Passmed Dermatology - Pharmacological Managements

Question 1

Acne vulgaris

Answer 1

1st - topical retinoids/benzoyl peroxide
2nd - topical tetracycline
3rd - oral tetracycline or erythromycin if pregnant/BFing. COCP/Dianette also an alternative (max 3 months)
4th - oral isotretinoin

Question 2

Actinic keratoses

Answer 2

Topical fluorouracil, 2-3 weeks, with topical hydrocortisone

Question 3

Alopecia areata

Answer 3

Topical/intralesional steroids

Question 4

Sedating vs Non-sedating antihistamines?

Answer 4

Sedating - chlorpheniramine
Non-sedating - loratidine, cetirizine (more drowsiness than other non-sedating)

Question 5

Athlete’s foot

Answer 5

Topical imidazole

Question 6

Bullous pemphigoid

Answer 6

Oral steroids

Question 7

Eczema herpeticum

Answer 7

IV aciclovir

Question 8

Erysipelas + cellulitis

Answer 8

Flucloxacillin

Question 9

Fungal nail infection

Answer 9

Limited = topical amorolfine nail lacquer
Extensive dermatophyte = oral terbinafine
Extensive candida = oral itrazonazole

Question 10

Hyperhidrosis

Answer 10

Topical aluminium chloride

Question 11

Impetigo

Answer 11

1st - topical hydrogen peroxide
2nd - topical fusidic acid, mupirocin if resistant

Extensive = oral flucloxacillin, erythromycin IPA

Question 12

Key safety point about ketoconazole?

Answer 12

Oral version is high risk for hepatic toxicity so virtually completely contraindicated
Topical version is fine due to low systemic absorption

Question 13

Lichen planus

Answer 13

Potent topical steroid
Benzydamine mouthwash/spray for oral involvement
Extensive = oral steroids

Question 14

Lichen sclerosus

Answer 14

Topical steroids + emollients

Question 15

Drug that causes Pellagra?

Answer 15

Isoniazid

Question 16

Pemphigus vulgaris

Answer 16

Steroids

Question 17

Pityriasis versicolor

Answer 17

1st - Ketoconazole shampoo
2nd - oral itraconazole

Question 18

Plaque psoriasis

Answer 18

1st - topical potent steroid + vit D analogue once daily
2nd - vit D twice daily
3rd - potent steroid twice daily OR coal tar OR dithranol

Steroids for max 4 weeks at a time

Question 19

Scalp and face/flexural/genital psoriasis

Answer 19

Scalp - topical potent steroid
FFG - topical mild/moderate steroid

Question 20

Rosacea

Answer 20

Flushing - Topical brimonidine
Papules/pustules - Topical ivermectin. Add oral doxycycline if moderate/severe

Question 21

Scabies

Answer 21

1st - Permethrin 5%
2nd - Malathion 0.5%

Question 22

Seborrheic dermatitis

Answer 22

Scalp - OTC zinc pyrithione/tar, topical ketoconazole
Face/body - topical ketoconazole

Question 23

Shingles

Answer 23

<72 hrs = aciclovir/famciclovir/valaciclovir
Pain relief = paracetamol/NSAIDs, neuropathic agent, steroid

Question 24

Drugs that cause toxic epidermal necrolysis?

Answer 24

SCAN PP
- sulphonamides
- carbamazepine
- allopurinol
- NSAIDs
- phenytoin
- penicillins

Question 25

Urticaria

Answer 25

Non-sedating antihistamine (cetirizine, loratidine)
Prednisolone if refractory

Question 26

Oral agent can give for peripheral vasodilation in venous ulcer?

Answer 26

Oral pentoxifylline