Topical Corticosteroids Flashcards
(26 cards)
What is the function of the epidermis and its components?
Prevents water loss and protects against external threat.
Melanocytes: Pigment protects from UV radiation
Keratinocytes: formed constantly and migrates to surface every 4 weeks then sheds
What is the epidermis?
Outer thin layer of varying thickness
List the components found in the dermis (second layer of skin)
- A collagen and elastin protein network
- Contains: blood vessels, lymph vessels, nerves, hair follicles, sweat glands and muscles
List the components found in the subcutaneous layer of skin and its function
- Protects and Insulates
- Contains: collagen fibres and fat cells, blood vessels and nerves
Outline the characteristics of skin
- Normal skin - moisture and oil balance, pH: 4.5-5.75, residential bacteria and yeasts
What questions can we ask about skin conditions?
- Tell me about where it first started?
- Are you experiencing anything else?
(other symptoms) - Occupational History (activities)
- General Medical history
- Any recent travel
- Family & household contact history
**7. The patient’s thoughts on the cause of the problem **
Non-pharmalogical Treatment for Dry Skin
- pH balanced soap free products for bathing/showering
- pH balanced non-perfumed emollients for improving skin hydration - use regularly
- Non-irritant clothing
- Good oral hydration
- avoid cosmetic use
- Improve diet and reduce stress
Participating Pharmacies can help manage minor skin conditions for eligible patients, including herpes zoster (shingles), impetigo (school sores), atopic dermatitis (eczema) and acute exacerbations of mild plaque psoriasis – from 19 July 2024 until 31 August 2025. True or False
True
Mediators associated with skin inflammation include is primarily Th1, Th2 cells with IgE associated to urticaria. True or False
True
What can cause skin inflammation?
Genetics (atopic dermatitis)
Environment
stress
Diet
Medications
Mechanism of Action of Topical Corticosteriods?
Anti-inflammatory, Immunosuppressive, Antimitotic activity against cutaneous fibroblasts and epidermal cells.
ALSO VASO-CONSTRICTIVE
Indication of TC:
Relief of inflammation (redness+swelling) and itch
Precautions of TC
Diabetes, Immunocompromised, other skin conditions,
elderly, pregnancy and breast feeding, children
Adverse Effects of TC
Rare: Subcutaneous Tissue Atropy - a common concern but a rare adverse effect
The incidence and severity of adverse effects is determined by:
- Patient age (young and elderly)
- Greater site and extent of disease - more likely to experience adverse effects
- Higher potency - more likely to experience
- Method of application (finger-tip dosage units) and length of Tx
Identify the different topical corticosteroids and its schedule
- Hydrocortisone or hydrocortisone acetate 0.5% - Schedule 2 medicine
- Clobetasone (clobetasone-17-butyrate) 0.05 % - Schedule 3
- Hydrocortisone or hydrocortisone acetate 1% - schedule 3
- Mometasone 0.1%
- Triamcinalone 0.1% (Buccal only - schedule 3
- [Alclometasone 0.05%] - schedule 3
List examples of a mild corticosteriod
Hydrocortisone or hydrocortisone acetate: Facial or flexural dermatitis and psorasis; nappy dermatitis
Are moderate corticosteroids 2-25 times
more potent as hydrocortisone?
Yes
Are potent corticosteroids 100-150 times as potent as hydrocortisone.
Yes
Main counselling points when it comes using topical corticosteroids
- Treat all areas of inflammation until dermatitis has gone and skin is completely clear
- When undertreated reoccurence is more common - Tx failure
- Apply liberally 1-2 times daily
- Choose potency approapriate to the site of action
- Skin atrophy is a common concern but is actually a rare adverse effect
- When applying >1 product to the same area of skin, allow sufficient time for absorption between applications.
What type of skin are ointments used on?
Didadvantages and Advantages
Dry scaly skin.
* Greasy, difficult to wash off, may cause folliculitis
* Better penetration into skin
What type of skin are creams used on?
Didadvantages and Advantages
Moist or dry skin; preferred for face and flexures
* preservatives can cause sensitisation; less emollient and more irritant than ointments
* Washable; non-greasy
Finger-tip dosage unit is not the right dosage unit for eye/ear/mouth preparations. True or False?
True
What is a finger-tip unit?
One fingertip unit is the amount of cream or ointment, squeezed out of a tube, from the tip of an adult’s index finger to the first crease in the finger
