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1. 4th year > Derm treatments > Flashcards

Derm treatments Flashcards

(113 cards)

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1
Q

Bullous pemphigoid

A

oral corticosteroids

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2
Q

pemphigus vulgaris

  • localised
  • systemic
A

localised/1st line - topical steroids

systemic - high dose steroids + immunosuppression +/- rituximab

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3
Q

Dermatitis herpetiformis

A

gluten free diet +/- Dapsone

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4
Q

Guttate psoriasis

A

self-limiting, resolves in 6 weeks

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5
Q

Psoriasis 1st line

A

potent corticosteroid alongside vitamin D analogue

e.g. betamethasone + calciprotriol

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6
Q

psoriasis 2nd line

A

if no improvement after 8 weeks offer increase dose of vitamin D analogue to twice daily

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7
Q

psoriasis 3rd line

A

if no improvement after 8-12 weeks then either increase corticosteroid dose or coal tar preparation

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8
Q

psoriasis severe/non-responsive

A

oral methotrexate

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9
Q

when is methotrexate particularly useful in psoriasis

A

psoriatic arthritis

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10
Q

Scalp psoriasis

A

potent topical corticosteroid once daily 4 weeks - if no improvement use a different formulation e.g. shampoo to remove scale before application of the steroid

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11
Q

face/flexural/genital psoriasis

A

mild or moderate potency corticosteroid once or twice daily for max of 2 weeks

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12
Q

how much of a gap should be left between courses of corticosteroids

A

4 weeks

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13
Q

eczema herpeticum

A

admission for IV aciclovir

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14
Q

atopic eczema standard for everyone even when asymptomatic

A

avoid irritants

emollients

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15
Q

how should one be advised to use a steroid and emollient together

A

emollient first wait 30 mins then topical steroid

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16
Q

itch in atopic eczema

A

anti-histamine

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17
Q

flare in atopic eczema

A

topical steroids

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18
Q

mild eczema

A

emollient + mild topical steroid

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19
Q

example of mild topical steroid

A

hydrocortisone

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20
Q

moderate atopic eczema

A

emollient + moderate topical steroid +/- tacrolimus

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21
Q

example of a moderate topical steroid

A

eumovate

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22
Q

severe atopic eczema

A

potent topical steroid +/- UV light therapy +/- immunosuppresion e.g. ciclosporin - specialist advice

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23
Q

example of a potent topical steroid

A

betnovate

fluticasone

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24
Q

what kind of drug is tacrolimus

A

topical calcinurin inhibitor

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25
example of a very potent topical corticosteroid
dermovate
26
seborrhoeic dermatitis - infantile
baby shampoo and baby oil | emollients +/- topical steroids
27
seborrhoeic dermatitis - adult scalp disease
neutrogena and head+shoulders
28
seborrhoeic dermatitis - adult 1st line, non-scalp
topical ketoconazole | + emollients +topical steroids
29
pompholyx
cool compresses, emollients, topical steroids
30
azteototic eczema
emollients
31
venous eczema
compression bandage
32
contact dermatitis - allergic and irritant
antigen avoidance regular emollients potent topical steroids during flares
33
mild acne
topical therapy only - benzoyl peroxide salicylic acid topical retinoid
34
moderate acne
topical retinoid + topical benzoyl peroxide + topical antibiotic
35
what antibiotics are used in acne
tetracyclines
36
moderate/severe acne
oral antibiotic instead of topical
37
should oral antibiotic be given as a monotherapy in acne
no always co-prescribe with topical therapy
38
severe acne
topical therapies + oral isotretinoin
39
can GP prescribe isotretinoin
no - specialist advice needed so refer to dermatology
40
what is needed in women of CBA on isotretanoin
double contraception and pregnancy test before each monthly prescription
41
acne fulminans
hospital admission + oral steroids
42
Rosacea 1st line
topical metronidazole
43
what is good in rosacea with flushing and limited telangiectasia
topical brimonidine gel
44
severe rosacea
systemic antibiotics - tetracyclines
45
what tetracyclines are ok for use in pregnancy and breastfeeding
erythromycin
46
telangiectasia is rosacea
laser
47
last line in rosacea
isotretinoin
48
pityriasis rosea
self limiting over 6-12 weeks, emollients and anti-histamines if needed
49
lichen planus
potent topical steroid
50
oral lichen planus
benzydamine mouth wash
51
port wine stain
cosmetic camouflage or laser therapy
52
infantile haemangioma
leave alone
53
erythema multiforme
supportive care and treat underlying cause
54
investigation to do with erythema nodosum of unknown cause
xray to exclude sarcoidosis and TB
55
necrobiosis lipoidica
improve glycaemic control | topical or intralesional steroid
56
pyoderma gangrenosum
very potent topical steroid | immunosuppressant e.g. infliximab if resistant and treat underlying cause
57
seborrhoeic keratoses
leave alone, cryotherapy, curettage
58
BCC
leave alone and monitor or surgical (MOHS for awkward site) topical imiquimod or 5-FU
59
bowens/actinic keratoses
5-FU twice daily for 4 weeks | cryotherapy, curettage, excision
60
SCC
biopsy then surgical excision with 4mm margins if < 20mm or 6mm margins if > 20mm topical 5-FU
61
melanoma
surgical excision with 2mm margins, check breslow thickness then wide local excision
62
acute intermittent porphyria
avoid triggers | acute attack - IV haematin/haem arginate or IV glucose if former not available
63
prophyria cutanea tarda
venesection or chloroquine
64
herpes zoster opthalmicus
oral antiviral for 7-10 days
65
Ramsay hunt
oral aciclovir and corticosteroids
66
shingles
paracetamol and NSAIDs
67
when can oral antivirals be used in shingles
within 72 hours of ash unless under 50
68
antivirals aim to do what in the treatment of shingles
reduce post herpetic neuralgia
69
urticaria
antihistamines - more effective if taken regularly | UVB phototherapy
70
herpes simplex: gingivostomatitis
oral aciclovir | chlorhexidine mouthwash
71
herpes simplex cold sore
topical aciclovir
72
herpes simplex genital herpes
oral aciclovir
73
herpes simplex in pregnancy if primary attack occurs after 28 weeks
elective c section at term
74
herpes simplex in pregnancy recurrent (not first episode)
suppressive therapy and advise that transmission to baby is low
75
solitary keratinised genital wart
cryotherapy
76
multiple non keratinised genital warts
topical podophyllum
77
2nd line genital wards
imiquimod
78
common warts
salicyclic acid cryotherapy imiquimod
79
molloscum in kids
resolve in 18 months encourage not to itch can prescribe emollient if that is an issue
80
orf
resolve after 4-6 weeks
81
hand foot and mouth
self limiting
82
tinea capitis
topical ketoconazole shampoo
83
localised tinea
topical antifungals - clotrimazole, miconazole continuing for 10 days post lesion healing
84
widespread tinea or nails
oral antifungals
85
finger nail tinea
terbinafine 250mg 6-12 weeks
86
toe nail tinea
terbinafine 250mg 3-6 months
87
alternative to oral terbinafine
oral itraconazole
88
what monitoring does terbinafine need
LFTs
89
tx genital candida 1st line
oral fluconazole 150mg single dose
90
2nd line tx genital candida if oral contraindicated e.g. pregnant
topical clotrimazole - cream or pessary
91
oral candida
nystatin
92
skin candida
topical clotrimazole or oral fluconazole
93
pityriasis versicolor
topical antifungal
94
2nd line pityriasis versicolor
oral itraconazole
95
impetigo
1st - hydrogen peroxide 1% cream | 2nd line - topical fusidic acid 7 days
96
extensive or severe impetigo
oral flucloxacillin erythromycin if pen al (if group A strep phenoxymethylpenicillin)
97
folliculitis
topical benzylperoxide and loose clothes
98
boil / furuncle
10 days oral flucloxicillin
99
cellulitis
flucloxicillin | if PA - clarithromycin, erythromyin or doxycycline
100
cellulitis in pregnancy
erythromycin
101
severe cellulitis
co-amoxiclav, cefuroxime, clindamycin or ceftriaxone
102
erysipelas
IV flucloxicillin
103
necrotising fasciitis
urgent surgical debridement and IV antibiotics
104
scabes 1st line
permethrin 5%
105
scabies 2nd line
malathion 0.5%
106
how many cycles of treatment does scabies require
2, 7 days apart
107
do house hold contacts need to be treated in scabies?
yes, all household and close physical contacts treated as if they have it - 2 cycles 7 days apart
108
lice - head/body/pubic
malathion | if resistant - dimeticone
109
lyme disease
doxycycline disseminated disease - ceftriaxone
110
lyme disease in pregnancy
amoxicillin
111
venous ulcer
compression banding | pentoxifylline - improves healing
112
vitiligo
sun cream | topical steroids
113
kawasaki
high dose aspirin and IV immunoglobulin

1. 4th year (23 decks)

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