Week 3 - Dermatological Therapeutics Flashcards Preview

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Flashcards in Week 3 - Dermatological Therapeutics Deck (46):
0

How do retinoids work?

Vitamin A analogs - work through nuclear receptors on DNA causing alteration of gene transcription

1

What are the actions, uses and adverse effects of corticosteroids?

Actions: anti-inflammatory, immunosuppressive, anti-proliferative, vasoconstrictive
Uses: eczema, contact dermatitis, psoriasis, itch, lichen planus
Adverse effects: Skin atrophy/thinning, acne, striae

2

What are retinoids used for?

Acne, psoriasis, cosmetic skin improvement

3

What are adverse effects of retinoids?

dryness, irritation, sun sensitivity

4

What are the actions of retinoids?

Regulate cell growth, inhibit carcinogenesis, alter enzymes involved with cellular differentiation

5

How does Calcipotriene work? What is it used for and what are some adverse effects of it?

Ex: Donovex
A vitamin D analog that acts through DNA receptors to alter skin differentiation
Uses: psoriasis, eczema
Adverse effects: irritation, increased serum calcium

6

What are some topical antimicrobials and what are they used for?

Clindamycin, erthyromycin gels, benzoyl peroxide gel or wash, terbinafine, oxiconazole creams,
Uses: acne, rosacea, wounds, fungal infections

7

How do Topical Calcineurin Inhibitors (TCIs) work?

They work through calcineurin to alter T-cell activation

8

What are TCIs used for and why are they controversial?

-Work well for eczema (atopic dermatitis)
-May cause limited local irritation or burning
-Has FDA warning because it caused lymphomas in animal studies

9

What is atopic dermatitis?

Eczema!

10

What is dermatitis?

Inflammation of the skin

11

What does broad spectrum mean? And how much of the suns rays does SPF 30 block?

-covers all wavelengths
-blocks 97% of sun's UV rays

12

How does an imiquimod work?

-Aldara cream
-ramps up the immune system to attack something in skin (immune response modifier)
-works through toll receptors to activate immune cascades locally
-Used for actinic keratosis, BCC

13

What is topical 5-Fluorouracil?

It inhibits thymidylate synthase, resulting in reduced DNA synthesis. It acts selectively in actinic damaged skin cells

14

How should you take care of wounds?

-Keep wound covered with a nonstick dressing to allow natural cytokines to facilitate healing (don't want to 'air out' as this increases scarring)

15

What are systemic retinoids used for and how do they work?

They are used for acne, psoriasis, ichthyosis, chemopropholaxis of skin --> repair disordered keratinization (Accutane)
-They are vitamin A analogs that bind to nuclear retinoid receptors to alter cell differentiation
-They have many adverse effects and need to be monitored closely (government regulates accutane)

16

What can systemic retinoids do?

They can cure/remove acne permanently and they are used for psoriasis that has multiple spots

17

What is dapsone used for?

Leprosy therapy!
-Dermatitis herpiformis, linear IgA disease, bullous lupus, spider bites

18

What is methotrexate (systemic drug) used for?

Psoriasis & lupus

19

How does methotrexate work?

Dihydrofolate reductase inhibitor that disrupts DNA synthesis to block cell division. Immunosuppressive

20

What are systemic biological therapies?

Biogenetically engineered proteins which disrupt/inhibit focused portions of the immune system involved in psoriasis
-Used to treat psoriasis, psoriatic arthritis, (RA)

21

What are some cons to using biological therapies?

VERY Expensive
-Injection site irritation
-Risk of infection
-Our bodies can develop antibodies to these

22

How are biological therapies given?

They are given as a vaccination every other week.

23

What is ultraviolet light therapy used for?

Anti-inflammtory, immunosuppresive
- Used for psoriasis, pruritis, ezcema, CTCL (cutaneous T cell lymphoma)

24

What does ultraviolet therapy do?

It forms pyrimidine dimers in DNA and reduces langerhans cell and leukocytes

25

What is minoxidil best used for?

Alopecia - It's rogaine
Action: vasodilation & direct stimulation of hair shaft growth

26

What is finasteride used for?

Male pattern baldness - Androgenetic Alopecia
Action: blocks 5-alpha reductase enzyme in follicles to inhibit the conversion of testosterone to dihydrotestosterone

27

What do alpha hydroxy acids do?

They exfoliate, thicken epidermis, stimulate collagen growth, increase skin profusion - result in fewer wrinkles, more pliable skin, with better hydration
-Cosmetic product

28

What are the three stages of normal hair cycle? How many hairs are lost each day?

100-150 hairs each day
Anagen -> Catagen -> Telogen

29

What is the cause of Androgenetic alopecia and what treatments are usually used?

It's caused by genetically determined miniaturization of follicles triggered by androgens. Usually occurs on the top of the scalp.
Treatment: Minoxidil, Finasteride, Hair transplants

30

What is telogen effluvium?

It is stress hair loss. It is caused by disrupted growth cycle of hairs causing premature shift from anagen to telogen. It's triggered by pregnancy, surgery, high fever, extreme diet

31

How does Telogen effluvium effect the hair? What is the treatment?

Area: diffuse scalp involvement - "coming out in bunches"
Treatment: Remove the trigger, Minoxidil?, Time, Reassurance

32

What causes Alopecia areata?

It's AUTOIMMUNE - can be associated with other immune diseases (vitiligo, diabetes)
-T cells attack the hair bulb - "swarm of bees"
-HLA/genetically determined
-Circular patches on scalp or beard

33

What are treatments for Alopecia areata?

Watch, wait, topical or IL steroids - Minoxidil

34

A. Totalis =
A. Universalis =

all scalp hair lost
all body hair lost

35

What is secondary alopecia and what causes it?

Diffuse hair thinning as a complication of an existing medication or medical problem
Causes: Chemotherapy, Meds, Thyroid disease, Iron deficiency, Nutritional disorders, Renal or Hepatic failure, other chronic illnesses

36

How do you treat secondary alopecia?

Remove the cause, Minoxidil??

37

What causes Tinea capitis and in what population is it most common?

It is fungus growth on scalp and hair shafts, caused by trichophyton tonsurans mostly.
-Most common in African Americans

38

What is the standard treatment for Tinea capitis?

Griseofulvin
-Tinea capitis can cause scarring!

39

What type of hair loss does lupus cause? What are the treatments?

Dicoid lupus of the scalp results in destruction of hair units
-Often scarring
-Area: Discoid (round) patches with redness, scale, scarring anywhere on scalp or beard
-Treatment: Topical or systemic steroids, hydroxychloroquine

40

What is pediculosis?

Head lice & Pubic Lice

41

What is used to treat pediculosis?

Permethrin, GBH, Malathion, Vaseline, Cetaphil, Remove nits, hot water and dryer for clothes and bedding, unwashables in bag for 2 weeks

42

What is paronychia?

Inflammation of nail folds, can be infectious and non-infectious

43

What can cause acute and/or chronic paronychia?

Trauma, bacteria, contact dermatitis, acute eczema, flair, irritant contact dermatitis, eczema, psoriasis, Candida

44

How to treat ingrown nails?

-Always cut nails straight across
-Don't tear or pull
-Can get infected
-Proper fitting shoes
-Soaks, Antibiotics, Surgery

45

What is onychomycosis?

It's caused by fungal growth on or under the nail. It's commonly caused by Trichophyton rubrum or T. mentagrophytes.
Treatment: Terbinafine (Lamisil), Itraconazole (Sporonox), Ciclopirox (penlac lacquer)