Skin conditions

Question 1

What are the three layers of the human skin?

Answer 1

Epidermis, Dermis and Hypodermis

Question 2

What are some of the symptoms of atopic eczema?

Answer 2

Dry, red, cracked, rough, flaky skin

Question 3

What causes atopic eczema?

Answer 3

Allergies, Family history of eczema or it may develop over other conditions such as asthma.

Flare ups can be caused by washing detergents

Question 4

What are the two types of OTC medications available for treatment of eczema? (also for contact dermatitis)

Answer 4

Emollients: creams and ointments used to soothe the skin

Topical hydrocortisone: also used for bites and allergic dermatitis

Antipruritic: reduces discomfort of itchy skin

Question 5

What counselling advice would you give for topical hydrocortisones?

Answer 5

Do not apply to the face, genital area or broken skin unless recommended by a Doctor
Not suitable for under 10s
Needs to be applied once to twice a day but 8-12 hours in between

Question 6

What is the cause of contact dermatitis?

Answer 6

Exposure to irritant such as soap, detergents, solvents or water.

Question 7

What are the symptoms of contact dermatitis?

Answer 7

Red, blistered, dry and cracked skin

Question 8

What areas of the body does Seborrheic dermatitis affect?

Answer 8

Normally the scalp but it can affect the face, sides of the nose, eyelids and chest.

Question 9

What is the first and second line treatment for Seborrheic dermatitis?

Answer 9

Ketoconazole 2% shampoo; First line treatment, maximum application of once every 3 days
Selenium Sulphide: Second line treatment

Question 10

How should cradle cap be treated?

Answer 10

With olive or archis oil followed by gentle baby shampoo

Question 11

What are the symptoms of psoriasis?

Answer 11

The skin becomes inflamed with red scaly patches forming of the hands, knees and elbows.

Question 12

What are the main treatments of psoriasis?

Answer 12

Emulsifying ointments: soothe and hydrate the skin

Calciptrol or tacalcitol: a newer treatment which contains Vitamin D

Topical steroids: suppress skin plaques, can’t use on the scalp

Question 13

What is hives also known as?

Answer 13

Urticaria

Question 14

What are the main symptoms of hives?

Answer 14

A raised, itchy rash that is very pale in colour. Can occur anywhere on the body.

Question 15

What can cause hives?

Answer 15

Food
Pollen
Insect bites
Chemicals

Question 16

How often should you take the four anti-histamines recommended for treating hives?

Answer 16

Certrizine: one daily
Loratidine: 10mg once a day
Chloraphenamine: 4mg every 4-6 hours. Maximum 24mg daily
Promethazine: 10-20mg 2-3 times a day

Question 17

What are some of the alarm symptoms of warts?

Answer 17

If they are on the face
Patient is diabetic 
Patient is pregnant 
Change in appearance of them 
Bleeding 
Genital warts 
Immunosuppressed patient

Question 18

What treatments are available OTC for warts?

Answer 18

Salicylic acid based products

Glutaraldehyde and lactic acid

Cryotherapy: freezing warts using liquid nitrogen

Question 19

When is it appropriate to refer to the Pharmacist for nappy rash?

Answer 19

If the skin is broken or weeping

The rash hasn’t cleared up after a week of using a OTC medication

Question 20

What advice can you provide to the parent of a child with nappy rash?

Answer 20

Use non-perfumed wipes
Frequently change the nappy
Wash the bottom instead of wipes if possible
Keep bottom exposed to air if possible

Question 21

What medication is available for nappy rash?

Answer 21

Emollient is generally the first line treatment. And is a water repellent.

Zinc acts as a soothing agent

Lanolin emollient helps to hydrate the skin

Castor oil/ cod liver oil provides a water resistance layer on the skin.

Question 22

When should you refer to a Pharmacist with burns?

Answer 22

Burn size is greater than the patient’s hand
On the face
It is blistered or painful
Shortness or breath following chemical burns

Question 23

What dressings are recommended for burns?

Answer 23

Alginate, paraffin gauze and clear film dressing may be used.

Question 24

What are some symptoms of heatstroke?

Answer 24

Nausea
Dizziness
Headaches

Question 25

What OTC products are available to treat cases of sunburn?

Answer 25

Painkillers such as paracetamol and ibuprofen can be used
Aftersuns soothe the burn and prevent the skin from peeling
Calamine and glycerine creams help to soothe the soreness

Question 26

What causes the irritation of insect bits?

Answer 26

The injection of saliva into the skin

Question 27

What are the alarm symptoms associated with insect bites?

Answer 27

If there is a risk of bacterial infection or cellulitis due to the puncture.

If the patient is struggling to breathe or has a tightness across the chest as this suggests they are experiencing anaphylaxis.

Question 28

What is lifestyle advice that can be provided to reduce possibility of getting bitten?

Answer 28

Wear long sleeves
Anti-malarial drugs if going to a country where Malaria has high prevalence
Mosquito nets
Avoid camping near pools of water (mosquito breeding grounds)
Keep sweet smelling food covered when eating outside

Question 29

What medications are available for dealing with bites and stings?

Answer 29

Anti histamine creams
Oral anti histamines
Topical steroids
Local anesthetics/ antiseptics for secondary bacterial infection

Question 30

State three anti-histamines and their corresponding doses required for treating bites and stings?

Answer 30

Mepyramine Maleate: Apply two to three times a day to the affected area for up to three days

Loratadine: 10mg daily (Aged 2+)

Chloraphenamine: 4mg every 4-6 hours; maximum 24mg per day (Aged 12+)