Dry and scaling skin orders Flashcards
Emollients soothe, smooth and hydrate the skin. What is the MHRA advice for them?
Emollients - risk of severe and fatal burns with paraffin containing and paraffin free emollients
Build up residue in bedding and clothing
Avoid smoking, naked flames etc
Washing at high temps may remove some build up but not totally remove it
First line treatment for nappy rash ?
Further advice?
Nappies changed frequently and avoid tight fitting water proof pants
Rash may clear when left exposed to air and a barrier preparation applied after each nappy change
2nd line treatment for nappy rash?
What if it is fungal?
Mild corticosteroid e.g. 0.5% or 1% hydrocortisone to be used no more than a week
Anti -fungal - clotrimazole
Aminoglycosides (gentamicin) can still have risk of ototoxicity when used topically…especially when used…. in certain patients…
Large area of skin being treated
Children
Elderly
Renal impairment
What is used for infected burns?
Silver sulfadiazine
Metronidazole is used for what kind of skin conditions (3)
Topically for
Rosacea
Reduce odour associated with anaerobic infections
Orally
Wounds infected with anaerobic bacteria
To prevent relapse after anti fungal treatment - how long should treatment continue for?
1- 2 weeks after disappearance of all signs of infection
What antifungals can be used to treat ringworm / tinea e.g. athletes foot infection ?
- Imidazoles:
Clotrimazole, Ketoconazole, Miconazole, Econazole
- Terbinafine (more expensive)
- Griseofulvin
What is Pityriasis versicolor and treatment options?
Pityriasis versicolor is a harmless fungal infection (yeast overgrowth) that causes patches of discoloured skin.
Antifungal shampoos e.g. ketoconazole or selenium sulfide
Treatment options for candidiasis/thrush?
Imidazole group
Miconazole, ketoconazole, clotrimazole etc
Refractory requires systemic treatment with a triazole such as fluconazole
Aciclovir is used for ? (2)
Herpes simplex infections - buccal or vaginal Herpes Zoster (shingles)
Treatment for scabies? (2)
- Permethrin
- Malathion
Should be applied twice - one week apart
Itch and eczema of scabies can last for weeks after treatment - what can be used to help? (3)
- Crotamiton
- Topical corticosteroid
- Oral antihistamine at night (sedating)
What is involved in the management of eczema?
- Emollients applied regularly (BD daily) to help with dryness and irritation
- Topical corticosteroids
- Antihistamine
Eczema can commonly be infected with …and sometimes with?
Staphylococcus aureus
Occasionally streptococcus pyogenes
Which drugs can provoke or exacerbate psoriasis ? (6)
- Lithium
- NSAIDs
- Beta-blockers
- Chloroquine
- Hydroxy chloroquine
- ACE inhibitors
May be seen weeks or months of treatment
When should corticosteroid CREAM or OINTMENTS be used?
creams most suitable for moist or weeping lesions
ointments for dry, lichenified or scaly lesions or where a more occlusive effect is required
MHRA warning on corticosteroids? whether it be topical/systemic etc
Rare risk of chorioretinopathy (retinal disorder)
pt advised to look out for changes in vision/blurred
refer to opthalmologist
Treatment options for hyperhidrosis? (2)
Aluminium chloride hexahydrate antiperspirant
more severe glycopyrronium bromide
Hormone treatment co-cyprindiol can be used for the treatment of …..in women only.
acne and moderate hirsutism
Treatment options for mild to moderate acne? (3)
- Topical Benzoyl peroxide / Azelaic acid
if acne doesn’t respond after 2 months tryantibacterial
- Topical retinoid (tretinoin)
- Topical antibacterial e.g. erythromycin, clindamycin for inflammatory acne
Treatment options for moderate to severe acne?
Oral antibacterials e.g. oxytetracylcine or tetracycline
If no improvement first 3 months another oral antibac to be used for example
- Doxycycline
- Lymecycline
How does Isotretinoin work? used for what type of acne?
how long is the course?
reduces sebum secretion
treat cystic acne, scarring, severe acne, acne not responding to other treatments
16 weeks
Isotretinoin should only be prescribed for… because it is….?
for women who will practice effective contraception (oral progestogen only contraceptives not considered effective) and registered with pregnancy prevention programme
teratogenic!
