Skin infection, fungal nail, itch, psoriasis, rossacea, scabies and lice Flashcards
(50 cards)
how to treat impetigo
saline compress 10-15 min 2-3 times per day to remove crusts, apply topical antibiotic (mupiroc or fuc) f7-10d, if no improvement in 48 hours PO abx (cephalex 7-10 days)
what is onychomycosis and what is it usually caused by
fungal nail infection- dermatophytes
non drug treatment for onychomycosis
footwear and socks that minimize humidity, dry feet and in between toes thoroughly after washing, use footwear to avoid transmission, keep nails clean and short, avoid sharing nail clippers or footwear, prevent further trauma to nail, emollients on cracked skin to prevent further entry points for fungus, control DB/vascular diseases
treatment (pharm) for onychomycosis
not always necessary just monitor- if patient wants, multiple nails, severe, DM or immunocomp, can treat. Can use cipclopirox lacquer or oral terbinafine. Topical less effective and longer healing but can be used for early mild.
how to use ciclopirox for nail infections
apply topically for 48 weeks. daily application, weekly removal of lacquer with ruing alcohol and trim any damaged parts of nail throughout therapy
is fluconazole (PO) CI in preg?
only doses over 400mg per day
which TCA may be helpful in treating itch
doxepin- has some potent antihistamine properties for chronic urticaria or psychogenic causes of itch
antihistamines of choice in pregnancy
loratidine and cetirizie on sedating, or desloratidine. If want sedating, chlorpheniramine, diphehydramie or hydroxyzine all safe
what is characteristic of psoriasis
increased cell skin turnover, thick silvery scales
therapy for psoriasis
emollients and avoid triggers, then topical steroids along or in combination with other topicals (tar, vitamin D derivatives, tazarotene, anthralin), then UVB/PUVA, then systemic MTX, cyclosporine, bioligics etc
principles of treating scalp psoriasis
remove scales- use oil based product with or without SA or calcipotriol, with or without medium potency CS (betamethasone)
principles of treating facial psoriasis
HC 1%, then calcineurin inh (tacrolimus, pimecrolimus)
principles of treating psoriasis of hands and feet
frequent petrolatum and a medium to high potency CS with or without SA
compare the therapies (CS, Tar, antifungals) for psoriasis, tinea and eczema
order for best in psoriasis: tar, CS. Tinea only antifungals. Eczema CS, tar.
principles of treating body and extremity psoriasis
medium-high potency CS, vitamin D derivatives (calcipotriol, calcitriol), tazarotene, tar, anthralin ] all alone or in combo
non pharm for rosaccea
avoid extremes of weather as it can irritate (protect skin from sun-suncreen- and harsh winds),
what is rosaccea often misdiagnosed as
acne
how to treat rosaccea
topical metroidazole usually, or topical brimonidine if no papules or pustules, or systemic ABX if severe/recurrent. Isotretinoin low dose if treatment resistant
how soon can you expect improvement with topical metronidazole or azelaic acid for rosaccea
2-4 weeks - but treatment may need to continue indefinitely
what things worsen rossacea
steroids and sunlight
how long do lice typically survive away from a person
48 hours
why is retreatment recommended in lice and when should you do it
to get full lifecycle (eggs too)- 7-10 days later
why are isopropyl and dimeticone recommended over pyrethin and permethrin?
lice can develop resistance to them as they have a neurotoxic mode of action. Others are physicial agents ie isopropyl disrupts wax layer and dehydrates them and dimeticone coat surface and suffocate them
what product is approved for pubic lice? scabies?
permethrin 1% or pyrethins. 5% perm for scabies
