Xerosis and Atopic Dermatitis

Question 1

What is xerosis

Answer 1

dry skin

Question 2

What are the external or environmental factors that can cause xerosis

Answer 2

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

Question 3

What are some internal factors that can cause xerosis

Answer 3

dehydration
malnutrition
health conditions like hypothyroidism

Question 4

What are the presenting symptoms of xerosis

Answer 4

roughness
scaling
cracking
fissuring
erythema
pruritis

Question 5

When should you refer someone experiencing xerosis

Answer 5

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

Question 6

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

Answer 6

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

Question 7

When should topical hydrocortisone be used

Answer 7

ONLY IF there is pruritis and erythema

Question 8

When should moisturizers be applied

Answer 8

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

Question 9

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

Answer 9

humidify air
drink water

Question 10

What OTC treatment options are available for xerosis

Answer 10

moisturizers
cleansers
hydrocortisone ointment/cream

Question 11

Why should soap not be used with xerosis

Answer 11

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

Question 12

What is the follow-up recommendation for xerosis

Answer 12

follow-up with prescriber in 1 week if not resolved

Question 13

What is atopic dermatitis

Answer 13

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

also known as eczema

Question 14

What can cause eczema

Answer 14

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

Question 15

What are the presenting symptoms of eczema

Answer 15

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

Question 16

When should you not self-treat eczema

Answer 16

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

Question 17

What are the goals of therapy of eczema

Answer 17

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

Question 18

What is the general treatment approach for eczema

Answer 18

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

Question 19

What are complementary and non-pharmacologic options for eczema

Answer 19

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

Question 20

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

Answer 20

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

Question 21

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

Answer 21

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

Question 22

What is the purpose of diluted bleach baths

Answer 22

control bacteria growth

Question 23

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

Answer 23

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

Question 24

What OTC treatment options are available for eczema

Answer 24

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

Question 25

When should you recommend a patient seek follow up for their eczema

Answer 25

symptoms worsen or do not improve after one week
itching is not improves after 1 week of topical hydrocortisone

Question 26

What is the mechanism of action behind bath oils

Answer 26

lubricate dry skin

Question 27

what is the mechanism of action behind cleansers

Answer 27

reduce skin drying

Question 28

What is the MOA of an emollient

Answer 28

fill the space between flaking dead skin cells with oil droplets

Question 29

What are some examples of an emollient

Answer 29

glycol
glyceryl stearate

Question 30

What is the MOA of occlusives

Answer 30

prevent evaporation of water from the skin

Question 31

What are some examples of occlusives

Answer 31

petrolatum
mineral oil
dimethicone

Question 32

What is the MOA of humectants

Answer 32

Attract and hold water in the skin

Question 33

what are some examples of humectants

Answer 33

glycerol
lactic acid
urea

Question 34

How do you use moisturizers

Answer 34

apply liberally and frequently
apply within 3 minutes of toweling off
*at least twice a day and up to 4 times a day

Question 35

What is the MOA of hydrocortisone

Answer 35

suppresses cytokines involved in inflammation and itching

Question 36

What is the onset and duration of hydrocortsone

Answer 36

onset within 10 minutes and lasts 10-12 hours

Question 37

What are the side effects of hydrocortisone

Answer 37

skin atrophy/thinning

Question 38

When should you avoid using hydrocortisone

Answer 38

weeping lesions present on the skin
cracked, open or infected skin

Question 39

What is the dosing and usage guidelines for hydrocosrtisone

Answer 39

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