Unit 4 Flashcards
(200 cards)
1
Q
What is candidiasis?
A
Infections caused by Candida yeast, mainly Candida albicans.
2
Q
What are common types of candidiasis?
A
Oral Thrush (white patches in mouth), Angular Cheilitis (cracks at mouth corners), Intertrigo (rash in skin folds), Vulvovaginal Candidiasis (vaginal yeast infection).
3
Q
What causes oral thrush?
A
Damaged mucosal barrier or weakened immunity.
4
Q
What are the symptoms of oral thrush?
A
White/yellow plaques on cheeks, gums, tongue.
5
Q
How is oral thrush treated?
A
Miconazole Gel (2.5 ml, hold in mouth for 7 days + 1 extra week after symptoms resolve).
6
Q
What is a key caution when using miconazole gel?
A
Avoid if taking warfarin (increased bleeding risk).
7
Q
What advice should be given to oral thrush patients?
A
Rinse mouth after steroid inhalers; clean dentures regularly.
8
Q
What is intertrigo?
A
Inflamed, itchy rash in skin folds (armpits, fingers, under breasts).
9
Q
How is intertrigo treated?
A
Topical imidazoles (e.g., miconazole); avoid terbinafine (not OTC licensed for yeast infections).
10
Q
What causes vulvovaginal candidiasis (vaginal thrush)?
A
Candida albicans, triggered by hormonal changes, diabetes, antibiotics, or immunosuppression.
“Thrush LOVES HDAI → Hormones, Diabetes, Antibiotics, Immunosuppression.
11
Q
What are the symptoms of vaginal thrush?
A
Itching, soreness, white ‘cheese-like’ discharge.
12
Q
How do you differentiate vaginal thrush from bacterial vaginosis?
A
Thrush: Itching + white ‘cheese-like’ discharge. BV: No itching, malodorous discharge.
13
Q
What are the treatments for vaginal thrush?
A
Topical azoles (creams/pessaries) OR Oral fluconazole (150 mg, single dose for women 16-60).
14
Q
How is thrush treated during pregnancy?
A
Topical azoles (NO oral fluconazole); refer to GP.
15
Q
What are symptoms of thrush in men?
A
Irritation, burning, white discharge at penis head.
16
Q
How is thrush treated in men?
A
Topical azoles; recommend condom use if partner is infected.
17
Q
What are the common types of bacterial skin infections?
A
Cellulitis and impetigo. Non-OTC-treatable cases should be referred to a GP.
18
Q
What is the difference between erysipelas and cellulitis?
A
Erysipelas affects the upper dermis and is usually caused by Streptococcus pyogenes, while cellulitis is a deeper tissue infection caused by various bacteria.
19
Q
What are the characteristics of erysipelas?
A
Erysipelas affects the upper dermis, usually caused by Streptococcus pyogenes.
20
Q
What are the characteristics of cellulitis?
A
Cellulitis is a deeper tissue infection caused by various bacteria, typically affecting the skin and subcutaneous tissue.
21
Q
What are the risk factors for developing erysipelas or cellulitis?
A
Skin breaks, wounds, venous disease, immunodeficiency.
22
Q
What are the symptoms of erysipelas or cellulitis?
A
Rapid onset with red, hot, swollen limbs, fever; often affects the lower limbs.
23
Q
What complications can arise from untreated erysipelas or cellulitis?
A
Can lead to abscesses, gangrene, chronic swelling, and severe infections.
24
Q
How are mild bacterial skin infections managed?
A
Rest, elevate limb, use analgesics like paracetamol or ibuprofen.
25
How are severe bacterial skin infections managed?
Oral antibiotics; IV antibiotics may be needed in severe cases.
26
What is the prognosis for bacterial skin infections if treated appropriately?
Generally excellent if uncomplicated.
27
What advice should be given to patients to prevent bacterial skin infections?
Treat skin conditions (e.g., athlete's foot), clean wounds, elevate leg to reduce swelling, and use emollients to prevent dry skin.
28
What bacteria causes impetigo?
Caused by Staphylococcus aureus or Streptococcus pyogenes; highly contagious.
29
What are the risk factors for impetigo?
Poor hygiene, skin trauma, eczema.
30
What are the symptoms of impetigo?
Pink macules that evolve into vesicles with 'honey-colored' crust, often on the face.
31
How is localized impetigo managed?
Topical antibiotics for localized cases.
32
How is widespread impetigo managed?
Oral antibiotics for widespread cases.
33
What hygiene practices should be followed for impetigo?
Wash the affected area with soap to prevent the spread of the infection.
34
What are the common causes of viral skin infections (exanthema)?
Measles, Rubella, Fifth disease, Hand/foot/mouth disease, Chickenpox.
35
What are the common viruses that cause viral skin infections?
Varicella zoster (chickenpox), Herpes simplex, HPV.
36
How is chickenpox (Varicella Zoster) transmitted?
Airborne and contact transmission; highly infectious.
37
What are the symptoms of chickenpox (Varicella Zoster)?
Fever followed by a rash (papules, vesicles, crusts), mainly on the face and trunk.
38
How is chickenpox managed?
Symptomatic relief with antihistamines and paracetamol.
39
What precautions should be taken for chickenpox?
Avoid pregnant women, young children, and immunocompromised individuals.
40
What is the treatment for severe chickenpox cases?
Oral acyclovir for adults at high risk.
41
What does NICE guidance say about managing chickenpox?
Avoid NSAIDs due to the risk of necrotizing infections.
42
What causes herpes zoster (shingles)?
Reactivation of the chickenpox virus, usually in adults over 50.
43
What are the symptoms of herpes zoster (shingles)?
Painful rash along dermatomes; vesicles that crust over in 7-10 days.
44
How is herpes zoster (shingles) managed?
Oral antivirals for adults over 50 or with severe cases.
45
What is Post-Herpetic Neuralgia (PHN)?
PHN is pain that persists for months or years after the shingles rash has healed. Treatment includes amitriptyline, gabapentin, or capsaicin.
46
How is herpes simplex virus (HSV-1) transmitted?
Direct contact; commonly causes cold sores.
47
What are the symptoms of herpes simplex virus (HSV-1)?
Prodrome of burning or itching, followed by lesion appearance, typically resolving within 10-14 days.
48
How is herpes simplex virus (HSV-1) managed?
Analgesics for pain relief; topical antivirals are effective only during the prodrome phase.
49
What advice should be given to patients with herpes simplex virus (HSV-1)?
Avoid lesion contact, practice good hand hygiene, and limit triggers such as UV exposure and stress.
50
How is HPV (Human Papillomavirus) transmitted?
Contact with an infected person or contaminated surfaces.
51
What types of warts are caused by HPV?
Common warts (asymptomatic, can appear anywhere), plantar warts (painful with lateral pressure, typically on feet).
52
How is HPV (warts) treated with salicylic acid?
Apply salicylic acid daily for up to 12 weeks; debride the area and protect surrounding skin.
53
How is HPV (warts) treated with cryotherapy?
Cryotherapy with liquid nitrogen every two weeks; avoid in young children.
54
What types of damage can insect bites & stings cause?
Mechanical, Allergic, and Infective damage.
55
What are common insects responsible for bites?
Blood-sucking insects (mosquitos, ticks).
56
What are the three types of lice?
Head lice, body lice, pubic lice.
57
What is the prevalence of head lice?
Affects 4-22% of children, mostly ages 4-11.
58
How is head lice transmitted?
Head-to-head contact; lice survive 1-2 days off the host.
59
What are the symptoms of head lice?
Often asymptomatic; pruritus (itching) from bites/saliva.
60
How is head lice diagnosed?
Confirm live lice presence.
61
How is head lice treated?
Non-Chemical: Wet/dry combing with detection comb. Chemical: Malathion 0.5% (12h, repeat in 7 days), Dimethicone 4% (8h, repeat in 7 days).
62
What post-treatment advice should be given for head lice?
Check for lice on days 3 and 7. Prevent recurrence with regular combing; avoid prophylactic insecticides.
63
What are the two types of insect bites & stings?
Stinging insects: Bees (stinger stays), Wasps/Hornets (multiple stings). Biting insects: Mosquitos, fleas, ticks (saliva causes inflammation).
64
What are the symptoms of insect bites?
Itchy, erythematous papules.
65
What are the symptoms of insect stings?
Immediate pain, vasodilation, swelling, erythema.
66
What are systemic reactions to bites/stings?
Delayed or immediate hypersensitivity (e.g., wheals, anaphylaxis).
67
How should insect stings be managed immediately?
Remove bee stinger (scrape sideways), apply cold packs, use antihistamines.
68
How should severe insect sting reactions be managed?
Watch for anaphylaxis signs (breathing issues, facial swelling), use adrenaline auto-injector if needed.
69
How should localized insect bite/sting reactions be treated?
Oral analgesics (pain relief), topical antihistamines/steroids (itch relief), crotamiton/calamine for soothing.
70
What is a complication of untreated insect bites?
Secondary infection (often Staphylococcus aureus), may require antibiotics.
71
What advice should patients follow for insect stings?
Scrape bee stingers sideways, wear protective clothing, avoid bright colors, perfumes, be cautious when eating outdoors.
72
What are systemic effects of stings?
Anaphylaxis risk (bee, wasp, hornet stings).
73
What are symptoms of anaphylaxis?
Urticaria, angioedema, bronchospasm, possible unconsciousness.
74
How is anaphylaxis treated?
Adrenaline auto-injector, seek immediate medical care.
75
What is osteoarthritis (OA)?
OA is a joint disorder caused by cartilage loss, bone remodeling, and inflammation. It mainly affects the knees, hips, and hands, especially in older adults.
76
What are the major risk factors for OA?
1. Genetic (no specific genes identified) 2. Occupational (kneeling, squatting jobs e.g., construction) 3. Obesity (worsens OA, especially in knees/hands) 4. Joint Injury (previous injuries increase risk).
77
What are the symptoms of knee OA?
Pain while walking, stiffness after sitting, swelling, and muscle weakness.
78
What are the symptoms of hip OA?
Pain while walking and at night; may require hip replacement.
79
What are the symptoms of hand OA?
Common in women (~50 years old), stiffness, and knuckle bony growths.
80
What are the symptoms of foot/ankle OA?
Big toe OA is common; managed with orthotics or surgery.
81
What are the symptoms of shoulder OA?
Rare, usually post-injury, managed with NSAIDs.
82
What are the symptoms of spinal OA?
Disc degeneration → back pain; treated with pain relief, exercise, steroid injections.
83
What happens in the disease process of OA?
Cartilage degeneration → Inflammation in ligaments & bones → Bone spurs form (not always painful).
84
What are the clinical features of OA?
Symptoms: Stiffness, fatigue, weakness, joint pain, swelling, joint deformity. Signs: Discomfort, limited motion, reduced stamina, swelling, warmth, tenderness, abnormal posture/gait, crepitation.
85
What are the key self-management strategies for OA?
Exercise (strengthening & aerobic), weight loss, proper footwear for lower limb OA.
86
What is the first-line pharmacological treatment for OA?
Topical NSAIDs are first-line. Oral NSAIDs if needed (monitor toxicity, use gastroprotection).
87
What are other pharmacological options for OA?
Paracetamol or weak opioids for short-term use.
88
Why should caution be taken with glucosamine & strong opioids in OA?
Limited evidence & risk of side effects.
89
What should be ruled out when assessing low back pain & sciatica?
Rule out cancer, infection, trauma, spondyloarthritis, and refer to NICE guidelines for serious conditions.
90
What are the two risk categories for low back pain and sciatica?
Low-risk: Reassurance, activity advice, self-management. High-risk: Intensive support (exercise, therapy).
91
When should imaging be used in low back pain & sciatica?
Imaging should be avoided unless the management plan will change based on the results.
92
What are the key elements of self-management for low back pain?
Tailored advice and staying active.
93
What types of exercise are recommended for low back pain & sciatica?
Group exercise such as bio-mechanical, aerobic, and mind-body exercises based on individual needs.
94
What orthotic treatments should be avoided for low back pain?
Avoid belts, corsets, or rocker shoes.
95
What is the role of manual therapy in low back pain management?
Avoid traction; it should be used as part of a broader treatment plan.
96
Should acupuncture and electro-therapies be offered for low back pain?
No, acupuncture and electro-therapies should not be offered.
97
What psychological therapy should be considered for low back pain?
Consider CBT-based (Cognitive Behavioral Therapy) therapy.
98
What should be encouraged for patients with low back pain in terms of work?
Encourage return to normal activities and work.
99
Which medications should be avoided in sciatica treatment?
Gabapentinoids, anti-epileptics, corticosteroids, benzodiazepines, opioids.
100
How should NSAIDs be used in the management of sciatica?
Use NSAIDs cautiously at the lowest effective dose and consider gastroprotective treatment.
101
How should NSAIDs be used in low back pain management?
Use NSAIDs cautiously, with monitoring for potential risks.
102
What is the recommendation for opioid use in low back pain?
Weak opioids can be used for acute pain; avoid them for chronic pain management.
103
Which medications should be avoided for low back pain?
Avoid paracetamol alone, opioids, antidepressants, and gabapentinoids.
104
What is the recommendation regarding spinal injections for low back pain?
Spinal injections should be avoided for low back pain.
| siatica we can give epidural inj or cortio
105
What invasive treatment can be considered if non-surgical treatments fail for low back pain or sciatica?
Radiofrequency denervation can be considered if non-surgical treatments fail.
106
When should epidural injections be considered for sciatica?
Epidural injections should be considered for acute severe sciatica but avoided for neurogenic claudication.
107
What is the consideration for surgical intervention in sciatica?
Do not consider BMI, smoking, or psychological distress as barriers to surgery.
108
What is the recommendation for spinal decompression surgery?
Consider spinal decompression surgery if non-surgical treatments fail.
109
When should spinal fusion or disc replacement be considered?
Spinal fusion or disc replacement should be avoided unless part of a trial.
110
What is non-specific low back pain?
Non-specific low back pain is mechanical, musculoskeletal pain without a serious underlying cause.
111
What is sciatica?
Sciatica refers to leg pain caused by issues with the lumbosacral nerve roots.
112
What medications are being reviewed for the treatment of sciatica?
Gabapentin and pregabalin are under review for treating sciatica.
113
What is atopic eczema (AE)?
A chronic inflammatory skin condition caused by genetic predisposition, affecting the skin, gut, sinuses, and airways.
114
What are the key symptoms of AE?
Dry skin, itching, redness, and inflammation.
115
What are the key symptoms of AE?
Dry, cracked, scaly, and itchy skin. Most important feature is ITCHINESS – if there’s no itch, it’s unlikely to be eczema.
116
What causes AE?
Altered skin barrier function & immune dysregulation → skin loses water, leading to dryness and irritation.
117
Why does scratching worsen AE?
Scratching damages the skin → releases inflammatory cytokines → worsens itch → more scratching (itch-scratch cycle).
118
How do emollients help treat AE?
Create a protective layer to prevent water loss, improve hydration, and block allergens/irritants.
119
What do humectants in emollients do?
They are hygroscopic, meaning they attract & retain water in the skin.
120
How often should emollients be applied?
Several times a day, immediately after bathing, and on the whole body (not just affected areas).
121
How much emollient should be prescribed?
1–1.2 kg per month.
122
When should topical steroids be applied in relation to emollients?
NICE: Apply emollient 30 minutes BEFORE the steroid.
123
What advice should be given to patients using emollients?
1. Avoid soaps & detergents 2. Use frequently, even when skin looks normal 3. Pat skin dry after bathing (don’t rub) 4. Apply by dotting & stroking downwards 5. Use a pump dispenser (avoid hand contamination in tubs).
124
What determines the potency of a topical steroid?
The steroid molecule itself, its physicochemical properties, and formulation.
125
Does a higher concentration always mean higher potency?
No!.
126
How do topical steroids work?
Bind to glucocorticoid receptors in keratinocytes & fibroblasts → suppress pro-inflammatory agents, reduce Langerhans cells, block vasodilators (e.g., histamine & bradykinin).
127
What are the four main effects of topical steroids?
1. Anti-inflammatory 2. Immunosuppressive 3. Anti-proliferative 4. Vasoconstrictive
128
Which topical steroid potency is used for mild eczema?
Mild potency steroid.
129
Which potency is used for moderate eczema?
Moderate potency steroid.
130
Which potency is used for severe eczema?
Potent steroid.
131
Which potency is used for facial, genital, or axilla eczema?
Start with mild potency; increase if necessary.
132
How does eczema become infected?
Persistent scratching damages the skin barrier, allowing bacteria (mainly Staphylococcus aureus) to infect the skin.
133
What are common signs of infected eczema?
Red, angry, weepy skin with yellow crusts; pustules & papules; fever & malaise; itchy, hot, sore skin.
134
What antibiotic is used for infected eczema?
Flucloxacillin for up to 2 weeks.
135
What are calcineurin inhibitors?
Second-line treatments for eczema that suppress the immune system by blocking calcineurin, which activates T-cells.
136
What are the two available calcineurin inhibitors?
Tacrolimus (Protopic) & Pimecrolimus (Elidel).
137
How do calcineurin inhibitors work?
Bind to calcineurin proteins → prevent T-cell activation → reduce pro-inflammatory cytokines.
138
What are oral treatments for eczema?
Ciclosporin, Azathioprine, Oral Corticosteroids, Mycophenolate Mofetil, Methotrexate.
139
Why can’t oral immunosuppressants be used long term?
Risk of serious side effects (e.g., infections, organ toxicity, immune suppression).
140
How does phototherapy work for eczema?
Alters cytokine production, kills infiltrating T-cells, inhibits antigen-presenting Langerhans cells, and thickens the epidermis to block allergens.
141
When is UV light therapy used?
Second-line treatment when topical agents don’t work. Can be used alone or with oral treatments.
142
Which biologic agent is licensed for moderate-to-severe AE?
Dupilumab (used for both eczema & psoriasis).
143
What is irritant contact dermatitis (ICD)?
Skin damage from chemical/physical agents (e.g., solvents, detergents) faster than the skin can repair.
144
Who is commonly affected by irritant contact dermatitis?
Occupational exposure (e.g., cleaners, hairdressers), young children (dribble rash), babies (nappy rash).
145
Where does irritant contact dermatitis commonly appear?
Hands.
146
What are symptoms of irritant contact dermatitis?
Inflamed skin, blisters, scaling.
147
How is irritant contact dermatitis managed?
Avoidance of irritant (e.g., gloves), emollients, topical steroids. May take up to 12 weeks to heal.
148
What is allergic contact dermatitis (ACD)?
Delayed allergic reaction (48-72 hours) to specific allergens like nickel, watch straps, perfumes.
149
What is the management of allergic contact dermatitis?
Avoid allergen, use emollients & topical steroids. If cause is unknown, refer for a patch test.
150
Why is dermatology more complex in darker skin tones?
Inflammatory changes are less obvious and may appear dark purple or hyperpigmented.
151
How does the skin barrier differ by ethnicity?
Black skin has more corneocyte layers but less lipid content (prone to dryness).
152
What are useful dermatology resources for skin of color?
Brown Skin Matters & Skin of Colour Society.
153
What is urticaria?
Allergy rash ('hives')—itchy, blotchy, raised rash due to mast cell activation & histamine release.
154
What chemicals cause swelling in urticaria?
Histamine, bradykinin, leukotrienes, prostaglandins.
155
What are causes of acute urticaria?
Food allergies, insect bites, stings, NSAIDs, viral infections, physical stimuli (pressure, cold, heat, sun exposure).
156
How is urticaria managed?
Avoid triggers, use non-sedating antihistamines, and topical therapies like calamine.
157
What is acne vulgaris?
A disease of the pilosebaceous follicle, mainly affecting the T-zone, chest, and back.
158
What are the 4 stages of acne development?
1. Release of inflammatory agents 2. Increased androgen-driven sebum production 3. Abnormal keratinocyte proliferation & blockage 4. Proliferation of Cutibacterium acnes.
159
What is a microcomedone?
A blocked follicle, the earliest acne lesion.
160
How do comedones form?
Blackheads (open comedones) form when blockage is near the surface (melanin oxidation). Whiteheads (closed comedones) form deeper due to pressure buildup.
161
What are different acne lesions & their features?
Papules = Small, red, tender. Pustules = Papules with pus. Nodules = Deep, solid, painful. Cysts = Nodules filled with pus.
162
Which acne lesions cause scarring?
Nodules & cysts.
163
When should acne be referred to a GP?
If acne affects the chest or back (topicals harder to apply).
164
What is the first-line OTC treatment for acne?
Benzoyl peroxide.
165
How does benzoyl peroxide work?
Bactericidal against C. acnes, reduces inflammation, targets comedones.
166
How does nicotinamide help acne?
Vitamin B3 derivative, reduces inflammation & sebum production.
167
What is the function of salicylic acid?
Keratolytic action—breaks down comedones.
168
How long should acne treatment be continued before switching?
At least 6 weeks.
169
What are dietary triggers for acne?
Greasy food, dairy, chocolate.
170
How does stress worsen acne?
Sebaceous glands are influenced by corticotropin-releasing hormone (CRH), increasing oil production.
171
Should acne patients pick or squeeze spots?
No, increases scarring risk.
172
How to reduce irritation from topical treatments?
Short contact therapy—start with 15 min application, wash off, then gradually increase. Use every other day if irritation occurs.
173
What is the benzoyl peroxide warning for patients?
Can bleach clothes & pillows.
174
What are the best formulations for different skin types?
Gels = Oily skin. Creams/Lotions = Dry/sensitive skin.
175
What does ‘comedogenic’ mean?
Causes acne (e.g., some moisturizers).
176
Should moisturizers be used in acne?
Yes, to prevent dryness from treatments—apply after topicals.
177
What are the 3 main oranism causes of superficial fungal infections?
1. Dermatophytes (keratinised areas: skin, hair, nails) 2. Candidiasis (yeast: mouth, vagina, GI) 3. Malassezia (lipid-dependent, in oily skin areas).
178
How do dermatophytes grow?
They need keratin & release keratinase, staying confined to the epidermis.
179
What are key risk factors for dermatophyte infections?
Moist/damaged skin, warm/humid environments.
180
How are dermatophyte infections transmitted?
Direct or indirect contact.
181
What are the clinical forms of tinea?
1. Tinea Corporis (ringworm): Red, scaly patch with central clearing 2. Jock itch (Tinea Cruris): Red, scaly rash in the groin 3. Athlete’s Foot (Tinea Pedis): Moist, peeling skin between toes.
182
What is a major risk of athlete’s foot?
Bacterial infection (e.g., cellulitis) due to cracked skin.
183
What are pharmacy treatments for fungal skin infections?
1. Imidazoles (e.g., clotrimazole) – Fungistatic, disrupts fungal membranes. 2. Allylamines (e.g., terbinafine) – Fungicidal, shorter treatment.
184
What are combination products for fungal infections with inflammation?
Daktacort®, Canesten HC® (max 7 days OTC use).
185
How long should topical antifungals be used?
- Imidazoles: 2-6 weeks, continue 1 week after symptom resolution. - Terbinafine: 1–2 weeks (body/groin), 7 days (feet).
186
How should antifungals be applied?
Apply to affected area + 4-6 cm radius, on dry skin.
187
What are preventive measures for fungal infections?
1. Use antifungal talc in shoes, rotate footwear. 2. Wear cotton socks/clothes to reduce moisture.
188
What is the best OTC treatment for fungal nail infections?
Amorolfine 5% (Curanail®) – applied once weekly.
189
How long does it take to treat fungal nails?
Fingernails: 6 months. Toenails: 9–12 months (up to 2 nails).
190
mild topical corticosteroids
**Hydrocortisone acetate (Mild)**
Fluocinolone acetonide 0.0025%
Indication: Mild eczema.
Side effects: Skin atrophy, depigmentation, vasodilation, adrenal suppression.
191
Calcineurin Inhibitors (Immunosuppressants for Eczema)
Tacrolimus (Protopic®) – Inhibits T-cell proliferation. Indication: Moderate-severe atopic eczema (short-term). Side effects: Infection risk, abnormal sensation, skin reactions.
Pimecrolimus (Elidel®) – Inhibits T-cell proliferation. Indication: Mild-moderate atopic eczema (short-term). Side effects: Infection risk, rare skin discoloration.
Cyclosporin – Inhibits lymphokine release. Indication: Severe atopic dermatitis (short-term). Side effects: Hypertension, tremor, nausea, vomiting, hair changes
192
Systemic Immunosuppressants for Severe Eczema & Psoriasis
## Footnote
bank roberry
Azathioprine – Metabolized to mercaptopurine. Indication: Severe refractory eczema. Side effects: Infection risk, anemia, hypersensitivity.
Methotrexate – Inhibits dihydrofolate reductase. Indication: Severe psoriasis. Side effects: Infections, diarrhea, GI & hepatic issues.
Mycophenolate – Inhibits inosine monophosphate dehydrogenase. Indication: Severe refractory eczema (Unlicensed use). Side effects: Infection risk, acidosis, alopecia, tachycardia.
Dupilumab – Inhibits IL-4 & IL-13 signaling. Indication: Moderate-severe atopic eczema. Side effects: Arthralgia, dry eye, eosinophilia, eye inflammation, oral herpes.
193
Antibiotic for Skin Infections
Flucloxacillin – Interferes with bacterial cell wall synthesis. Indication: Secondary bacterial infection of eczema. Side effects: Diarrhea, nausea, hypersensitivity.
194
Antihistamines (For Allergies, Urticaria, Atopic Dermatitis)
Loratadine – Non-sedating H1 antagonist. Indication: Hay fever, urticaria. Side effects: Drowsiness, nervousness (children).
Cetirizine – Non-sedating H1 antagonist. Indication: Hay fever, urticaria, atopic dermatitis. Side effects: Headache, dry mouth, nausea (rarely agitation).
195
Acne & Skin Conditions drugs
Benzoyl peroxide (BPO) – Breaks down comedones, bactericidal. Indication: Acne vulgaris. Side effects: Dryness, redness, peeling, burning.
Salicylic Acid – Softens keratin. Indication: Warts. Side effects: Skin irritation.
196
antifungals drugs
Antifungals
Miconazole – Inhibits fungal membrane synthesis. Indication: Fungal skin infections, oral candidiasis. Side effects: Dry mouth, nausea, vomiting.
Fluconazole – Inhibits fungal cell growth. Indication: Vaginal/mucosal candidiasis, tinea. Side effects: GI discomfort, nausea, headache, skin reactions.
Terbinafine – Inhibits squalene epoxidase → fungal cell death. Indication: Dermatophyte infections (nails, tinea). Side effects: GI discomfort, headache, myalgia.
197
moderate steroids
**Clobetasone (Moderate)**
betamethasone RD
Indication: Eczemas & dermatitis of all types.
Side effects: Skin atrophy, depigmentation, vasodilation, adrenal suppression.
198
potent steroids
**Hydrocortisone butyrate (Potent)**
Indication: Severe inflammatory skin disorders (e.g., severe eczema, psoriasis).
Side effects: Skin atrophy, depigmentation, vasodilation, adrenal suppression.
**Betamethasone (Potent)**
Indication: Severe inflammatory skin conditions.
Side effects: Skin atrophy, depigmentation, vasodilation, adrenal suppression.
199
v potent steroids
**Clobetasol (Very potent)**
Indication: Recalcitrant eczema, psoriasis (short-term use).
Side effects: Skin atrophy, depigmentation, vasodilation, adrenal suppression.
**Diflucortolone (Very potent, discontinued)**
200
calamine mechanism
Calamine – Anti-pruritic. Indication: Minor skin conditions. Side effects: Occasional irritation.
