasis and eczema?

A

Patients are disappointed in prescribed treatments for psoriasis and eczema

  • educate on use of creams
  • be aware of side effects
  • offer practical advice
  • look out for drugs that may induce eczema/psoriasis
  • look out for drugs that may cause photosensitivity in phototherapy patients
34
Q

What is hyperhidrosis?

A

Excessive sweating from the eccrine sweat gland

35
Q

What are the issues with hyperhidrosis?

A

Significant impact on quality of life

Limited simple treatment options

36
Q

What are the treatment options for hyperhidrosis?

A 
Aluminium chloride hexhydrate
- can be purchased from the pharmacy
Glycopyrronium bromide
- outpatient appointment in combination with iontophoresis
Botulinum toxin
- outpatient appointment
- Botox only licenced brand in the UK
37
Q

Which drugs are frequently indicated in drug induced rashes?

A
  • antibiotics
  • sulphonamides
  • thiazides
  • barbiturates
  • anticonvulsants
  • salicylates
  • gold
38
Q

What types of rashes can be produced by taking medicines?

A

Toxic erythema
Urticaria (hives)
Eczematous lesions
Acneiform eruptions

39
Q

Which drugs can produce photosensitivity?

A 
Amiodorone
Tetracyclines
NSAIDs
Sulphonamides
Quinolones
Thiazides
Tricyclic antidepressants

MPharm 2 - PH2107 (26 decks)

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