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OTC > atopic dermatitis, dry skin, contact dermatitis > Flashcards

atopic dermatitis, dry skin, contact dermatitis Flashcards

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1
Q

atopic dermatitis definition

A

chronic, relapsing, skin disorder characterized by redness and inflammation caused by an exaggerated reactivity from environmental stimuli +/- genetic component

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2
Q

atopic triad

A

atopic dermatitis, asthma, allergic rhinitis

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3
Q

epidemiology of AD

A
  • most common dermatologic condition in children

- more common in males, Caucasians, in urban areas, and occurs in higher socioeconomic classes

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4
Q

signs and symptoms of AD

A

intense itching, vesicles and papules, chapping, redness, crusting and dry skin

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5
Q

2 months

location and signs of AD

A

location: chest and face
signs: red, raised vesicles, dry skin, oozing

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6
Q

2 years

location and signs of AD

A

location: scalp, neck, and extensor surface of extremities
signs: less acute lesions, edema, erythema

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7
Q

2-4 years

location and signs of AD

A

location: neck, wrist, elbow, knee
signs: dry and thickened plaques, hyperpigmentation

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8
Q

12-20 years

location and signs of AD

A

location: flexors, hands
signs: dry and thickened plaques, hyperpigmentation

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9
Q

xerosis common in

A

elderly population

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10
Q

xerosis is result

A

of decreased water content of the skin

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11
Q

exclusions for self treatment of atopic dermatitis and xerosis

A
  1. moderate - severe conditions with intense pruritus
  2. involvement of large area of body
  3. <1 year of age
  4. possible skin infection
  5. involvement of face or intertriginous areas
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12
Q

goals of therapy for atopic dermatitis and xerosis

A
  1. stop the itch/scratch cycle
  2. maintain skin hydration
  3. avoid or minimize aggravating factors
  4. prevent secondary infections
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13
Q

how to maintain skin hydration

A

drink plenty of water, avoid dehydration with improper bathing

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14
Q

soaps for AD and xerosis

A
  • use glycerin bars, non soap cleansers, bath oils

- bath oil in bathwater is very good for xerosis

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15
Q

use of emollients in AD and xerosis

A

applied within three minutes of bathing and reapplied 3-4x daily prn

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16
Q

emollient examples

A
  • petroleum emollients

- lubricating ointments

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17
Q

non pharm treatment for AD and xerosis

A
  • drink plenty of water
  • use humidifiers to maintain room hydration
  • use cold compresses for wet oozing or crusty vehicles
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18
Q

cold compress examples

A

isotonic saline solution or wet cold compresses using tap water for 15-20 minutes at a time 4-6 times daily

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19
Q

avoid or minimize aggravating factors of AD or xerosis

A
  1. avoid irritating or tight clothing; cotton is recommended
  2. follow proper bathing techniques
  3. use of hypoallergenic cleansers
  4. use detergents and cosmetics without perfumes or fragrances
  5. avoid fabric softeners
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20
Q

AD pharm treatment

A

no cure, controlling symptoms

  • hydrocortisone cream or ointment
  • topical anesthetics
  • antihistamines
  • astringent compresses
  • topical antibiotics
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21
Q

hydrocortisone application

A

apply sparingly 1-2 times daily with intermittent courses of therapy

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22
Q

do not use hydrocortisone longer than

A

7 days

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23
Q

hydrocortisone can be used on

A

neck, face, axillae, and groin (do not apply to > 20% BSA)

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24
Q

avoid hydrocortisone if

Study These Flashcards
A
  • oozing / weeping lesion or open / cracked skin

- not for children < 2 y/o

25
topical anesthetics moa
block conduction along the axonal membranes that carry sensation of itching and pain to the CNS
26
applying topical anesthetics
apply sparingly, 3-4x a day for up to 7 days
27
avoid topical anesthetics if
skin is raw, blistered, or on large surface areas
28
do not take topical antihistamines longer than
7 days, they are sensitizers and can make AD worse
29
astringent compress examples
- aluminum acetate (burrow's solution) diluted 1:40 with water - witch hazel
30
topical antibiotic examples
polysporin or Neosporin
31
xerosis pharm treatment
- moisturizers w urea or lactic acid - aluminum lactate 12% lotion - hydrocortisone
32
irritant contact dermatitis
direct tissue damage by irritant; usually results from occupational exposure to chemicals or solvents
33
first and second likely cause of ICD
1. occupation exposure | 2. diaper rash
34
ICD generally appears
after single exposure
35
ICD usually seen on
hands, face, forearms
36
signs/symptoms of ICD
red, inflamed, swollen skin; dry, macerated, or cracked skin; +/- vesicles or papule formation and/or peeling or sloughing of skin; painful, burning or stinging
37
goals of treatment for ICD
remove offending agent, prevent future exposure, relieve inflammation/irritation, and patient education
38
non pharm treatment of ICD
- avoid irritant and use protective clothing (if irritant cant be avoided use barrier creams) - immediately wash exposed area - apply emollients liberally or cold compresses
39
pharm treatment of ICD
- liberal application of emollients | - colloidal oatmeal baths
40
avoid use of ____ in ICD
topical -caine anesthetics
41
allergic contact dermatitis (ACD)
immunologic reaction of the skin caused by exposure to an antigen
42
ACD is a _____ reaction
delayed; typically does not appear on first contact
43
induction phase of ACD
usually no rash forms after initial exposure; immune system is sensitized to the antigen
44
second exposure in ACD
patient has type IV hypersensitivity reaction and release t-cells to fight antigen --> rash
45
ACD most commonly caused by
urushiol (poison ivy/oak), nickel, and latex
46
signs and symptoms of ACD
rash develops only in area where skin was exposed; intense pruritus, erythema, vesical formation; rash typically clears in 10-21 days
47
only FDA approved barrier product for prevention of ACD
ivyblock lotion - needs to be applied 15 minutes prior to exposure and every 4 hours - avoid in children < 6 years
48
prevention of ACD
- wear protective clothing | - wash all previously exposed clothing with detergent and hot water
49
goals of treatment in ACD
remove offending agent, treat inflammation / irritation, relieve itching/scratching
50
non pharm treatment of ACD
- wash exposed area (within 10 min of exposure) | - use approved soap/wash
51
approved washes for non pharm treatment of ACD
tecnu and zanfel
52
tecnu
- contains mineral spirits, water, soap, surface active ingredient - no more effective than soap - rub into affected area ASAP for at least two minutes
53
zanfel
- polyethylene granules, surfactant, etc. - marked to bind and remove urushiol from new or old rashes - expensive
54
pharm treatment of ACD
- hydrocortisone cream (2-4 times daily for up to 7 days) | - oral antihistamines
55
avoid ____ use in ACD
topical products containing anesthetics, antihistamines, and antibiotics (can cause drug induced ACD)
56
if ACD has nonweeping/oozing lesions
calamine lotions
57
if ACD has weeping/oozing lesions
consider astringent solutions to dry, soothe pruritus, or loosen exudate
58
exclusions for self treatment of ICD and ACD
1. patients < 2y/o 2. dermatitis present > 2 weeks 3. involvement of > 20% BSA 4. presence of numerous large blisters 5. extreme itching, irritation, or severe vesicle and blister formation 6. swelling of the body or extremities 7. swollen eyes or eyelids swollen shut 8. discomfort in genitalia from itching, redness, swelling, or irritation 9. involvement and/or itching of mucous membranes of the mouth, eyes, nose, or anus 10. signs of infection 11. symptoms worsen 12. low tolerance for pain, itching, or symptom discomfort 13. impairment of daily activities

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