Skin problems

Question 1

What are skin problems (6)

Answer 1

1. Scabies
2. Warts
3. Skin rashes
4. Eczema and dermatitis
5. Meningitis
6. Itchy and dry skin

Question 2

What are the types of warts (4)

Answer 2

1. Plantar - small rough bumps (feet)
2. Periungual - small shiny → cauliflower bumps (around nails)
3. Common - flesh coloured (hands and knees)
4. Flat - smooth and flat (face, lower legs and hands)

Question 3

What are the causes of warts (8)

Answer 3

1. human papilloma virus (HPV).
2. It can be passed from person to person via direct skin contact or indirectly through contaminated surfaces.
3. If skin is wet or damaged, the risk of infection is greater.
4. The virus increases the amount of keratin produced by the skin causing a hard lump on the surface of the skin.
5. The infection can lead to having one or more warts at the same time or on the same site.
6. They appear as small, hardened, raised areas of skin, often with a cauliflower-like appearance, but do not normally hurt and are not harmful.
7. They can appear on any part of the body, but most often on the hands.
8. Warts that occur on the soles of the feet are known as verrucas and can have tiny black dots on them.

Question 4

How are warts treated (6)

Answer 4

1. salicylic acid
2. lactic acid.
3. Creams, gels, paints and medicated plasters
4. in all cases, the healthy skin around the wart needs to be protected from the treatments.
5. The treatments are usually a long process, and it can take months/years before the wart disappears.
6. The customer needs to be advised that they may not experience instant results and to persevere with treatment until the wart disappears.

Question 5

What are special cautions for warts (7)

Answer 5

1. White soft paraffin or petroleum jelly can be applied to the healthy skin around the wart before the treatment is applied.
2. Some products also suggest to soften the wart by soaking in water and that the wart is filed with an emery board or pumice stone before treatment with the product.
3. Care should be taken to avoid damaging the healthy skin around it or rubbing so much that the wart starts to bleed.
4. Rubbing the wart gently with an emery board and then soaking the wart in water (for about 5 minutes) softens the skin and takes the top layer of dead skin off.
5. This allows the treatment to target the next layer quicker, and so on, until the virus itself is killed.
6. Remind the patient not to share the emery board or pumice stone with anyone else as this can spread the virus to others.
7. None of the OTC wart removal products are suitable for treating warts on the face or in the anal/genital areas. Always refer such patients to the pharmacist.

Question 6

What is dermatitis (2)

Answer 6

1. Skin conditions which cause inflammation.
2. The most common types of dermatitis are contact dermatitis and atopic dermatitis, also known as atopic eczema.

Question 7

What causes dermatitis (11)

Answer 7

1. Contact dermatitis - occurs as a response to an irritant or an allergen.
2. chemicals
3. metals
4. plants
5. laundry detergents
6. fabric softeners
7. perfumes
8. perfumed soaps
9. make up
10. latex gloves
11. dyes.

Question 8

What is eczema

Answer 8

a group of skin conditions that can cause symptoms such as redness, inflammation, crusting and scaling.

Question 9

What causes eczema (6)

Answer 9

1. has a genetic link and the likelihood of developing eczema is increased if one or both parents have eczema.
2. There are a number of trigger factors
3. irritants
4. cold and dry weather
5. house dust mites
6. hormonal changes.

Question 10

What are the treatments for dermatitis and eczema (3)

Answer 10

1. Emollients
2. Hydrocortisone - refer
3. Clobetasome butyrate

Question 11

What treatments are there for itchy skin (2)

Answer 11

1. Oral antihistamines
2. Crotamiton (Eurax)

Question 12

What treatments are there for dry skin (4)

Answer 12

1. Emollients
2. Paraffin
3. emulsifying ointment
4. Avoid soap and drying substances

Question 13

What are special cautions for emollients (3)

Answer 13

1. Fire hazard
2. transfer onto fabrics
3. establish smoking status

Question 14

What is scabies (3)

Answer 14

1. contagious skin condition that is caused by a mite infestation.
2. The mites are tiny insects that get under the epidermis of the skin
3. an itchy rash appears up to eight weeks after the person has been infected.

Question 15

What causes scabies (3)

Answer 15

1. The rash is caused by the body’s immune system reacting to the saliva and waste products the mites produce and people can be infected without knowing about it.
2. Scabies is passed on when there are long periods of skin-to-skin contact with an infected person as well as sexual intercourse and sharing of clothes, towels and bedding.
3. For this reason, it is important to treat all close contacts and household members at the same time whether they have the rash or not, to avoid re-infecting the treated people.

Question 16

What treatment is there for scabies (9)

Answer 16

1. Everywhere below the neck needs to be treated, including anal/genital areas, wrists, armpits, breasts, soles of feet, and in between the fingers and toes.
2. Particular attention needs to be paid to the areas between the fingers and toes and under the fingernails.
3. In children under the age of two years and the elderly, treatment should also be applied to the scalp, face and ears, avoiding the eyes and mouth.
4. Insecticides kill the mites
5. malathion
6. permethrin
7. The treatment should be applied to cool, dry skin and not immediately after a hot bath.
8. Malathion needs to be left on the body for 24 hours and permethrin for 8–12 hours. During this time if the person washes their hands or any other parts treated, they must re-apply the treatment.
9. Permethrin and malathion are usually recommended first, and both treatments should be repeated after seven days to ensure that any recently hatched mites are eliminated.

Question 17

What special cautions are there for scabies (5)

Answer 17

1. On the day they apply the treatment, patients should be advised to also wash their clothes, towels and bedding at over 50°C.
2. Items that can not be washed, can be placed in a plastic bag for 72 hours. This will kill any remaining mites and prevent re-infection.
3. Patients should be advised that the itching and rash associated with scabies infestation can persist for up to a month after treatment for the associated itching to settle down and longer for genital lesions to resolve.
4. An anti-itch cream (eg. crotamiton cream) can be recommended to relieve the itching if necessary.
5. Pregnant women and children under two will need to be referred to their doctor for treatment under their GP’s supervision.