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Flashcards in Curriculum Treatment Deck (46):
1

Mild cellulitis
first-line treatment

Amoxicillin
Flucloxacillin

2

Severe cellulitis
first-line treatment

Stronger gram +ve antibiotic
Benzylpenicillin
Flucloxacillin

3

in patients allergic to penicillin first-line treatment for severe cellulitis

Clindamycin

4

Mild atopic eczema
Moderate atopic eczema
Severe atopic eczema

First line topical treatments?

Emollients
Topical corticosteroids

5

Infantile haemangioma
(benign vascular tumour)
first-line treatment

Propranolol

6

Congenital Melanocytic Naevi (CMN)

First line recommended imaging

MRI

Any child born with two or more congenital melanocytic nevus in any location should have a routine MRI scan of the brain and spine, preferably by the age of six months,

7

Mongolian blue spots
first-line treatment

No treatment necessary

8

Sebaceous Naevus
first-line treatment

No treatment necessary

9

Tuberous Sclerosis
hint: think scans
first-line treatment

4 Options
• MDT
• MRI
• Renal Imaging
• Genetic counselling

10

Impetigo
(golden crusted lesions)
first-line treatment

Antibiotic for infection
• Flucloxacillin

11

Scarlet Fever
(group A streptococcus)

First line treatment for the infection + backup?

Antibiotic for infection
• Penicillin
• Erythromycin

12

Urticaria

Recommended patient lifestyle management advice and a recommended medication (hint: think hayfever)

Avoid trigger
Antihistamines

13

Psoriasis

First line topical treatments

Topical Treatments
• Emollients
• Topical steroids
• Vitamin D analogues - calciprotriol
• Vit D and steroid combinations


14

Psoriasis

Systemic therapy treatment examples

Biologics example

• Methotrexate Tablets (immunosuppressant)
• Acitretin (Retinoid)
• Ciclosporin Tablets (immunosuppressant)

4 Biologics:
• Infliximab
• Etanercept
• Adalibumab
• Ustekinumab

15

Scalp Psoriasis

first-line treatment according to NICE
back up for first line according to NICE

Potent topical corticosteroid OD + review after 4 weeks
Vitamin D preparation

16

Diphtheria first-line treatment
(Corynebacterium)

Name one Topical treatment
Name one Systemic treatment

Topical Treatment
Clindamycin

Systemic Treatment
Oral Erythromycin

17

Necrotising Fasciitis
(Group A Strep)

Name the four medications used to treat Necrotising Fasciitis

• Metronidazole
• Clindamycin
• Tazocin
• Gentamicin

18

Common Warts
(HPV epidermal infection)

Name three treatment options if warts do not self-resolve after 6-12 months

• Salicylic acid
• Lactic acid
• Cryotherapy – repeat every 3-4 weeks
• Curettage Scraping
• Excision

19

Genital Warts
(HPV 6/11 infection)

Name two creams
Name a treatment option if the cream does not work

First Line Treatment
Creams
• Podophyllotoxin 0.15%
• Imiquimod 5%

Second Line Treatment
• Cryotherapy

20

Scabies
(Infestation by Sarcoptes scabiei mite)

Name a topical treatment and give instructions on how to use

Topical treatment

Permethrin 5% (insecticide)

• left on for 24 hours
• applied to neck down
• reapplied to hands after washing
• repeated after 1 week

21

Seborrhoeic dermatitis
(Eyebrow Dandruff)
(Nose dandruff)

Name 2 creams that can be used to relieve symptoms

• Moderately potent topical steroids

• Topical tacrolimus ointment (Protopic)

22

Flexural Psoriasis first-line treatment
(Underboob)

Topical Agents

• Mild or moderate potency
topical steroids

• Combination therapies with
anti fungals

• Silkis ointment Vitamin D
analogue

23

Herpes Simplex first-line treatment
Herpes Zoster first-line treatment

antiviral cream

24

Tinea corporis first-line treatment

thrush first-line treatment

candida oesophagitis first-line treatment

topical antifungal (fluconazole)

thrush nystatin

oral antifungal

25

ACNE first-line treatment

Acne vulgaris first-line treatment

Acne rosacea first-line treatment mild


topical retinoids

topical metronidazole or azelaic acid

26

Bullous pemphigoid first-line treatment

Pemphigus vulgaris first-line treatment

Pemphigus foliaceus first-line treatment

Corticosteroids (oral or cream)

dapsone high doses of steroid medication

Topical treatment with corticosteroids and antibiotics

27

Erythrodermic psoriasis

You are the GP
Patient presents with this condition
What do you need to tell them at the end of the consultation when discussing management?

(hint: dont forget to referr or admit to hospital if necessary)

That you will arrange for an immediate same-day specialist dermatology assessment

28

rapidly developing angiodema first-line treatment

Give slow intravenous (IV) or intramuscular (IM) chlorphenamine and hydrocortisone

29

anaphylaxis first-line treatment

IM adrenaline

30

BASAL CELL CARCINOMA first-line treatment

Stage 0
Stage 1
Stage 2

Consider topical imiquimod1 to treat stage 0 melanoma in adult

Offer excision with a clinical margin of at least 1 cm to people with stage I melanoma

Offer excision with a clinical margin of at least 2 cm to people with stage II melanoma

31

BENIGN NAEVI first-line treatment

watch and wait

32

Bowen’s Disease (in situ squamous cell carcinoma) first-line treatment
non melanoma skin cancer

Freezing with liquid nitrogen
Curettage
Excision
5-fluorouracil cream

33

Malignant melanoma first-line treatment

Chemotoxic chemotherapy
Immunotherapy
BRAF V600 targeted therapy

34

SEBORRHOEIC KERATOSIS first-line
treatment
also known as seborrhoeic warts

Benign

if patient wants removed cryotherapy or curettage

35

SOLAR (ACTINIC) KERATOSIS first-line treatment
Rough areas of sun damaged skin can be brown in appearance

destructive therapies
- cryotherapy,
- dermabrasion,
- photodynamic therapy [PDT]),

topical medications
- topical fluorouracil
- imiquimod,
- mebutate,
- diclofenac

chemical peels

36

SQUAMOUS CELL CARCINOMA first-line treatment
non melanoma skin cancer

SCC Mgx 1st Line = Surgical excision

4mm margins if lesion <20mm in diameter.
6mm margins if lesion >20mm in diameter.

Mohs micrographic surgery high-risk patients and in cosmetically important sites.

37

Melasma (chloasma) first-line treatment
For symptoms of abnormally
tan or dark skin discoloration

Benign

Avoiding triggers, such as the oral contraceptive pill
 sun avoidance + sun-blocking
 Skin-lightening agents
 Chemical peels, dermabrasion and laser treatment.
 Skin camouflage.

38

Vitiligo first-line treatment

Image

Topical corticosteroids — Mid- to super-high-potency topical corticosteroids are commonly used as a first-line therapy for the treatment of limited vitiligo

However no treatment is an option

39

Alopecia areata first-line treatment

If there is evidence of hair regrowth

If there is no hair regrowth and the person has less than 50% hair loss

If there is no hair regrowth and the person has more than 50% hair loss, or treatment is preferred

no treatment

watch and wait

Consider a trial of a potent topical corticosteroid

40

Erythema multiforme first-line treatment

Mild rashes

Severe rashes

will clear up in a few weeks spontaneously

In the absence of infection, oral
corticosteroids are sometimes given in the early stages of the eruption.

41

Stevens Johnson syndrome first-line treatment

What causes Stevens Johnson syndrome normally? Is a big hint to treatment

medication induced

remove offending medication

IVIG
corticosteroids

42

Toxic epidermal necrolysis first-line treatment
The usual cause is the same as for Stevens Johnson syndrome which is a hint to treatment

medication induced

remove offending medication

43

Eczema herpeticum
(widespread herpes simplex virus infection)

You are the A and E doctor

Patient presents with areas of rapidly worsening, painful eczema

clustered blisters consistent with early-stage cold sores

punched-out erosions 1–3 mm

fever

lethargy

You suspect Eczema herpeticum what do you need to give them as first line treatment?

IV Aciclovir

44

Venous Leg Ulcer

You are the GP
Patient presents with this condition
What do you need to tell them when discussing the management of a venous leg ulcer?

keep the ulcer clean and in a dressing
use compression bandages if there is no problem with arterial supply to leg

45

Guttate psoriasis

You are the GP
Patient presents with this condition
What do you need to tell them at the end of the consultation when discussing the prognosis of guttate psoriasis?

usually a self-limiting condition that typically resolves within 3–4 months of onset, and reassure that it is not infectious

46

Erythema Nodosum

No active treatment