Xerosis and Atopic Dermatitis Flashcards

1
Q

What is xerosis

A

dry skin

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2
Q

What are the external or environmental factors that can cause xerosis

A

dry air and wind
long and hot showers
prolonged use of detergents and soaps

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3
Q

What are some internal factors that can cause xerosis

A

dehydration
malnutrition
health conditions like hypothyroidism

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4
Q

What are the presenting symptoms of xerosis

A

roughness
scaling
cracking
fissuring
erythema
pruritis

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5
Q

When should you refer someone experiencing xerosis

A

severe dry skin (bleeding or infection)
large body surface area
intense itching
infection skin

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6
Q

What is the general treatment approach when it comes to treating xerosis

A

modify environmental factors and bathing habits
bath oils and moisturizers
topical hydro cortisone

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7
Q

When should topical hydrocortisone be used

A

ONLY IF there is pruritis and erythema

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8
Q

When should moisturizers be applied

A

while skin is still damp after bath/shower
*within 3 minutes
**frequent re-application during the daytime

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9
Q

What other complementary and non-pharmacologic options are available for xerosis

A

humidify air
drink water

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10
Q

What OTC treatment options are available for xerosis

A

moisturizers
cleansers
hydrocortisone ointment/cream

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11
Q

Why should soap not be used with xerosis

A

pulls lipids and oils out of the skin and can worsen the dryness

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12
Q

What is the follow-up recommendation for xerosis

A

follow-up with prescriber in 1 week if not resolved

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13
Q

What is atopic dermatitis

A

an inflammatory condition of the epidermis and dermis characterized by episodic flares and periods of remission

also known as eczema

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14
Q

What can cause eczema

A

genes/mutations
environmental triggers such as diet, pollution, tobacco smoke, clothing, climate, stress, and more

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15
Q

What are the presenting symptoms of eczema

A

redness and scaling
crusts and pustules caused by itching
remissions and flares
lichenification of the skin
secondary infections can occur

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16
Q

When should you not self-treat eczema

A

*same as xerosis
age less than 1 year old
face or intertriginous areas
*skin or skin folds are touching or rubbing

17
Q

What are the goals of therapy of eczema

A

stop the itch-scratch cycle
maintain skin hydration and barrier function
avoid or minimize triggers
prevent secondary infections

18
Q

What is the general treatment approach for eczema

A

manage symptoms because there is no cure
nonpharmacologic first
hydration
skin barrier support and moisture
topical hydrocortisone for itch and inflammation

19
Q

What are complementary and non-pharmacologic options for eczema

A

trigger avoidance
oral hydration
skin hydration
trim fingernails short and keep clean
wear cotton gloves at night
wear wet wrap compresses
moisturizers
moderate to severe AD can use dilutes bleach baths

20
Q

What is the process for preparing and wearing the wet wrap compress

A

apply an emollient and/or topical hydrocortisone, cooked and cooled oatmeal
wrap in wet layer and then wrap in a dry layer
keep in place overnight

21
Q

What kind of moisturizers should be used when someone is experiencing eczema

A

emollients used at least 2 times a day
patient product/ingredient preference
use creams and ointments
coconut oil
*AVOID lotions because they are pretty watery and will evaporate off skin and worsen condition

22
Q

What is the purpose of diluted bleach baths

A

control bacteria growth

23
Q

What are the directions for preparing and using the diluted bleach bath

A

use 2 times daily 3 times per week
add 1/ cup of 5% household bleach in 40 gallons/full tub and soak for 10 minutes
Rinse with fresh water and pat dry
Apply moisturizer within 3 minutes

24
Q

What OTC treatment options are available for eczema

A

bath oils
cleansers
moisturizers
hydrocortisone ointment/cream
*use fragrance free products
**avoid products that say they are unscented

25
When should you recommend a patient seek follow up for their eczema
symptoms worsen or do not improve after one week itching is not improves after 1 week of topical hydrocortisone
26
What is the mechanism of action behind bath oils
lubricate dry skin
27
what is the mechanism of action behind cleansers
reduce skin drying
28
What is the MOA of an emollient
fill the space between flaking dead skin cells with oil droplets
29
What are some examples of an emollient
glycol glyceryl stearate
30
What is the MOA of occlusives
prevent evaporation of water from the skin
31
What are some examples of occlusives
petrolatum mineral oil dimethicone
32
What is the MOA of humectants
Attract and hold water in the skin
33
what are some examples of humectants
glycerol lactic acid urea
34
How do you use moisturizers
apply liberally and frequently apply within 3 minutes of toweling off *at least twice a day and up to 4 times a day
35
What is the MOA of hydrocortisone
suppresses cytokines involved in inflammation and itching
36
What is the onset and duration of hydrocortsone
onset within 10 minutes and lasts 10-12 hours
37
What are the side effects of hydrocortisone
skin atrophy/thinning
38
When should you avoid using hydrocortisone
weeping lesions present on the skin cracked, open or infected skin
39
What is the dosing and usage guidelines for hydrocosrtisone
apply before any moisturizers apply twice daily during flares ONLY use as much as the tip of your index finger use sparingly use for a MAX of 7 days