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Low Weighted Topics > Skin > Flashcards

Skin Flashcards

(50 cards)

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1
Q

Creams, gels, lotions, ointment, paste and dilutions

A

Creams - emulsions of oil and water, LESS greasy than ointments and easier to apply
Gels - higher water content, suitable hydrophilic/hydrophobic bases in active ingredient
Lotions - cooling effect, preferred if applying to hairy areas
Ointment - greasy, preparation, insoluble in water and are more occlusive than creams, can be combined with mixture paraffin
Pastes - contain high proportion of finely powdered solid, less occlusive than ointments
Dilutions - avoid to prevent microbial contaminations, if diluted don’t use more than 2 weeks

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2
Q

Emollients and barrier preparations

A

Smooth, smooth and hydrate the skin and indicated for all dry or scaly disorders
Apply frequently, apply in direction of hair growth (prevent folliculitis) and apply gayer washing or bathing (maximise hydration)

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3
Q

ACBS

A

Advisory committee on borderline substances
Responsible for advising NHS
On prescribing items specially formulated for medical conditions
E.g enteral feeds but can include toiletries and sun blocks

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4
Q

Emolllient bath and shower preparations

A

Emollient bath additive; e.g oilatum
Added to bath water ; use a clean spoon to prevent contamination
Soak in 10-20 mins to improve hydration
Some bath emollients can be applied to wet skin undiluted and rinsed
Avoid soap in dry skin conditions it will make it worse
Slipping hazard

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5
Q

Paraffin

A

MHRA fire risk hazard
With paraffin based skin emollients on dressings and clothing
Cover up, not to use smoke or be near naked flame
Change bedding regularly as they can soak up the sheets or mattress or bedding

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6
Q

Barrier preparations

A

Contain watery repellent substances, such as dimeticone or other silicones
Used on the skin around stomas, bedsores and pressure areas in the elderly

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7
Q

Nappy rash

A

1st line to change nappies regularly
2nd line antifungals - clotrimazole
Alternatively zinc oxide cream or ointment - titanium or bepanthen
Barrier methods ; sudo cream and above

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8
Q

Cellulitis

A

Draw line around to help track if it is growing
Need flucloxacillin or clarithromycin
Rapid spreading infection needs systemic treatment

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9
Q

Impetigo

A

Fusidic acid
Mupirocin
If long lasting or bad use antibiotics oral

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10
Q

Infected burn

A

Flamazine used - silver Sulfasalazine

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11
Q

Fusidic acid

A

Staph infections
Impetigo
Angular chelitis

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12
Q

Metronidazole

A

Rosacea
Anaerobic infections first choice

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13
Q

Antifungals treatment

A

Topical first line
1-2 weeks to prevent relapse
Systemic treatment by oral route if it doesn’t get better or if its necessary

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14
Q

Dermatophytoses

A

Ringworm - tines captitis
Body - tines corpora’s
Groin - tines cruris
Hand - tines monium
Foot - tine pedi a or atheletes foot
Nail - tines linguin

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15
Q

Pityriasis versicolor

A

Ketoconazole or selenium sulfide shampoo
Candidiasis - topical imidazole antifungals
Refractory candiadiasis requires systemic treatment e.g Fluconazole
Angular cheilitis - miconazole

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16
Q

Antivirals

A

Aciclovir cream for herpes simples or zoster
Apply early as possible - from signs of tingling
5 times a day
Penciclovir cream for herpes labialis
Systemic treatment if frequently recur - oral tablets

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17
Q

Scabies

A

Permethrin or malathion
Treat all house members at the same time
Apply to the whole body
Reapply if washed hands
Pay attention when applying to webs and fingers and toes
Itching - can lasts a few weeks after; can have antihistamine at night

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18
Q

Head lice

A

Dimeticone (hedrin) coats head lice
Interferes with water balance in lice
By preventing the excretion of water
Repeat after 7 days
Malathion (Derbac M)- alternative to dimeticone; NOT use if asthmatic or if hedrin not helped or allergic
Crab lice - refer

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19
Q

Eczema

A

Irritant, allergic contact, atopic, various and discoid
Atopic eczema is most common, dry skin
Can lead to infection and lichenification
Management; apply emollients regularly and liberally, keep using even if it gets better
Topical corticosteroids decided by severity and applying

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20
Q

Risk factor eczema

A

Genetics
Environment
Skin irritants
Extremes in temperature or climate
Lack of moisturising after bathing

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21
Q

The skin

Study These Flashcards
A

Age - epidemiology of skin conditions various with age
Site - certain parts of the body linked with different aetiologies e.g warm, moist-areas ideal for fungal growth
Number of lesions - allows to determine extent of problem and rule out certain aetiologies e.g most bacterial infections confined to a specific area
Characteristics; shape, edge, colour, secondary features
Distribution patterns - e.g excess likely inside of joints, psoriasis on outside
Associated symptoms; itching, pain, discomfort

22
Q

Characteristics

Study These Flashcards
A

Flat <0.5 cm; macula
Flat >0.5 cm; patch, plaque
Raised <0.5 cm; papule, vesicle and pustule
Raised >0.5 cm; nodule, bulla
Shape; circular, linear, annular, irregular
Edge; well-demarcated, ill defined
Colour; erythematous, depigmented, pigmented
Secondary features; crusted, scaly, lichenified, eroded, fissured, ulcerated

23
Q

Infection

Study These Flashcards
A

Lichenification - potent corticosteroid needed
Excessive rubbing and itching leading to thick, leathery patches of skin
Non-sedating antihistamines to itching
A sedating antihistamines to help sleep
Exudative ‘weeping’ - potent corticosteroid
Severe refractory eczema - phototherapy

24
Q

Seborrheic dermatitis (cradle cap)

Study These Flashcards
A

Yeast infection
Very common in infants usually before 6 months,
Yellow scale/crusts on the scalp; greasy to touch
Self-limiting and does not cause the baby any itching or distress, not contagious
1st line; topical emollient; olive or veg oil massaged to loosen the scales, brush with soft brush and wash with shampoo, thicker scales to be soaked overnight and washed in morning
2nd line - clotrimazole 1% cream or miconazole 2%
REFER; secondary infection (caused by picking), self management/OTC failure

25
Eczema and psoriasis drugs affecting the immune response
Used to treat eczema and psoriasis Under specialise supervision Pimercrolimus or tacrolimus used for atopic eczema or psoriasis Methotrexate in severe cases of psoriasis with folic acid
26
Psoriasis
Worsened by; lithium, hyrdroxychloroquinine, BBS, NSAIDS and ACEI Emollients used as adjuvant Can be used for plaque psoriasis Scalp psoriasis use tar based shampoo Mild to moderate corticosteroid; facial, flexible and genital psoriasis Calcitriol for long term treatment Coal tar for chronic plaque psoriasis; anti scaling properties
27
Topical corticosteroids
Treat inflammatory skin conditions When emollients are ineffective Not recommended for acne Can cause rebound withdrawn Can cause skin thinning if overused
28
Choice of formulation steroid
Apply thinly no more than BD Avoid prolonged use especially on face Emollient is applied first wait half an hour then apply steroid for max absorption Urea/salicylic acid increase penetration of the steroid Occlusive polythene or hydrocolloid dressing increase absorbtion
29
Mild potency steorid
Mild - hydrocortisone 0.1 % to 2.5 % Dioderm, mildison Generic
30
Mild potency steroid with Antimicrobials
Canesten HC Fusidic H Timodine
31
Moderate steroid
Betamethasone 0.025% - betnovateRD Clobetasone butyrate 0.05% - eumovate / clobavate Fluocinolone acetonide 0.001% - synalar 1 in 4 dilution
32
Moderate with Antimicrobials steroid
Trimovate
33
Moderate steroid with urea
Alphaderm
34
Potent steroid
Betamethasone vale rate 0.1% - betnovate Fluticasone propionate 0.05% - cutivate Hydrocortisone butyrate 0.01% - locoid Mometasone furoate 0.1% - elcon
35
Potent with anti microbial steroids
Synalar C Sylvaner N
36
Potent with salycilic acid steroid
Diprosalic
37
Very potent steroid and very potent steroid with Antimicrobials
Dermovate - clobetasone propionate Dermovate NN
38
Acne
Tetracycline systemic if topical doesn’t help Minocycline has greater risk of lupus erythematosus like syndrome Trimethoprim if acne resistant Diannete (co-cyprindiol) Oral retinoids
39
Isotretinoin
Reduced sebum secretion and used for systemic treatment of severe acne Consultant dermatologist - new rule under 18 need 2 dr For at least 16 weeks MHRA; rare reports erectile dysfunction and decreased libido S/e; severe dryness of the skin and mucous membranes, nose bleeds, Teratogenic and must be given to women as last resort with effective contraction PPP Prescription valid for 7 days from negative test, can dispense 30 caps Avoid; UV sunlight, avoid during 6 months after; dermabrasion and waxing Stop if psychiatric reaction occur
40
Rosacea
Brimonidine - mirvasc (MHRA; risk CVD effects, can exacerbate rosacea; apply small then increase) Low dose doxycycline 6-12 week course
41
Pustules and papules
Topical - metronidazole azelaic acid, ivermectin Oral - oxytetracyline, tetracycline, erythromycin
42
Rubella
German measles RNA virus and spread by close personal contact or airborne droplets Less infectious than measles and symptoms usually less severe Prodromal period of up to 5 days; cold symptoms, fever, swollen glands, aching joints Pinpoint macular rash; red pink rash with small spots Treatment; improves with 7-10 days, simple analgesics
43
Mumps
Raised temperature, headache and joint pain, swelling at side of face and under ears, distinctive ‘hamster face’ Refer to GP - notifiable disease Simple analgesia for relieve pain Complications; rare, viral meningitis, inflammation of other organs (reproductive), infertility
44
Measles
Most dangerous childhood virus, serious complications more common Respiratory conditions such as pneumonia occur in 7% cases Encephalitis in 1 in every 600-1000 Self limiting; red blotchy rash around ears and face first then spread to trunk and limbs Paramyxovirus spread by droplet inhalation Prodromal symptoms 4-5 days before rash appears; URTI, conjunctivitis and small red spots inside mouth (koplik spots)
45
Chickenpox
Varicella zoster virus Droplet infection 10-20 day incubation and ineffective for 7 days after vesicles appeared and until crusted Fever, headache, sore throat, off food, grizzly Red lumps appear rapidly develop into vesicles - crus over in 3-5 days rash is very itchy Advice; hydrated, short fingernails and clean, cotton clothing, dress appropriately Calamine lotion and chlorphenamine to help itch Paracetamol for pain Aciclovir for immunocompromised
46
Wart and verruca
Both small, rough non-cancerous lumps of skin caused by HPV virus Excessive keratin in epidermis Highly contagious Verruca; plantar war; black dot in centre of white lump = blood vessel Treatment not 100% effective, mostly harmless, take years to go away Salicylic acid; OTC limited evidence, bazuka (has lactic acid as well) Cyrotherapy Advice; dont bite, pick or scratch at warts as will cause ‘autoinoculation’ Refer; bleed, changed appearance or spread, pain, distress or embarrassment diabetic patients, poor circulation such as peripheral vascular disease
47
Scalp psoriasis
Silver plaque is indicator Reduce weight and alcohol intake 1st like - topical corticosteroid OD for 4 weeks 2nd like trial alternative formulation of potent topical corticosteroid e.g shampoo or moose) and / or topical agent remover or softener 3rd line Betamethasone in combination with calcipotriol (vitamin D analogue) 4th very potent steroid BD for 2 weeks OR coal tar or Refer
48
Types of eczema
Irritant Allergic contact Atopic Venous Discoid
49
What shouldn’t be given in chickenpox
Ibuprofen
50
Ring worm treatment
Miconazole 2%

Low Weighted Topics (13 decks)

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