Lecture 3 Flashcards Preview

DEENT Exam 3 > Lecture 3 > Flashcards

Flashcards in Lecture 3 Deck (23):
1

Atopic Dermatitis Definition

Chronic, recurring inflammatory skin disorder
Type 1 (IgE-mediated) hypersensitivity reaction
AKA eczema

2

atopic traid

Eczema
Allergic rhinitis
Asthma

3

Atopic Dermatitis Essential features

Pruritus
Eczema
Typical morphology and age-specific patterns
Chronic or relapsing history
Xerosis (dry skin)
lichenification (thickened)

4

Atopic Dermatitis Exclusions

Severe condition with intense pruritus
Involvement of large are of body
less than 2 years of age
Skin appears to be infected
Involvement of intertriginous areas (pubic area)

5

Atopic Dermatitis Treatment

Moisturizer (petrolatum)
If moisturizers fail: Topical steroid (hydrocortisone)

6

Types of Moisturizers

Aquaphor
Eucerin
Lubriderm (mineral oil, lanolin, petrolatum)
CeraVe (Glycerin, Petroleum, ceramides, Hylauronic acid)

7

Reasons to use Urea (Carmol, and Lac-Hydrin)

For severe cases. Increases water uptake, side effects of burning, stinging, irritation on broken skin

8

Reasons to use lactic acid (AmLactin, Ammonium lactate, alpha-hydroxyl acids)

Helps when there is extra skin
For severe cases

9

Topical steroid use in AD

Low to medium potency
As needed for flare ups
No longer than 3-4 weeks at a time

10

2nd line agent for AD (patients who have ADEs to steroids or are unresponsive, or have a large BSA, or have face, eyelid, skin fold involvement)

Topical Calcineurin Inhibitors
Immunomodulator
Applied twice daily before a moisturizer
ADEs: Skin irritation and burning

11

Types of Topical Calcineurin Inhibitors

Pimecrolimus (Elidel) - mild to moderate 1%
Tacrolimus (Protopic) - moderate to severe
Use in children older than 2 0.03%
Adults 0.1%

12

Topical Calcineurin Inhibitors Black Box Warning

Associated with rare cases of lymphoma and skin malignancy.
Avoid use on malignant or premalignant skin conditions
Use for short-term
Use sunscreen

13

What do you use for babies less than 2 years that have AD?

Cetaphil cleanser

14

Non pharmacologic treatments for AD

Bathing practices (do not use hot water)
Non-soap cleansers
Wet wrap therapy
Bleach bath with intranasal topical mupirocin
Avoid known triggers
Decrease stress

15

Diaper Dermatitis exclusions for self-care

Lesions present more than 7 days
secondary infection
Outside of the diaper region
Broken skin
Behavioral changes

16

Diaper dermatitis treatment

Skin protectant (17 approved ingredients such as cocoa butter, glycerin, mineral oil, petrolatum, zinc oxide, lanolin, white wax, paraffin wax, thymol iodide) Peruvian balsam, boric acid, castor oil, beeswax, olive oil are not approved. See doctor if not healed after 7 days

17

Do not use for diaper dermatitis

Baby powders
Cornstarch
Topical antifungals
topical antibacterials
topical anesthetics
hydrocortisone

18

Exclusion criteria for sunscreen

Xeroderma pigmentosum
Allergy to all sunscreen ingredients
less than 6 months of age

19

Sunscreen selection tips

Pick a braod spectrum sunscreen
Advise for a least SPF over 15
Over SPF 50 does not provide additional benefit
If skin is sensitive avoid PABA (aminobenzoic acid)
consider physical sunscreen

20

Sunscreen Application

Apply 1 ounce each application 15-30 minutes prior to exposure and at least every 2 hours.

21

FDA Sunscreen Application Recommendations

Face and Neck 1/2 teaspoon
Arms and shoulders 1/2 teaspoon to each side
Torso 1/2 teaspoon each side
Legs and top of feet 1 teaspoon to each side

22

Treatment plan for sunburn

In past 20 minutes immerse in cool water
Treat symptoms:
Systemic analgesics
Skin protectants (cocoa butter, petrolatum) as often as needed
Topical anesthetics (not recommended for routine use and only in small areas)
Should see doctor if not better in 7 days

23

Sunburn alternative treatment

Aloe Vera - not FDA approved, don't use with dye, use on intact skin