Unit 4 Flashcards
What is candidiasis?
Infections caused by Candida yeast, mainly Candida albicans.
What are common types of candidiasis?
Oral Thrush (white patches in mouth), Angular Cheilitis (cracks at mouth corners), Intertrigo (rash in skin folds), Vulvovaginal Candidiasis (vaginal yeast infection).
What causes oral thrush?
Damaged mucosal barrier or weakened immunity.
What are the symptoms of oral thrush?
White/yellow plaques on cheeks, gums, tongue.
How is oral thrush treated?
Miconazole Gel (2.5 ml, hold in mouth for 7 days + 1 extra week after symptoms resolve).
What is a key caution when using miconazole gel?
Avoid if taking warfarin (increased bleeding risk).
What advice should be given to oral thrush patients?
Rinse mouth after steroid inhalers; clean dentures regularly.
What is intertrigo?
Inflamed, itchy rash in skin folds (armpits, fingers, under breasts).
How is intertrigo treated?
Topical imidazoles (e.g., miconazole); avoid terbinafine (not OTC licensed for yeast infections).
What causes vulvovaginal candidiasis (vaginal thrush)?
Candida albicans, triggered by hormonal changes, diabetes, antibiotics, or immunosuppression.
“Thrush LOVES HDAI → Hormones, Diabetes, Antibiotics, Immunosuppression.
What are the symptoms of vaginal thrush?
Itching, soreness, white ‘cheese-like’ discharge.
How do you differentiate vaginal thrush from bacterial vaginosis?
Thrush: Itching + white ‘cheese-like’ discharge. BV: No itching, malodorous discharge.
What are the treatments for vaginal thrush?
Topical azoles (creams/pessaries) OR Oral fluconazole (150 mg, single dose for women 16-60).
How is thrush treated during pregnancy?
Topical azoles (NO oral fluconazole); refer to GP.
What are symptoms of thrush in men?
Irritation, burning, white discharge at penis head.
How is thrush treated in men?
Topical azoles; recommend condom use if partner is infected.
What are the common types of bacterial skin infections?
Cellulitis and impetigo. Non-OTC-treatable cases should be referred to a GP.
What is the difference between erysipelas and cellulitis?
Erysipelas affects the upper dermis and is usually caused by Streptococcus pyogenes, while cellulitis is a deeper tissue infection caused by various bacteria.
What are the characteristics of erysipelas?
Erysipelas affects the upper dermis, usually caused by Streptococcus pyogenes.
What are the characteristics of cellulitis?
Cellulitis is a deeper tissue infection caused by various bacteria, typically affecting the skin and subcutaneous tissue.
What are the risk factors for developing erysipelas or cellulitis?
Skin breaks, wounds, venous disease, immunodeficiency.
What are the symptoms of erysipelas or cellulitis?
Rapid onset with red, hot, swollen limbs, fever; often affects the lower limbs.
What complications can arise from untreated erysipelas or cellulitis?
Can lead to abscesses, gangrene, chronic swelling, and severe infections.
How are mild bacterial skin infections managed?
Rest, elevate limb, use analgesics like paracetamol or ibuprofen.
How are severe bacterial skin infections managed?
Oral antibiotics; IV antibiotics may be needed in severe cases.
What is the prognosis for bacterial skin infections if treated appropriately?
Generally excellent if uncomplicated.
What advice should be given to patients to prevent bacterial skin infections?
Treat skin conditions (e.g., athlete’s foot), clean wounds, elevate leg to reduce swelling, and use emollients to prevent dry skin.
What bacteria causes impetigo?
Caused by Staphylococcus aureus or Streptococcus pyogenes; highly contagious.
What are the risk factors for impetigo?
Poor hygiene, skin trauma, eczema.
What are the symptoms of impetigo?
Pink macules that evolve into vesicles with ‘honey-colored’ crust, often on the face.
How is localized impetigo managed?
Topical antibiotics for localized cases.
How is widespread impetigo managed?
Oral antibiotics for widespread cases.
What hygiene practices should be followed for impetigo?
Wash the affected area with soap to prevent the spread of the infection.
What are the common causes of viral skin infections (exanthema)?
Measles, Rubella, Fifth disease, Hand/foot/mouth disease, Chickenpox.
What are the common viruses that cause viral skin infections?
Varicella zoster (chickenpox), Herpes simplex, HPV.
How is chickenpox (Varicella Zoster) transmitted?
Airborne and contact transmission; highly infectious.
What are the symptoms of chickenpox (Varicella Zoster)?
Fever followed by a rash (papules, vesicles, crusts), mainly on the face and trunk.
How is chickenpox managed?
Symptomatic relief with antihistamines and paracetamol.
What precautions should be taken for chickenpox?
Avoid pregnant women, young children, and immunocompromised individuals.
What is the treatment for severe chickenpox cases?
Oral acyclovir for adults at high risk.
What does NICE guidance say about managing chickenpox?
Avoid NSAIDs due to the risk of necrotizing infections.
What causes herpes zoster (shingles)?
Reactivation of the chickenpox virus, usually in adults over 50.
What are the symptoms of herpes zoster (shingles)?
Painful rash along dermatomes; vesicles that crust over in 7-10 days.
How is herpes zoster (shingles) managed?
Oral antivirals for adults over 50 or with severe cases.
What is Post-Herpetic Neuralgia (PHN)?
PHN is pain that persists for months or years after the shingles rash has healed. Treatment includes amitriptyline, gabapentin, or capsaicin.
How is herpes simplex virus (HSV-1) transmitted?
Direct contact; commonly causes cold sores.
What are the symptoms of herpes simplex virus (HSV-1)?
Prodrome of burning or itching, followed by lesion appearance, typically resolving within 10-14 days.
How is herpes simplex virus (HSV-1) managed?
Analgesics for pain relief; topical antivirals are effective only during the prodrome phase.
What advice should be given to patients with herpes simplex virus (HSV-1)?
Avoid lesion contact, practice good hand hygiene, and limit triggers such as UV exposure and stress.
How is HPV (Human Papillomavirus) transmitted?
Contact with an infected person or contaminated surfaces.
What types of warts are caused by HPV?
Common warts (asymptomatic, can appear anywhere), plantar warts (painful with lateral pressure, typically on feet).
How is HPV (warts) treated with salicylic acid?
Apply salicylic acid daily for up to 12 weeks; debride the area and protect surrounding skin.
How is HPV (warts) treated with cryotherapy?
Cryotherapy with liquid nitrogen every two weeks; avoid in young children.
What types of damage can insect bites & stings cause?
Mechanical, Allergic, and Infective damage.
What are common insects responsible for bites?
Blood-sucking insects (mosquitos, ticks).
What are the three types of lice?
Head lice, body lice, pubic lice.
What is the prevalence of head lice?
Affects 4-22% of children, mostly ages 4-11.
How is head lice transmitted?
Head-to-head contact; lice survive 1-2 days off the host.
What are the symptoms of head lice?
Often asymptomatic; pruritus (itching) from bites/saliva.
How is head lice diagnosed?
Confirm live lice presence.
How is head lice treated?
Non-Chemical: Wet/dry combing with detection comb. Chemical: Malathion 0.5% (12h, repeat in 7 days), Dimethicone 4% (8h, repeat in 7 days).
What post-treatment advice should be given for head lice?
Check for lice on days 3 and 7. Prevent recurrence with regular combing; avoid prophylactic insecticides.
What are the two types of insect bites & stings?
Stinging insects: Bees (stinger stays), Wasps/Hornets (multiple stings). Biting insects: Mosquitos, fleas, ticks (saliva causes inflammation).
What are the symptoms of insect bites?
Itchy, erythematous papules.
What are the symptoms of insect stings?
Immediate pain, vasodilation, swelling, erythema.
What are systemic reactions to bites/stings?
Delayed or immediate hypersensitivity (e.g., wheals, anaphylaxis).
How should insect stings be managed immediately?
Remove bee stinger (scrape sideways), apply cold packs, use antihistamines.
How should severe insect sting reactions be managed?
Watch for anaphylaxis signs (breathing issues, facial swelling), use adrenaline auto-injector if needed.
How should localized insect bite/sting reactions be treated?
Oral analgesics (pain relief), topical antihistamines/steroids (itch relief), crotamiton/calamine for soothing.
What is a complication of untreated insect bites?
Secondary infection (often Staphylococcus aureus), may require antibiotics.
What advice should patients follow for insect stings?
Scrape bee stingers sideways, wear protective clothing, avoid bright colors, perfumes, be cautious when eating outdoors.
What are systemic effects of stings?
Anaphylaxis risk (bee, wasp, hornet stings).
What are symptoms of anaphylaxis?
Urticaria, angioedema, bronchospasm, possible unconsciousness.
How is anaphylaxis treated?
Adrenaline auto-injector, seek immediate medical care.
What is osteoarthritis (OA)?
OA is a joint disorder caused by cartilage loss, bone remodeling, and inflammation. It mainly affects the knees, hips, and hands, especially in older adults.
What are the major risk factors for OA?
- Genetic (no specific genes identified) 2. Occupational (kneeling, squatting jobs e.g., construction) 3. Obesity (worsens OA, especially in knees/hands) 4. Joint Injury (previous injuries increase risk).
What are the symptoms of knee OA?
Pain while walking, stiffness after sitting, swelling, and muscle weakness.
What are the symptoms of hip OA?
Pain while walking and at night; may require hip replacement.
What are the symptoms of hand OA?
Common in women (~50 years old), stiffness, and knuckle bony growths.
What are the symptoms of foot/ankle OA?
Big toe OA is common; managed with orthotics or surgery.
What are the symptoms of shoulder OA?
Rare, usually post-injury, managed with NSAIDs.
What are the symptoms of spinal OA?
Disc degeneration → back pain; treated with pain relief, exercise, steroid injections.
What happens in the disease process of OA?
Cartilage degeneration → Inflammation in ligaments & bones → Bone spurs form (not always painful).
What are the clinical features of OA?
Symptoms: Stiffness, fatigue, weakness, joint pain, swelling, joint deformity. Signs: Discomfort, limited motion, reduced stamina, swelling, warmth, tenderness, abnormal posture/gait, crepitation.
What are the key self-management strategies for OA?
Exercise (strengthening & aerobic), weight loss, proper footwear for lower limb OA.
What is the first-line pharmacological treatment for OA?
Topical NSAIDs are first-line. Oral NSAIDs if needed (monitor toxicity, use gastroprotection).
What are other pharmacological options for OA?
Paracetamol or weak opioids for short-term use.
Why should caution be taken with glucosamine & strong opioids in OA?
Limited evidence & risk of side effects.
What should be ruled out when assessing low back pain & sciatica?
Rule out cancer, infection, trauma, spondyloarthritis, and refer to NICE guidelines for serious conditions.
What are the two risk categories for low back pain and sciatica?
Low-risk: Reassurance, activity advice, self-management. High-risk: Intensive support (exercise, therapy).
When should imaging be used in low back pain & sciatica?
Imaging should be avoided unless the management plan will change based on the results.
What are the key elements of self-management for low back pain?
Tailored advice and staying active.
What types of exercise are recommended for low back pain & sciatica?
Group exercise such as bio-mechanical, aerobic, and mind-body exercises based on individual needs.
What orthotic treatments should be avoided for low back pain?
Avoid belts, corsets, or rocker shoes.
What is the role of manual therapy in low back pain management?
Avoid traction; it should be used as part of a broader treatment plan.
Should acupuncture and electro-therapies be offered for low back pain?
No, acupuncture and electro-therapies should not be offered.
What psychological therapy should be considered for low back pain?
Consider CBT-based (Cognitive Behavioral Therapy) therapy.
What should be encouraged for patients with low back pain in terms of work?
Encourage return to normal activities and work.
Which medications should be avoided in sciatica treatment?
Gabapentinoids, anti-epileptics, corticosteroids, benzodiazepines, opioids.
How should NSAIDs be used in the management of sciatica?
Use NSAIDs cautiously at the lowest effective dose and consider gastroprotective treatment.
How should NSAIDs be used in low back pain management?
Use NSAIDs cautiously, with monitoring for potential risks.
What is the recommendation for opioid use in low back pain?
Weak opioids can be used for acute pain; avoid them for chronic pain management.
Which medications should be avoided for low back pain?
Avoid paracetamol alone, opioids, antidepressants, and gabapentinoids.
What is the recommendation regarding spinal injections for low back pain?
Spinal injections should be avoided for low back pain.
siatica we can give epidural inj or cortio
What invasive treatment can be considered if non-surgical treatments fail for low back pain or sciatica?
Radiofrequency denervation can be considered if non-surgical treatments fail.
When should epidural injections be considered for sciatica?
Epidural injections should be considered for acute severe sciatica but avoided for neurogenic claudication.
What is the consideration for surgical intervention in sciatica?
Do not consider BMI, smoking, or psychological distress as barriers to surgery.
What is the recommendation for spinal decompression surgery?
Consider spinal decompression surgery if non-surgical treatments fail.
When should spinal fusion or disc replacement be considered?
Spinal fusion or disc replacement should be avoided unless part of a trial.
What is non-specific low back pain?
Non-specific low back pain is mechanical, musculoskeletal pain without a serious underlying cause.
What is sciatica?
Sciatica refers to leg pain caused by issues with the lumbosacral nerve roots.
What medications are being reviewed for the treatment of sciatica?
Gabapentin and pregabalin are under review for treating sciatica.
What is atopic eczema (AE)?
A chronic inflammatory skin condition caused by genetic predisposition, affecting the skin, gut, sinuses, and airways.
What are the key symptoms of AE?
Dry skin, itching, redness, and inflammation.
What are the key symptoms of AE?
Dry, cracked, scaly, and itchy skin. Most important feature is ITCHINESS – if there’s no itch, it’s unlikely to be eczema.
What causes AE?
Altered skin barrier function & immune dysregulation → skin loses water, leading to dryness and irritation.
Why does scratching worsen AE?
Scratching damages the skin → releases inflammatory cytokines → worsens itch → more scratching (itch-scratch cycle).
How do emollients help treat AE?
Create a protective layer to prevent water loss, improve hydration, and block allergens/irritants.
What do humectants in emollients do?
They are hygroscopic, meaning they attract & retain water in the skin.
How often should emollients be applied?
Several times a day, immediately after bathing, and on the whole body (not just affected areas).
How much emollient should be prescribed?
1–1.2 kg per month.
When should topical steroids be applied in relation to emollients?
NICE: Apply emollient 30 minutes BEFORE the steroid.
What advice should be given to patients using emollients?
- Avoid soaps & detergents 2. Use frequently, even when skin looks normal 3. Pat skin dry after bathing (don’t rub) 4. Apply by dotting & stroking downwards 5. Use a pump dispenser (avoid hand contamination in tubs).
What determines the potency of a topical steroid?
The steroid molecule itself, its physicochemical properties, and formulation.
Does a higher concentration always mean higher potency?
No!.
How do topical steroids work?
Bind to glucocorticoid receptors in keratinocytes & fibroblasts → suppress pro-inflammatory agents, reduce Langerhans cells, block vasodilators (e.g., histamine & bradykinin).
What are the four main effects of topical steroids?
- Anti-inflammatory 2. Immunosuppressive 3. Anti-proliferative 4. Vasoconstrictive
Which topical steroid potency is used for mild eczema?
Mild potency steroid.
Which potency is used for moderate eczema?
Moderate potency steroid.
Which potency is used for severe eczema?
Potent steroid.
Which potency is used for facial, genital, or axilla eczema?
Start with mild potency; increase if necessary.
How does eczema become infected?
Persistent scratching damages the skin barrier, allowing bacteria (mainly Staphylococcus aureus) to infect the skin.
What are common signs of infected eczema?
Red, angry, weepy skin with yellow crusts; pustules & papules; fever & malaise; itchy, hot, sore skin.
What antibiotic is used for infected eczema?
Flucloxacillin for up to 2 weeks.
What are calcineurin inhibitors?
Second-line treatments for eczema that suppress the immune system by blocking calcineurin, which activates T-cells.
What are the two available calcineurin inhibitors?
Tacrolimus (Protopic) & Pimecrolimus (Elidel).
How do calcineurin inhibitors work?
Bind to calcineurin proteins → prevent T-cell activation → reduce pro-inflammatory cytokines.
What are oral treatments for eczema?
Ciclosporin, Azathioprine, Oral Corticosteroids, Mycophenolate Mofetil, Methotrexate.
Why can’t oral immunosuppressants be used long term?
Risk of serious side effects (e.g., infections, organ toxicity, immune suppression).
How does phototherapy work for eczema?
Alters cytokine production, kills infiltrating T-cells, inhibits antigen-presenting Langerhans cells, and thickens the epidermis to block allergens.
When is UV light therapy used?
Second-line treatment when topical agents don’t work. Can be used alone or with oral treatments.
Which biologic agent is licensed for moderate-to-severe AE?
Dupilumab (used for both eczema & psoriasis).
What is irritant contact dermatitis (ICD)?
Skin damage from chemical/physical agents (e.g., solvents, detergents) faster than the skin can repair.
Who is commonly affected by irritant contact dermatitis?
Occupational exposure (e.g., cleaners, hairdressers), young children (dribble rash), babies (nappy rash).
Where does irritant contact dermatitis commonly appear?
Hands.
What are symptoms of irritant contact dermatitis?
Inflamed skin, blisters, scaling.
How is irritant contact dermatitis managed?
Avoidance of irritant (e.g., gloves), emollients, topical steroids. May take up to 12 weeks to heal.
What is allergic contact dermatitis (ACD)?
Delayed allergic reaction (48-72 hours) to specific allergens like nickel, watch straps, perfumes.
What is the management of allergic contact dermatitis?
Avoid allergen, use emollients & topical steroids. If cause is unknown, refer for a patch test.
Why is dermatology more complex in darker skin tones?
Inflammatory changes are less obvious and may appear dark purple or hyperpigmented.
How does the skin barrier differ by ethnicity?
Black skin has more corneocyte layers but less lipid content (prone to dryness).
What are useful dermatology resources for skin of color?
Brown Skin Matters & Skin of Colour Society.
What is urticaria?
Allergy rash (‘hives’)—itchy, blotchy, raised rash due to mast cell activation & histamine release.
What chemicals cause swelling in urticaria?
Histamine, bradykinin, leukotrienes, prostaglandins.
What are causes of acute urticaria?
Food allergies, insect bites, stings, NSAIDs, viral infections, physical stimuli (pressure, cold, heat, sun exposure).
How is urticaria managed?
Avoid triggers, use non-sedating antihistamines, and topical therapies like calamine.
What is acne vulgaris?
A disease of the pilosebaceous follicle, mainly affecting the T-zone, chest, and back.
What are the 4 stages of acne development?
- Release of inflammatory agents 2. Increased androgen-driven sebum production 3. Abnormal keratinocyte proliferation & blockage 4. Proliferation of Cutibacterium acnes.
What is a microcomedone?
A blocked follicle, the earliest acne lesion.
How do comedones form?
Blackheads (open comedones) form when blockage is near the surface (melanin oxidation). Whiteheads (closed comedones) form deeper due to pressure buildup.
What are different acne lesions & their features?
Papules = Small, red, tender. Pustules = Papules with pus. Nodules = Deep, solid, painful. Cysts = Nodules filled with pus.
Which acne lesions cause scarring?
Nodules & cysts.
When should acne be referred to a GP?
If acne affects the chest or back (topicals harder to apply).
What is the first-line OTC treatment for acne?
Benzoyl peroxide.
How does benzoyl peroxide work?
Bactericidal against C. acnes, reduces inflammation, targets comedones.
How does nicotinamide help acne?
Vitamin B3 derivative, reduces inflammation & sebum production.
What is the function of salicylic acid?
Keratolytic action—breaks down comedones.
How long should acne treatment be continued before switching?
At least 6 weeks.
What are dietary triggers for acne?
Greasy food, dairy, chocolate.
How does stress worsen acne?
Sebaceous glands are influenced by corticotropin-releasing hormone (CRH), increasing oil production.
Should acne patients pick or squeeze spots?
No, increases scarring risk.
How to reduce irritation from topical treatments?
Short contact therapy—start with 15 min application, wash off, then gradually increase. Use every other day if irritation occurs.
What is the benzoyl peroxide warning for patients?
Can bleach clothes & pillows.
What are the best formulations for different skin types?
Gels = Oily skin. Creams/Lotions = Dry/sensitive skin.
What does ‘comedogenic’ mean?
Causes acne (e.g., some moisturizers).
Should moisturizers be used in acne?
Yes, to prevent dryness from treatments—apply after topicals.
What are the 3 main oranism causes of superficial fungal infections?
- Dermatophytes (keratinised areas: skin, hair, nails) 2. Candidiasis (yeast: mouth, vagina, GI) 3. Malassezia (lipid-dependent, in oily skin areas).
How do dermatophytes grow?
They need keratin & release keratinase, staying confined to the epidermis.
What are key risk factors for dermatophyte infections?
Moist/damaged skin, warm/humid environments.
How are dermatophyte infections transmitted?
Direct or indirect contact.
What are the clinical forms of tinea?
- Tinea Corporis (ringworm): Red, scaly patch with central clearing 2. Jock itch (Tinea Cruris): Red, scaly rash in the groin 3. Athlete’s Foot (Tinea Pedis): Moist, peeling skin between toes.
What is a major risk of athlete’s foot?
Bacterial infection (e.g., cellulitis) due to cracked skin.
What are pharmacy treatments for fungal skin infections?
- Imidazoles (e.g., clotrimazole) – Fungistatic, disrupts fungal membranes. 2. Allylamines (e.g., terbinafine) – Fungicidal, shorter treatment.
What are combination products for fungal infections with inflammation?
Daktacort®, Canesten HC® (max 7 days OTC use).
How long should topical antifungals be used?
- Imidazoles: 2-6 weeks, continue 1 week after symptom resolution. - Terbinafine: 1–2 weeks (body/groin), 7 days (feet).
How should antifungals be applied?
Apply to affected area + 4-6 cm radius, on dry skin.
What are preventive measures for fungal infections?
- Use antifungal talc in shoes, rotate footwear. 2. Wear cotton socks/clothes to reduce moisture.
What is the best OTC treatment for fungal nail infections?
Amorolfine 5% (Curanail®) – applied once weekly.
How long does it take to treat fungal nails?
Fingernails: 6 months. Toenails: 9–12 months (up to 2 nails).
mild topical corticosteroids
Hydrocortisone acetate (Mild)
Fluocinolone acetonide 0.0025%
Indication: Mild eczema.
Side effects: Skin atrophy, depigmentation, vasodilation, adrenal suppression.
Calcineurin Inhibitors (Immunosuppressants for Eczema)
Tacrolimus (Protopic®) – Inhibits T-cell proliferation. Indication: Moderate-severe atopic eczema (short-term). Side effects: Infection risk, abnormal sensation, skin reactions.
Pimecrolimus (Elidel®) – Inhibits T-cell proliferation. Indication: Mild-moderate atopic eczema (short-term). Side effects: Infection risk, rare skin discoloration.
Cyclosporin – Inhibits lymphokine release. Indication: Severe atopic dermatitis (short-term). Side effects: Hypertension, tremor, nausea, vomiting, hair changes
Systemic Immunosuppressants for Severe Eczema & Psoriasis
bank roberry
Azathioprine – Metabolized to mercaptopurine. Indication: Severe refractory eczema. Side effects: Infection risk, anemia, hypersensitivity.
Methotrexate – Inhibits dihydrofolate reductase. Indication: Severe psoriasis. Side effects: Infections, diarrhea, GI & hepatic issues.
Mycophenolate – Inhibits inosine monophosphate dehydrogenase. Indication: Severe refractory eczema (Unlicensed use). Side effects: Infection risk, acidosis, alopecia, tachycardia.
Dupilumab – Inhibits IL-4 & IL-13 signaling. Indication: Moderate-severe atopic eczema. Side effects: Arthralgia, dry eye, eosinophilia, eye inflammation, oral herpes.
Antibiotic for Skin Infections
Flucloxacillin – Interferes with bacterial cell wall synthesis. Indication: Secondary bacterial infection of eczema. Side effects: Diarrhea, nausea, hypersensitivity.
Antihistamines (For Allergies, Urticaria, Atopic Dermatitis)
Loratadine – Non-sedating H1 antagonist. Indication: Hay fever, urticaria. Side effects: Drowsiness, nervousness (children).
Cetirizine – Non-sedating H1 antagonist. Indication: Hay fever, urticaria, atopic dermatitis. Side effects: Headache, dry mouth, nausea (rarely agitation).
Acne & Skin Conditions drugs
Benzoyl peroxide (BPO) – Breaks down comedones, bactericidal. Indication: Acne vulgaris. Side effects: Dryness, redness, peeling, burning.
Salicylic Acid – Softens keratin. Indication: Warts. Side effects: Skin irritation.
antifungals drugs
Antifungals
Miconazole – Inhibits fungal membrane synthesis. Indication: Fungal skin infections, oral candidiasis. Side effects: Dry mouth, nausea, vomiting.
Fluconazole – Inhibits fungal cell growth. Indication: Vaginal/mucosal candidiasis, tinea. Side effects: GI discomfort, nausea, headache, skin reactions.
Terbinafine – Inhibits squalene epoxidase → fungal cell death. Indication: Dermatophyte infections (nails, tinea). Side effects: GI discomfort, headache, myalgia.
moderate steroids
Clobetasone (Moderate)
betamethasone RD
Indication: Eczemas & dermatitis of all types.
Side effects: Skin atrophy, depigmentation, vasodilation, adrenal suppression.
potent steroids
Hydrocortisone butyrate (Potent)
Indication: Severe inflammatory skin disorders (e.g., severe eczema, psoriasis).
Side effects: Skin atrophy, depigmentation, vasodilation, adrenal suppression.
Betamethasone (Potent)
Indication: Severe inflammatory skin conditions.
Side effects: Skin atrophy, depigmentation, vasodilation, adrenal suppression.
v potent steroids
Clobetasol (Very potent)
Indication: Recalcitrant eczema, psoriasis (short-term use).
Side effects: Skin atrophy, depigmentation, vasodilation, adrenal suppression.
Diflucortolone (Very potent, discontinued)
calamine mechanism
Calamine – Anti-pruritic. Indication: Minor skin conditions. Side effects: Occasional irritation.
