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Self Care > Week 8: Dermatology > Flashcards

Week 8: Dermatology Flashcards

1
Q

What is atopic dermatitis?

A
  1. Most common type of eczema
  2. Pervasive inflammatory condition
  3. 80% of cases, AD classified as mild and can be created with OTC in patients older than 2 years
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2
Q

What is the hallmark symptoms of atopic dermatitis?

A

Pruritus

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3
Q

What are 3 forms of AD?

A
  1. acute
  2. subacute
  3. chronic
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4
Q

What are the viral complications of AD?

A
  1. herpes simplex
  2. molluscum contagiosum
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5
Q

What is the bacterial complications of AD?

A
  1. alpha or strep
  2. infections manifest as yellowish crusting of the eczematous lesions
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6
Q

What are some triggers of AD?

A
  1. Food
  2. Aeroallergens
  3. Psychological stress
  4. Airborne irritants
  5. Cosmetics
  6. Excessive hand washing
  7. Tigh fitting clothes
  8. Dyes
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7
Q

What are the treatment goals of AD?

A
  1. Stop the itch-scratch cycle
  2. Maintain skin hydration and barrier function
  3. Avoid or minimize factors that trigger symptoms or aggravate the disorder
  4. Prevent secondary infections
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8
Q

What are the exclusion of AD self-care?

A
  1. Moderat to severe conditions with intense pruritis
  2. Involvement of large area of the body
  3. Less than 1
  4. Skin appears infected
  5. Involvement of face or intertriginous areas
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9
Q

What are non pharm treatment for AD?

A

Education and hydration

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10
Q

What is education of AD?

A

Avoidance of internal or external triggers

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11
Q

What is hydration of AD?

A

Decreased concentration of lipids, such as ceramides, cholesterol, and fatty acids means a decreased ability to retain moisture

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12
Q

What are petrolatum containing product?

A
  1. Aquaphor ointment
  2. Cetaphil cream
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13
Q

What are the ceramide containing products?

A
  1. CeraVe moisurizing lotion
  2. Eucerin professional repari
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14
Q

What are the miscellaneous emollients?

A
  1. Gold bond ultimate healing lotion
  2. Purpose gentle cleansing bar
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15
Q

What is the first line treatment for AD?

A

Topical corticosteroids

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16
Q

What is the advise when using topical corticosteroid?

A
  1. intermittent courses
  2. Refractory cases of AD necessitate referral to a primary care provider for prescription therapy
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17
Q

What are the complementary therapies for AD?

A
  1. Twice-daily diluted bleach baths and intranasal mupirocin
  2. Wet wraps
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18
Q

What is dry skin?

A

xerosis, decreased water-holding capacity of the skin with resulatant alteration of the stratum corneum

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19
Q

What are the treatment goals of dry skin?

A
  1. Improve skin hydration and minimize water loss
  2. Restore the skin’s barrier funciton
  3. Educate the patient about prevention and treatment
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20
Q

What are the non pharm treatments for dry skin?

A
  1. Moisturizer containing emollients that soften and smooth skin
  2. Modification to bathing practices
  3. Room humidity can be increased with a portable humidifier, or humidification unit
  4. Drinking ample water daily unless contraindicated by any medical disorders
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21
Q

What is the treatment for dry skin?

A
  1. Take tub baths with addition of bath oil 2–3 times per week for brief periods (3–5 minutes). Take sponge baths on other days. Use glycerin soap if possible.
  2. Bathe in tepid water, not more than 3°F above body temperature.
  3. Within 3 minutes of getting out of the tub, pat the body barely dry, leaving beads of moisture, and generously apply body moisturizer to trap the moisture.
  4. Apply the body moisturizer at least 3 additional times during the day to the whole body (preferably) or at least to the most affected areas.
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22
Q

What is the pham treatment for dry skin?

A
  1. Hydrocortisone cream, ointment would be better
  2. Maximizing the application of moisturizers in dry, itchy skin disorders
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23
Q

What is the rescriction of infants with dry skin?

A
  1. Less than 1
  2. Have a reduced capability for biotransformation of drugs absorbed by the cutaneous route and the proportion of drug absorbed per kilogram of body weight is greater in a newborn
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24
Q

What is the restriction of pregnancy or lactating with dry skin?

A
  1. treated with topical products if used appropriately.
  2. Risk to the fetus appears to be low if topical steroids are used in limited quantities and over limited areas of the body.
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25
Q

What is the restriction of geriatric with dry skin?

A
  1. Bath oils and greasy ointments should be used with caution in older patients because such products can create slippery surfaces
  2. May be at greater risk for the adverse effects of some agents owing to increased absorption through their thinner skin
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26
Q

What is dandruff?

A
  1. Mildly inflammatory scalp disorder that results in excessive scalp scaling
  2. Represents the milder end of the seborrheic dermatitis spectrum
  3. Minimal inflammation or erythema
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27
Q

What is dandruff caused by?

A
  1. Hyperproliferative epidermal disorder
  2. mild inflammation, flaking, and pruritus
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28
Q

What are the characteristics of Hyperproliferative epidermal disorder?

A
  1. accelerated epidermal cell turnover
  2. abnormal keritinations
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29
Q

What are processes involved dandruff?

A
  1. malassezia yeast
  2. Disruption in skin proliferation, differentiation, and barrier function
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30
Q

What are the treatment goals of dnadruff?

A
  1. Reduce the epidermal turnover rate of the scalp skin by reducing the number of malassezia fungi on the scalp.
  2. Minimize the cosmetic embarrassment of visible scaling.
  3. Minimize itch.
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31
Q

What are the exclusions of dandruff self treatment?

A
  1. Less than 2
  2. Worsening symptoms or no improvement after 2 weeks
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32
Q

What are the non pharm for dandruff?

A
  1. Routine shampooing
  2. Avoid shampoos containing harsh surfactants
  3. Scalp scrubber
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33
Q

What are the pharm meds to treat dandruff?

A
  1. Coal tar
  2. Hydrocortisone
  3. Ketoconazole
  4. Pyrithione zinc (brief exposure)
  5. Pyrithione zinc (residual)
  6. Salicylic acid
  7. Selenium sulfide
    8.Sulfur
34
Q

What is seborrheic dermatitis?

A
  1. Chronic inflammatory disorder that occurs predominantly in the face, scalp, and chest.
  2. Common in men
  3. Emotional stress
  4. Severe in winter
35
Q

What are the clinical presentations of seborrheic dermatitis?

A
  1. Can involve the scalp, eyebrows, glabella, eyelid margins, cheeks, and paranasal areas.
  2. Fairly well-demarcated, dull, yellowish, oily, scaly areas on reddened skin.
  3. Pruritus is common.
  4. Infantile form of seborrheic dermatitis, also known as cradle cap, is common in the first 3 months of life.
36
Q

What are the treatment goals of seborrheic dermatitis?

A
  1. Reduce inflammation and the epidermal turnover rate of the scalp skin by reducing the level of malassezia fungi.
  2. Minimize or eliminate visible erythema and scaling.
  3. Minimize itch.
37
Q

What are the exclusions of seborrheic dermatitis?

A
  1. Less than 2
  2. Worsening of symptoms or no improvement after 2 weeks of treatment
38
Q

What are the non pharm of seborrheic dermatitis?

A
  1. Mineral or olive oil
  2. For infants, seborrheic dermatitis usually is self-limited and is treated primarily by gently massaging the scalp with baby oil, followed by the use of a nonmedicated shampoo
39
Q

What is psoriasis?

A
  1. Lesions are often localized, but they may become generalized over much of the body surface.
  2. Remissions and exacerbations are unpredictable.
  3. Psychological and physical distress
40
Q

What are the triggers of psoriasis?

A
  1. Environmental
  2. Infection
  3. Prescription drug
  4. Emotional and psychological stress
  5. Alcohol and tobacco
41
Q

What are treatment goals for psoriasis?

A
  1. Control or eilimate the signs and symptoms
  2. Prevent or minimize the likelihood of flares
42
Q

What are the exclusion of psoriasis?

A
  1. Greater than 5% involvement of BSA
  2. Involvement of the face
  3. Presence of joint pain
  4. More than a few lesions
  5. Lesions larger than the size of a quarter.
  6. Less than 2 years of age
  7. Worsening of symptoms or no improvement after 2 weeks of treatment.
43
Q

What are the non pharm for psoriasis?

A
  1. Scale removal
  2. Bathe with lubricating bath products
  3. Daily lubrication
44
Q

What meds are not used for psoriasis and Seborrheic Dermatitis?

A

Sulfur

45
Q

What are cytostatic agents?

A
  1. Decrease the rate of epidermal replication
  2. Increased epidermal cell turnover time
  3. Allows the possibility of normalizing epidermal differentiation, slow decline in visible scales
46
Q

What are examples of cytostatic agents?

A
  1. Pyrithione zinc
  2. Selenium sulfide
  3. Coal tar
47
Q

What is the counseling point for PYRITHIONE ZINC?

A
  1. Avoid contact with eyes
  2. Longer contact time with affected area = greater effectiveness.
  3. Not associated with any major adverse effects
48
Q

What is the counseling point for SELENIUM SULFIDE?

A
  1. Avoid contact with eyes
  2. Longer contact time with affected area = greater effectiveness.
  3. Must be rinsed from the hair thoroughly.
  4. Frequent use may leave a residual odor and an oily scalp.
  5. Not associated with any major adverse effects
49
Q

What is the counseling point for coal tar?

A
  1. Causes folliculitis, stains skin and hair, photosentization, and irritant contact
  2. Applied to the body, arms, and legs at bedtime
  3. Bathe the morning after to remove residual coal tar and to loosen psoriatic scales.
  4. Avoid sun exposure for 24 hours after application.
50
Q

What is ketoconazole?

A
  1. Active against most pathogenic fungi but is indicated specifically for Malassezia infections.
  2. Initially shampoo twice a week for 4 weeks, with at least 3 days between each treatment.
  3. Once controlled apply once weekly to prevent relapse.
  4. Avoid contact with eyes
51
Q

What are the adverse effects of ketoconazole?

A

Hair loss, skin irritation, abnormal hair texture, dry

52
Q

What are kertolytic agents?

A

Sulfur and salicylic acid

53
Q

What is keatolytic agents used for?

A
  1. Used in dandruff and seborrheic dermatitis to loosen and lyse keratin aggregates.
  2. Contact time and concentration are important factors in the success of a keratolytic agent.
  3. Prolonged use (>4 weeks) usually is necessary to obtain a therapeutic response.
  4. Avoid contact with eyes.
54
Q

What are the categories of scaly dermatoses?

A
  1. Cytostatic
  2. Keratolytics
  3. ANtifungal
55
Q

What are the cytostatic products?

A
  1. DHS Tar Shampoo; DHS Tar Gel Shampoo; Pentrax Shampoo
  2. Head & Shoulders Dandruff Shampoo, Zincon Shampoo
56
Q

What are the keratolytic products?

A
  1. Sebulex Conditioning Shampoo with Protein
  2. Subucare Lotion
57
Q

What are the anti fungal products?

A

Nizoral A-D shampoo

58
Q

What is contact dermatitis?

A

A skin disorder characterized by inflammation, redness, and often vesicle and pustule formation, with symptoms of pruritus (itching), burning, and stinging, that develops subsequent to contact with an inciting exogenous substance.

59
Q

What are the types of contact dermatitis?

A

Irritant and allergic

60
Q

What is irritant CD?

A
  1. Persons who frequently wash their hands, handle food, and/or have repeated contact with skin irritants, such as hairstylists and restaurant dishwashers.
  2. After exposure to an irritant, the skin becomes inflamed, swells, and turns erythematous.
  3. Symptoms often are delayed in onset and generally do not occur immediately after exposure.
61
Q

What are the treatment goals of contact dermatitis?

A
  1. Remove the offending agent and to prevent future exposure to the irritant.
  2. Provide prompt treatment to prevent development of chronic dermatitis.
  3. Relieve the inflammation, dermal tenderness, and irritation.
  4. Educate the patient on self-management to prevent or treat recurrences.
62
Q

What are the exclusions of contact dermatitis?

A
  1. Less than 2 years of age
  2. Involvement of eyes, eye lids, mouth, face, neck and genitals.
  3. Involvement of greater than 10% of skin’s surface.
  4. Rash has not decreased in severity within one week.
  5. Chronic dermatitis symptoms are present.
63
Q

What are the non pharm treatments of contact dermatitis?

A

1.Wash the exposed area with copious amounts of lukewarm water and cleanse with a mild or hypoallergenic soap (cetaphil or dove) to reduce contact time with the irritant and to minimize local symptoms.
2. Use a saline soak (in a solution of 1 teaspoon of salt dissolved in 1 pint of water) to remove the irritant.

64
Q

What are pharm treatment for contact dermatitis?

A
  1. Burows solution
  2. Emollients
  3. Colloidal oatmeal baths
65
Q

What is allergic CD?

A
  1. poison ivy. sumac, oak
  2. Micke
  3. jewelry
  4. Latex
66
Q

What is the pathophysiology of ACD?

A
  1. Delayed hypersensitivity reaction.
  2. Sensitized T cells are activated and migrate to the site of contact to release inflammatory mediators.
  3. ICD often is a precursor to further contact sensitization and subsequent ACD.
67
Q

Where is urushiol found in?

A
  1. Poison ivy
  2. Oak
  3. SUmac
68
Q

What are the treatment goals of allergic CD?

A
  1. Remove and avoid further contact with the offending agent
  2. Treat the inflammation.
  3. Relieve itching and prevent excessive scratching.
  4. Relieve the accumulation of debris from oozing, crusting, and scaling of the vesicle fluids.
  5. Prevent secondary skin infections.
69
Q

What are nonpharm for allergic CD?

A
  1. Prevention
  2. Wash exposed areas
  3. Cold or luke warm showers
  4. Trim fingernails
  5. Zanfel and Tecnu
70
Q

What are the guideline for zanfel?

A
  1. Wet the affected area.
  2. Measure 1½ inches of the extruded product into one palm.
  3. Wet both hands and rub the product into a paste.
  4. Rub both hands on the affected area until complete relief of itching is obtained (for up to 3 minutes).
  5. Rinse the affected area thoroughly.
  6. If itching returns after several hours, the product may be used again.
71
Q

What are the guideline for Tecnu Original Outdoor Skin Cleanser
?

A
  1. Apply product to dry, contaminated areas as soon after exposure as possible.
  2. Cleanse the treated skin areas by rubbing vigorously for 2 minutes.
  3. Wipe away product using a cloth or rinse off with cool water.
  4. Product can be used up to 8 hours after exposure to remove any free oil from the skin.
  5. Product also may be used to remove urushiol from objects and pet fur.
72
Q

What are the guideline for Tecnu Extreme Medicated Poison Ivy Scrub?

A
  1. Squeeze product into the palm of one hand.
  2. Add an equal amount of water to the product and mix.
  3. Apply the product to affected skin, and gently rub the area for 15 seconds.
  4. Rinse with cool water and gently towel dry.
  5. Repeat as needed.
73
Q

What are pharm treatments of allergic CD?

A
  1. 1st gen anithistime
  2. Astringents
  3. Hydrocortisone (0.5% and 1%)
74
Q

What are child recs of CD?

A

children younger than 8 years of age are more susceptible to systemic absorption of topical pharmacologic agents.

75
Q

What are preg recs for CD?

A
  1. calamine, colloidal oatmeal, aluminum acetate are in the “undetermined” pregnancy category.
  2. Topical preparations generally considered safe if they are not used for long periods or over extensive areas of the body.
76
Q

What are the geriatric patients for CD?

A
  1. avoid first-generation antihistamines.
  2. Increased risk of skin damage and infections due to itching.
  3. Oatmeal baths and creams and topical hydrocortisone, if used on a small area, can be used to manage itching in these patients.
77
Q

What is the caution using Hydrocortisone (0.5% and 1%)?

A
  1. Rarely causes contact dermatitis
  2. Not to be used with bandages or dressings.
  3. Only use if less than 20% of the body is affected
  4. Not for use in patients younger than 2 years unless directed by primary care provider.
78
Q

What is the OTC hydrocortisone strengths?

A

0.5% and 1%

79
Q

What are the products for poison ivy/oak/sumac dermatitis?

A

1.Aveeno Soothing Bath Treatment
2. Burow’s solution
3. Caladryal Lotion
4. Cortaid Cream
5. Domeboro Astringent Solution Powder Packets
6. Ivarest Poison Ivy Itch Spray

80
Q

How do you use Burrow’s solution?

A
  1. Prepare a 1:40 aluminum acetate solution (i.e., Burow’s solution) using prepackaged tablets or powder, or add 1–3 tablets or powder packets to 1 pint of cool tap water.
  2. Stir or shake until fully dissolved.
  3. Soak affected area 15–30 minutes 3–4 times daily.
  4. Alternatively, loosely apply a compress to the affected area:
    – Prepare compress by soaking a washcloth, cheesecloth, or small towel in the prepared solution.
    – Gently wring the compress and apply it to the affected area.
    – Rewet and reapply the compress for 20–30 minutes, 4–6 times daily.
  5. Prepare a fresh container of solution for each soak or application of a compress.

Self Care (16 decks)

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