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Dermatology > Treatments > Flashcards

Treatments Flashcards

1
Q

what are the advantages of topical treatments?

A
  • direct application

- reduced systemic effects

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2
Q

what are the disadvantages of topical treatments?

A
  • time consuming
  • correct dosage can be difficult
  • messy to use
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3
Q

what are creams?

A

semi-solid emulsion of oil in water

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4
Q

what do creams contain that ointments don’t?

A

preservatives

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5
Q

name some advantages of creams

A
  • high water content
  • cooling & mositurising
  • non-greasy
  • easy to apply
  • cosmetically acceptable
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6
Q

what are ointments?

A

semisolid grease/oil (soft paraffin)

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7
Q

name some advantages of ointments

A
  • occlusive & emollient

- restrict transepidermal water loss

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8
Q

name some disadvantages of ointments

A
  • greasy
  • less cosmetically attractive
  • higher risk of infection as patients constantly putting hands in & out of tub
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9
Q

what are lotions?

A

a liquid formulation of a suspension or solution of medication in water, alcohol or other liquids

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10
Q

what are the advantages of lotions?

A

can treat hair/scalp well

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11
Q

what are the disadvantages of lotions?

A

if they contain alcohol, they may sting

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12
Q

what are gels?

A

thickened aqueous lotions, semi-solids containing high molecular weight polymers

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13
Q

what are gels used for?

A

to treat scalp, hair bearing areas & face

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14
Q

what are pastes?

A

semisolids containing finely powdered material

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15
Q

what are the advantages of pastes?

A
  • protective
  • occlusive
  • hydrating
    often used in cooling, drying & soothing bandages & can be used for leakage around ulcers
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16
Q

what are the disadvantages of pastes?

A
  • stiff
  • greasy
  • difficult to apply
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17
Q

what are emollients used for?

A

rehydration of the epidermis in all dry/scaly conditions especially eczema

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18
Q

what are the disadvantages of emollients?

A

need frequent application

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19
Q

what are the advantages of emollients?

A

emulsifying ointment can be used as soap substitutes

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20
Q

what is wet wrap therapy used for?

A

very dry (xerotic) skin but difficult & time consuming to apply

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21
Q

give an example of a mild topical steroid

A

hydrocortisone

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22
Q

give an example of a moderate topical steroid

A

modrasone
clobetasone
butyrate

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23
Q

give an example of a potent topical steroid

A

mometasone
betamethasone
valerate

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24
Q

give an example of a very potent topical steroid

A

clobetasol

poprionate

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25
Q

when are topical corticosteroids used?

A
  • eczema (dermatitis)
  • psoriasis
  • other non-infective inflammatory dermatoses
  • keloid scars
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26
Q

what can intralesional steroids be used for?

A

hair loss

27
Q

what should one fingertip unit be able to cover?

A

2 hand areas

28
Q

what are the side effects of topical steroids?

A
  • thinning of the skin (skin creases are most susceptible)
  • purpura
  • stretch marks
  • steroid rosacea
  • fixed telangectasia
  • perioral dermatitis
  • can worsen or mask infections
  • systemic absorption
  • tachyphylaxis
  • rebound flare of disease
29
Q

what is tachyphylaxis?

A

decrease in response to anti-inflammatory effects

30
Q

which type of infection in particular get much worse when given steroids?

A

fungal infections

31
Q

which antiseptic is useful in bad eczema?

A

crystacide

32
Q

what are the disadvantages of antiseptics?

A
  • resistance can be built up
  • can be irritating to the skin
  • patients can become allergic
33
Q

when are antiseptics used?

A
  • recurrent infections
  • antibiotic resistance
  • wound irrigation
34
Q

which antibiotics are given for acne?

A

clindamycin
erythromycin
tetracycline
a drying agent

35
Q

which antibiotics are given for rosacea?

A

metronidazole

36
Q

which antibiotics are given for impetigo?

A

mupirocin

fusidic acid

37
Q

which antibiotics are given for infected eczema?

A

combined corticosteroid & antibacterial substance (short-term)

38
Q

what type of antiviral is given in herpes simplex virus?

A

topical

39
Q

what type of antiviral is given in herpes zoster & eczema herpeticum?

A

oral

40
Q

when is a topical antiviral given in herpes zoster?

A

if it’s around they eye

41
Q

what is given in candida?

A

anti-yeast

42
Q

what is given with dermatophytes?

A

antifungals

43
Q

what is given in pitryasis versicolor?

A

ketoconazole

44
Q

what is napkin dermatitis?

A

little inflamed papillose & pustules of yeast infection

45
Q

name some antipruritics

A

menthol
capsaicin
camphor/phenol
crotamiton

46
Q

how does capsaicin work?

A

depletes substance P at nerve endings & reduces neurotransmission, effect gradually builds

47
Q

what side effect of capsaicin is particularly unpleasant?

A

causes a burning sensation when first applied so is used for more localised itch

48
Q

what are keratolytics used for?

A

to soften keratin:

  • viral warts
  • hyperkeratotic eczema & psoriasis
  • corns & calluses
  • to remove jeratin plaques in scalp
49
Q

how are warts treated?

A

mechanical paring plus:

  • keratolytics
  • formaldahyde
  • glutaraldehyde
  • silver nitrate
  • cryotherapy
  • podophyllin
50
Q

how is psoriasis topically treated?

A

emollients plus:

  • coal tar
  • Vit. D analogue
  • Keratolytic
  • topical steroid
  • dithranol
51
Q

what are the advantages & disadvantages of coal tar?

A

can get a range of mild - strong solutions

messy & smelly

52
Q

what are the advantages & disadvantages of Vit. D analogues?

A

clean, no smell, easy to apply

can be irritant & use is limited

53
Q

what are the advantages & disadvantages of dithranol?

A

effective

difficult to use, irritant & stains normal skin

54
Q

how can dithranol be made more manageable?

A

do a short application, put on for 30 mins & then wash off

55
Q

what treatments can be used for scalp psoriasis?

A
  • greasy ointments to soften scale
  • tar shampoo
  • steroids in alcohol base/shampoo
  • Vit. D analogues
56
Q

what is imiquimod?

A

an immune response modulator

57
Q

what does imiquimod do?

A

enhances innate & cell-mediated immunity

58
Q

what effects does imiquimod have?

A

anti-viral

anti-tumour

59
Q

what is imiquimod used in?

A
  • genital warts
  • superficial BCC
  • solar keratoses
  • lentigo maligna
  • Bowen’s disease
  • verrucae
60
Q

what do calicneurin inhibitors do?

A

suppress lymphocyte activation

61
Q

when are calicneurin used?

A

in atopic eczema with no cutaneous atrophy

62
Q

what are the disadvantages of calicneurin inhibitors?

A
  • may cause burning sensation on application

- risk of cutaenous infection & skin cancer

63
Q

what are the general side effects of topical therapies?

A
  • burning or irritation
  • contact allergic dermatitis
  • local toxicity
  • systemic toxicity

Dermatology (16 decks)

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