Skin Conditions Flashcards by Jimmy Hayden

What natural product has been used to treat cold sores?

Lysine

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Main drugs that can discolor skin and secrtions

Levodopa, entacapone (Brown)
Methocarbamol
Metronidazole, tinidazole
Nitrofurantoin
Sulfasalazine
Phenazopyridine
Amiodarone

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Classification of acne

Mild: few, occasional pimples
Moderate: inflammatory papules
Severe: nodules and cysts

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OTC meds for acne

Benzoyl peroxide: most effective OTC agent
Also comes in combonation products as Rx
Salicyclic acid: mildly useful, in many medicated pads

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Usual drug of choice for acne

topical retinoids (Vit A analogs)
Tretinoin (Atralin, Retin-A, more)
Adapalene (differin)
Tazarotene (Tazorac) (reserved for harder cases)

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Notes for topical retinoids

Limit sun exposure
Apply daily, usually at bedtime
only need pea-sized amount for face
takes 4-12 weeks to see response; may worsen acne at first
Differin 1% gel is now OTC
Main SE: skin irritation 
Adapalene + benzyl peroxide (Epiduo)

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Notes for benzyl peroxide

start with 2.5-5% 
Limit sun exposure
Combo with other drugs;
Erythromycin
Clindamycin
Hydrocortisone

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Topical antibiotics used for acne

Erythromycin
Clindamycin
Dapsone (Aczone)
Takes 2-6 weeks to see effect

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Isotretinoin

oral retinoid
Claravis and other brands
only for severe acne
0.5-1 mg/kg/day divided BID
2 forms of birth control required (birth defects)
females: 2 negative preg test prior to starting
SEs: dry mouth, dry eyes, photosensitivity

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Oral antibiotics for acne

Minocycline (Solodyn)
Doxycycline
Can be used if 12+ y/o
Bactrim has been used sometimes

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Drugs used for alopecia

Finasteride (propecia):
5-alpha reductase inhibitor
1 mg daily
see effects after 3+ months
Must be used indefinitely 
Less sexual side effects w/ lower dose
Topical minoxidil (Rogaine):
Available in 2% and 5%
Used indefinitely
Used in men and women

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Latissee

Bimatoprost solution
for thinning eyelashes
use nightly, apply to skin at the base of the upper eyelash

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Cold sores are caused by:

herpes simplex virus
HSV-1 in children usually
HSV-2 when older

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Cold sore notes

Sore eruption is preceded by tingling, itching soreness
start taking meds ASAP to reduce sore duration
OTC:
Docosanol (Abreva) - apply 5x/day at first sign of outbreak
RX:
Acyclovir (Zovirax) - 5x/day x 4 days
Penciclovir (Denavir) - apply q2hs while awake x 4 days
Recurrence > 4x/year: might b=require chronic suppression therapy.

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Causes and treatment of dandruff

Eczema or fungal overgrowth
OTC:
Selenium sulfide shampoos
Rub in well and leave in for 5 mins
Rx:
Ketoconazole shampoo (Nizoral A-D):
apply twice weekly for up to 8 weeks
can cause skin irritation

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Diaper rash treatments

Desitin (petrolatum + zinc oxide) - dry out skin, skin protectant
A&D oint (petrolatum)
Vusion (miconazole/zinc oxide/ petrolatum)
Low dose hydrocortisone (only used for a few days)

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eczema backgroud

aka atopic dematitis
skin rashes that become crusty and scaly
can be caused by environmental irritants/allergens
Moisturizers decr severity (Aquaphor, Eucerin)

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Eczema treatment

Moisturizers
1st line: topical steroids (oral for outbreaks)
antihistamines for itching 
If steroids don't work:
topical calcineurin inhibitors (2+ y/o)
used for short-periods of time = incr risk of skin cancer
Tacrolimus (Protopic)
Pimecrolimus (Elidel)
Topical PDE-4 inhibitor
Crisaborole (Eucrisa)

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Tinea pedis

athlete’s foot

itching, peeling, redness, mild burning, sores (rare)

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Tinea cruris

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Jock itch
affects genitals, inner thighs, buttocks
red, itchy rash (can be ring-shaped)

Tinea corporis

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Ringworm (not a worm)
can appear anywhere on body
The outer part of the sore can become raised
Tinea capitis - ringworm on the scalp - treated systemically

OTC drugs used for topical fungal infections

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Terbinafine (Lamisil AT)
Butenafine (Lotrimin ultra)
Clotrimazole (Lotrimin AF)
Tolnaftate (Tinactin powder, use for prevention = put in shoes after gym, etc)
Undecylenic acid (Fungi-Nail)

used for 2-4 weeks
creams work best
Terbinafine and butenafine are highly effective

RX drugs used for topical fungal infections

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Betamethasone/clotrimazole (Lotrisone)
Ketoconazole
Luliconazole (Luzu)

Onychomycosis (tinea inguium)

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fungal infection of toenail & fingernail

topicals are only reserved for mild cases; usually need systemic treatment

Onychomycosis (tinea inguium) treatment

``` FDA-approved: Itraconazole (Sporanox) 200 mg daily x 12 w (pulse-dosing for finger nails) Terbinafine oral (Lamisil) 250 mg daily x 6w (finger) x 12w (toe) Off-label: fluconazole, posaconazole Topicals Ciclopirox (usually used in combo with oral meds) Tavaborole (Kerydin) Efinaconazole (Jublia) ```

Fungal vaginal infections

More common week before menses Symptoms: itching, soreness, pain urinating/during sex, cottage cheese discharge (some) vaginal creams can weaken latex in condoms

Vaginal fungal infection treatments

``` OTC/Topicals: Butoconazole (1 day) Clotrimazole Miconazole ( Monistat 3 and others) Terconazole (Terazol 7) Oral: Fluconazole 150 mg x 1 ``` 7-10 days of treatment for complicated infections, preg

Treatment for genital warts

Imiquimod cream (Aldara, Zyclara) Apply at bedtime to affected area, wash off after 8 hrs, use 3x/week for max of 16 weeks Cause skin burning, edema, redness, itching

Hemorrhoids

swollen blood vessels in the lower rectum Treatment: Fiber/stool softener to reduce straining Phenylephrine (Preparation H) - shrinks hemrrhoids Hydrocortisone - reduce inflammation and itching Witch Hazel (Tuck's pads) - astringent that relieves itching suppositories used for internal hemorrhoids

Treatment for scabies

primarily spread through sexual contact permethrin cream (Elimite) + 2 doses of ivermectin (Stromectol) taken 1 week apart Ivermectin: poorly tolerated; arthralgias, skin tenderness, pruritis, fever

Treatment for lice

Permethrin is DOC Make sure to use lice comb to get out Nits or the med will not work. Use nit comb every 2-3 days Most drugs require re-treatment after 7-10 days Wash all clothes and bedding in hot water Other meds: Spinosad (Natroba) - 4+ yrs Malathion (Ovide) Ivermectin top (Sklice) 6+ mons

Neosporin

polymyxin, bacitracin, neomycin

Polysporin

bacitracin and polymyxin

Cortisporin

bacitracin, neomycin, polymyxin, Hydrocortisone | rx only

Pinworm (Vermicularis) infection

``` most common in children and presents as anal itching OTC: Pyrantel (Reese's Pinworm) 3 treatments seperated by 3 weeks Pamix and Pin-X Rx: Albendazole (Albenza) Mebendazole Cause HA, nausea, hepatoxicity Albendazole: given with anticonvulsants and high-dose steroids to decr CNS inflammation Take with high fat meal ```

Toxin of poison ivy, oak, sumac

Uroshiol

Treatments for poison ivy, etc

Aluminum acetate (Burrow's) - astringent Colloidal oatmeal (Aveeno) Calamine + pramoxine topical and oral steroids can be used make sure to wash exposed area of the body with soap and water ASAP Cold compress can help too

OTC hydrocostisone strength

0.5% and 1%

Steroid vehicle influence

Highest to weakest strength | Oint (form skin barrier) -> creams -> lotions -> solutions -> gels -> sprays

What oral med can be given for urticaria (hives)?

oral antihistamines 2nd gen preferred due to less sedation Others: Famotidine Hydroxyzine

Best type of sunscreen to use

``` "broad spectrum" covers UVA (aging) and UVB (burning) at least SPF of 15-30 or higher apply at least every 2 hours re-apply after swimming or sweating ```

Very high potency topical steroids

Clobetasol (Clobex/Cormax) Betamethasone oint (Diprolene) Halobetasol (Ultravate) Fluocinonide (Vanos)

High potency topical steroids

Betamethasone cream Mometasone oint (Elocon) Fluocinonide (Lidex) 0.05 % oint Desoximetasone (Topicort)

High-Med potency topical steroids

Fluticasone (Cutivate) | Fluocinonide 0.05% cream

Medium potency topical steroids

``` Mometasone cream (oint is high potency) Triamcinolone (Kenalog) Flucinolone oint (Synalar) Hydrocortisone valerate (Westcort oint) ```

Lower potency topical steroids

Desonide (DesOwen) Lotion Hydrocortison valerate cream (westcort cream) hydrocortisone butyrate (Locoid)/ probutate (Pandel)

Mild potency topical steroids

Desonide gel/cream/foam | FLucinolone oil/solution

Lowest potency topical steroids

hydrocortisone acetate all forms and strengths

Skin Conditions Flashcards

(48 cards)