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Flashcards in RTS - Dermatology Deck (65)
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1

The skin is the largest organ in the body, list its functions.

1) barrier
2) acting as a sensory organ
3) protects tissues
4) homoeostatic balance

2

Describe what emollients are and what they are used for.

1) Emollients are moisturising treatments applied directly to the skin to reduce the amount of water loss
2) they cover the skin and form a protective film
3) they help to manage dry or scaly skin conditions
4) they soften cracks in the skin
5) ease itching of the skin

3

outline the four different types of emollients

emollients are available as - creams, ointments, lotions or sprays, both oils and shower products

1) occlusive emollients- create a film over the skin to prevent water evaporating (diprobase)

2) Humectant-containing emollients- contain additives such as urea, propylene glycol and lactic acid to attract and hold water in the top layer of the skin (doublebase)

3) Antipruritic emollients- contain ingredients to prevent/combat itching (Eurax)

4) Antiseptic emollients- contain ingredients to combat/prevent infection (dermol)

4

Explain what topical corticosteroids are and what they are used for.

1) topical steroids are used to treat inflammatory skin conditions.
2) they reduce skin inflammation and skin irritation
3) they help induce remission during a flare up

hydrocortisone acetate 1% cream HC45, clobetasone butyrate 0.05% cream Eumovate.

5

describe how topical corticosteroids are classified and their side effects.

1) Mild, Moderate, Potent, Very potent (last 2 are prescription only). you want to use the least potient one to treat the condition.

side effects
1) skin thinning
2) skin more vulnerable to infection
3) skin changing colour

6

The skin is the largest organ in the body, list its functions.

1) barrier
2) acting as a sensory organ
3) protects tissues
4) homoeostatic balance

7

outline the restrictions to corticosteroid sale

patient factors
1) patient must be over 10 years (hydrocortisone), over 12 years (clobetasone)
2) not allowed in pregnancy/ breastfeeding

Treatment duration
3) applied TWICE a day, MAX 7 days use.

Pack size
4) can only sell 15g max at any one time.

site
5) cannot be used on face, anogenital, broken or infected skin.

8

Describe the application of a corticosteroid cream.

The finger tip unit
1) one FTU is the amount of topical steroid that is squeezed out from a standard tube along an adults fingertip.
2) a finger tip is from the very end of the finger to the first crease in the finger.
3) one FTU is enough to treat an area of skin twice the size of the flat of an adults hand.

9

Describe what Antifungals are and how they work.

1) killing the fungal cells: affecting the cell walls, causing the cells to leak out
2) prevent growth: prevent the fungal cells from reproducing.

available: cream, sprays, gels, powders
clotrimazole 1% canesten - athletes foot

10

Describe what emollients are and what they are used for.

1) Emollients are moisturising treatments applied directly to the skin to reduce the amount of water loss
2) they cover the skin and form a protective film
3) they help to manage dry or scaly skin conditions
4) they soften cracks in the skin
5) ease itching of the skin

11

outline the four different types of emollients

emollients are available as - creams, ointments, lotions or sprays, both oils and shower products

1) occlusive emollients- create a film over the skin to prevent water evaporating (diprobase)

2) Humectant-containing emollients- contain additives such as urea, propylene glycol and lactic acid to attract and hold water in the top layer of the skin (doublebase)

3) Antipruritic emollients- contain ingredients to prevent/combat itching (Eurax)

4) Antiseptic emollients- contain ingredients to combat/prevent infection (dermol)

12

list the possible causative reasons for a rash.

a rash is a symptom- it is not a disease
1) eczema
2) psoriasis
3) bacterial, viral or fungal infections
4) allergies
5) infestations

13

explain what Atopic eczema is and list some aggravating factors.

1) an allergic condition normally affecting infants and children. patients often have other sensitivities e.g asthma, hay fever. sensitisation occurs leading to an inflammatory response.

aggravating factors:
1) pollen, sweat, detergents/soaps, cosmetics, rubber and latex, dyes and colouring.

14

outline the presenting features of Atopic eczema

1) itching
2) redness
3) inflammation
4) papules
5) rash
6) dry skin
7) scaly skin
8) cracked skin
9) pruritus- itching sensation.

15

describe the treatment for Atopic eczema

1) emollient therapy- apply liberally
2) topical corticosteroid
- not for under 10 years
- not during pregnancy
- not for treatment on face

16

outline the referral criteria for Atopic eczema

1) treatment failure
2) presenting on the face
3) child
4) broken skin
5) pregnant or breastfeeding

red flag symptoms:
6) bleeding
7) weeping
8) infection (yellow crusts)
9) non-blanching rash.

17

describe the additional advice you would give to a patient suffering from Atopic eczema

1) avoid triggers
2) certain fabrics can irritate the skin , avoid these. wear : soft, fine-weave clothing or natural materials such as cotton
3) heat can aggravate eczema- keep rooms cool
4) avoid using soaps or detergents that affect your skin. use soap substitutes instead

18

describe what contact dermatitis is and list the parameters affecting the response.

1) inflammatory response of the skin after exposure to an irritant
2) an "agent" must penetrate the outer layer of skin - the stratum corneum

parameters affecting the response: ( All affect the severity of reaction)
1) type of irritant- acid
2) the concentration
3) quantity involved
4) length of exposure
this can occur with a single exposure , more commonly frequent exposures, the irritant accumulates on the skin.

19

list the aggravating factors for contact dermatitis

1) detergents/ soaps
2) cosmetics
3) rubber and latex
4) dyes and colouring
5) acid/ alkali - cement
6) jewellery - nickel

20

list the presenting features of contact dermatitis

1) itching
2) redness
3) Inflammation
4) papules
5) rash
6) dry skin
7) scaly skin
8) cracked skin
9) pruritis

21

Explain what topical corticosteroids are and what they are used for.

1) topical steroids are used to treat inflammatory skin conditions.
2) they reduce skin inflammation and skin irritation
3) they help induce remission during a flare up

hydrocortisone acetate 1% cream HC45, clobetasone butyrate 0.05% cream Eumovate.

22

outline the treatment options for contact dermatitis

1) emollient therapy
2) topical corticosteroid - not under 10 years, pregnant or breastfeeding, not for face.
3) remove the causative agent

23

describe the referral criteria for contact dermatitis

1) treatment failure
2) lesions on the face
3) child
4) pregnant/breastfeeding
5) broken / bleeding/ weeping skin
6) widespread
7) infection
8) red flag symptom - non blanching rash

24

outline the additional advice you would give to patients suffering from contact dermatitis

1) remove trigger
2) avoid scented/fragranced products
3) clean your skin
4) use protective clothing
5) change products
6) regular use of emollients

25

explain what psoriasis is, and where it commonly develops.

1) relapsing inflammatory disorder
2) lesions are present
3) can present at any time in life
4) rare in infants and uncommon in children
psoriasis develops:
5) at sites of skin trauma
6) at sunburnt areas
7) round cuts
8) during periods of stress.
symmetrical distribution - usually scalp, knees, elbows

26

outline the presenting features of psoriasis

1) characteristic "salmon pink" lesions
2) silvery-white scales
3) well defined boundaries
4) raised
5) large
6) redness
7) scaling
8) patches
9) plaques
10) history
11) long term
12) symmetry

27

outline the treatment options for psoriasis

pharmacist can be involved in diagnosis, suitably placed to refer patients, involved in treatment options. however treatment is likely to be initiated by doctor/dermatologist

1) emollients- alone or in conjunction with active therapy
2) coal tar based preparations- efficacious in management of psoriasis. e.g capasal- messy to use, can stain skin/clothing
3) keratolytics- incorporated into emollients. aid in clearing scale. Evidence vs practice , e.g. urea or salicylic acid.

28

explain the additional advice you would give to a patient with psoriasis

1) keep up with the treatment , if it feels better do not stop treatment
2) regular review with dermatology team
3) eating a healthy, balanced diet and exercising regularly can also relieve stress, which may help improve the psoriasis.

29

describe how topical corticosteroids are classified and their side effects.

1) Mild, Moderate, Potent, Very potent (last 2 are prescription only). you want to use the least potient one to treat the condition.

side effects
1) skin thinning
2) skin more vulnerable to infection
3) skin changing colour

30

The skin is the largest organ in the body, list its functions.

1) barrier
2) acting as a sensory organ
3) protects tissues
4) homoeostatic balance