Skin

Question 1

Skin Vehicle - Applications

Answer 1

Viscous Solutions ,emulsions or suspensions used on the scalp or nails

Question 2

Creams

Answer 2

Emulsions of oils and water.Less greasy than ointments and easier to apply

Question 3

Gels

Answer 3

High water content, face and scalp. Consist of active ingredient in suitable hydrophilic or hydrophobic bases

Question 4

Lotions

Answer 4

Cooling effect.Preffered if applying on hairy area

Question 5

Ointments

Answer 5

Greasy preparations, I soluable in water and are more occlusive than creams. Can be combines with a mixture of paraffin

Question 6

Pastes

Answer 6

Contain high proportion of finely powdered solids. Less occlusive than ointments

Question 7

Emollients and barrier preps do what?

Answer 7

They Soothe
Smooth and hydrate
Used for all dry skin or scaling conditions

Question 8

ACBS

Answer 8

Responsible for advising NHS

On prescribing items specially formulated for medical conditions

Eg. External feeds and foods (gluten free) but can include toiletries and sun blocks

Question 9

Emollient Bath and shower preparations

Answer 9

Emolients bath additives
Added to bath water
Soak in 10-20 mins
Some bath emollients can be applied to wet skin undiluted and then rinsed off
Avoid soap in dry skin conditions

Question 10

Paraffin warnings

Answer 10

Risk of fire, high temperature

Question 11

Barrier preps

Answer 11

Contain water - repellent substances such as dimeticone or other silicones

Used on the skin around stomas,bedsores,pressure areas in elderly

Question 12

Nappy rash

Answer 12

1st line - change nappies frequently
2nd line - antifungal eg. Clotrimazole
- alternatively zinc oxide cream/ointment

Question 13

Bacterial skin infections

Answer 13

Cellulitis - rapid spreading skin infection,needs antibiotic treatment

Impetigo - Fusidic acid/mupirocin,antibiotics if long standing
- Don’t use longer than 10 days

• silver sulfadiazine (flamazine) -infected burns

Question 14

Fusidic acid

Answer 14

STAPH infections - impetigo, angular chelitis - painful cracks edge mouth

Question 15

Metronidazole

Answer 15

Rosacea - flushing redness and anaerobic infections inside mouth

Question 16

Antifungals

Answer 16

Used topically - 1-2 weeks after to prevent relapse

Systemic - oral medication if it doesn’t get better

Question 17

Griseofluvin

Answer 17

Grisol spray

Question 18

Amilofine/Ticonazole

Answer 18

For fungal infections

Question 19

Candidasis

Answer 19

Topical imidazole
Refractory - if happens again - candidiasis requires oral antifungal treatment eg. With fluconazole

Question 20

Scaly fungal infection in hair

Answer 20

Ketoconazole/selenium sulfide shampoooo

Question 21

Angular Cheilitis

Answer 21

Miconazole

Question 22

Permethrin

Answer 22

Treat all house members at the same time

Adults over 2 year old
Applied to whole body but not to head and face

Elderly patient and children under 2
Apply cream to whole body - everywhere

Question 23

How to use permethrin

Answer 23

Apply and leave on 8-12 hours and wash off
Apply again a week later
Reapply if washed hands
Pay attention when applying to webs of fingers and toes

Itching - itch and eczema like at night - can have crotamiton,corticosteroid or sedating antihistamines at night
Send kids to school 24 hrs after first treatment

Question 24

Headline

Answer 24

Dimeticone-coats lice
Interest with water balance in lice
By preventing the excretion of water
Repeat after 7 days

Malathion - alternative to dimeticone

Question 25

Headline application

Answer 25

Apply and let dry Wash off after 12 hours Repeat after 7 days Treat all body surfaces

Question 26

Psoriasis

Answer 26

Worsened by lithium,hydrixychloriquine,BB,NSAIDS and ACE I Emollients used as adjuncts to more specific treatment Pimercrolimus/tacrolimus used for a atopic eczema/psoriasis Methotrexate - severe Different corticosteroids and forms depending on severity and location

Question 27

Potencies of topical steroids

Answer 27

Mild - Hydrocortisone Moderate-Betamethasone 0.025% (betnovate RD/Clobetasone Potent - Betamethasone - 0.1%/mometasone Very potent - Clobetasol (most potent)

Question 28

Mild creams

Answer 28

Hydrocortisone Mild anti microbial Canesten HC Fucidin H Timodine

Question 29

Moderate

Answer 29

Betnovate Eumovate Moderate with anti microbial Trimovate Moderate with urea Alphaderm

Question 30

Potent

Answer 30

Betamethasone valerate 0.1% Moderate Furoate 0.1 = Elocon Hydrocortisone Butyrate - Locoid

Question 33

ACNE -Mild to moderate

Answer 33

Topical tretinoin,isotertnoin,adapalene Need several months Acne - oral preps Tetracycline systemic antibiotics if topical doesn’t help May need to take 2 years or longer

Question 34

Isotert

Answer 34

Last option, 16 weeks by consultant dermatologist Severe dryness of skin,lips and eyes Nose bleeds and joint pain Teratogenic - must not be given to women of child bearing age, practice effective contraception