Chapter 13- Skin

Question 1

Why is urea used with other topical ingredients

Answer 1

To enhance penetration of the skin

Question 2

Caution with paraffin based products - why?

Answer 2

Flammable!

Question 3

A mild corticosteroid (0.5-1%) can be used in nappy rash for how long

Answer 3

No more than a week

Question 4

Topical skin products should be applied in the direction of hair growth - why?

Answer 4

To reduce risk of folliculitis

Question 5

What topical product is used for MRSA

Answer 5

Chlorhexidine scrub and mupirocin

Question 6

What can be used for acute impetigo

Answer 6

Short term application of fusidic acid

Question 7

Oral antibiotic good for skin infections and why?

Answer 7

Flucloxacillin

Good penetration into skin

Question 8

Mupiricin and fusidic acid should not be used for longer than what and why

Answer 8

10 days risk of if resistance

Question 9

What’s used in the treatment of infected burns

Answer 9

Silver sulfadiazine

Question 10

To prevent relapse - local antifungal treatment is continued for how long after the disappearance of infection

Answer 10

1-2 weeks

Question 11

Name three treatment options for scabies

Answer 11

Permethrin
Malathion
Benzyl benzoate (less effective)

Question 12

How do you use dimeticone for headlice

Answer 12

8-12 hrs repeat after 7 days

Question 13

Malathion used for headlice has problems with what?

Answer 13

Resistance

Question 14

What’s the wet combing method of headlice removal

Answer 14

Plastic detection comb 
Over 30 mins 
4 days intervals
For minimum of 2 weeks 
Continue until no lice found on 3 consecutive occasions

Question 15

What’s used to treat crab lice

Answer 15

Permethrin

Malathion

Question 16

Psoriasis can be provoked or exacerbated by what drugs

Answer 16

Lithium 
Chloroquine 
Hydroxychloroquine 
Beta blockers 
NSAIDs 
ACEI

Question 17

Emollients in addition to their effects on dryness, scaling and crackling have what additional effect in psoriasis

Answer 17

Anti-proliferative

Question 18

More specific topical treatment for chronic stable plaque psoriasis on extensor surfaces of trunk and limbs involved the use of vitamin D analogues - name three

Answer 18

Coal tar
Dithranol
Retinoid tazarotene

Question 19

First line treatment for scalp psoriasis

Answer 19

Tar based shampoo

Question 20

Second line treatment for scalp psoriasis

Answer 20

Keratolytic such as salicylic acid

Question 21

The keratolytic effect of salicylic acid does what to the absorption of topical corticosteroids

Answer 21

Facilitates it

Question 22

OTC advice with hydrocortisone cream

Answer 22

Can be sold for allergic contact dermatitis, irritant dermatitis, insect bite, mild to moderate eczema in patients over 10 to be applied sparingly for OD/BD for max 1 week (should not be sold to children under 10, pregnancy, or for application to:face, anogenital region, broken/infected skin)

Question 23

Canestan HC (clotrimazole + hydrocortisone) can be sold OTC when?

Answer 23

15g tube for athletes foot and fungal infection of skin folds with associated inflammation in patients 10years and over

Question 24

A 15g tube of hydrocortisone with miconazole is on sale OTC for what

Answer 24

Treatment of athletes foot and candida intertrigo

Question 25

What can be used for hyperhidrosis (perspiration)

Answer 25

Aluminium chloride hexahydrate Oxybutinin Botox

Question 26

List systemic diseases that can cause pruritus

Answer 26

``` Obstructive jaundice Endocrine disease Chronic renal disease Iron deficiency Malignant diseases ```

Question 27

What can be used to relieve pruritus

Answer 27

Levomenthol cream Crotamiton preps Calamine (ineffective) Doxepine 5% (used in eczema but drowsiness and sensitisation risk)

Question 28

Pruritus is common is biliary obstruction especially in primary biliary cirrhosis and drug induced cholestasis - what's the drug of choice in this case?

Answer 28

Oral administration of colestyramine

Question 29

Treatment of choice in insect bites or stings

Answer 29

Short course topical corticosteroids +\- sedating antihistamine

Question 30

Topical antihistamines should be avoided in eczema and are not recommended for longer than what

Answer 30

3days

Question 31

Name a hormone oral preparation used for acne that's used in women only

Answer 31

Co-cyprindiol (cyproterone acetate with ethinylestradiol)

Question 32

Treatment for mild to moderate acne

Answer 32

Benzoyl peroxide or topical retinoid

Question 33

Oral antibacterial for acne

Answer 33

Oxytetracyclin Tetracycline Doxycycline Lymecycline

Question 34

Minocycline is as effective as other tetracyclines for use in acne but is associated with what

Answer 34

Greater risk of lupus erythematosus like syndrome and can cause irriversible pigmentation

Question 35

Side effects of isotretinoin

Answer 35

``` Dryness of skin Dryness of mucous membranes Nose bleeds Joint pain Teratogenic ```

Question 36

Side effects/ further information with isotretinoin

Answer 36

Risk of pancreatitis if triglycerides >9mmol/litre Psychiatric side effects Visual disturbances Skin peeling

Question 37

Treatment options for mild seborrhoeic dermatitis

Answer 37

Shampoos containing antimicrobials agents such as pyrithione zinc and selenium Ketoconazole Corticosteroid gels

Question 38

Cradle cap can be treated with what

Answer 38

Coconut oil | Olive oil

Question 39

Hirsutism may result from hormonal disorders or as side effects of drugs such as..

Answer 39

``` Minoxidil Corticosteroids Anabolic steroid Androgens Danazol progestogens ```

Question 40

Treatment of androgenetic alopecia

Answer 40

Finasteride | Topical minoxidil