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Session 2 Pharm2
Pharm -2- Dermatology Self Care
| Question | Answer |
|---|---|
| What is dermatology made easy | dry hydrate it, moist dry it |
| what is the common name for atopic dermatitis or dyshidrosis | eczema |
| Where does atopic dermatitis usual affect | face, inside of knees and elbows, as well as neck |
| What is the most common skin condition in children | atopic dermatitis |
| What is the atopic triade | asthma, allergic rhinitis, & atopic dermatitis |
| What skin disease is marked by elevated IgE and periphereal eosinophilia, made worse by foods, soaps, detergents, chemicals, dust, pollens, temperature changes, emotional changes | atopic dermatitis |
| what are the three clinical forms of atopic dermatitis | Acute, subacute, chronic |
| What is Acute atopic dermatitis like | pruritic papules and vesicles with excoriation and exudate |
| What is subacute atopic dermatitis like | same as Acute but add scaling papules |
| What is chronic atopic dermatitis like | add thickened plaques plus all the same stuff from acute and subacute |
| What is the vicious cycle of Atopic Dermatitis | Scatching (excoriation) with lichenification |
| How do you prevent Atopic Dermatitis | Avoid allergens, irritants, infections |
| What is the main treatment for atopic dermatitis | Hydration |
| What is an emollient | skin softener |
| When wouldn't you want to have a patient self treat for Atopic Dermatitis | Sever condition with intense pruritis, Large part of body afected, less than 2yrs old, have additional skin infection (staph, strep) |
| What are the clinical pearls for atopic dermatitis | keep fingernails trimmed short, oatmeal baths, use bath oils at end of bath, rule of 3, avoid bar soaps, bath every other day, use humidifier, use creams and lotions. |
| What is another term for dry skin | xerosis |
| what is the minimum needed humidity for normal balance | 10% |
| what is the most common cause of pruritis | xerosis dry skin |
| What are major causes of dry skin | natural aging, detergent use, malnutrition, skin damage, hot showers, bar soaps, wind exposure |
| What is the rule of 3 | bathe every other day, 3 min, no more than 3 degrees warmer than body temp, |
| Name some OTC treatments for xerosis | hydrocortisone treatment up to 7 days ammonium lactate 12% for cracked skin Bath oils added at end of bath oatmeal products cleansers emollients/moisturizers humectants urea alpha hydroxy acids astringents |
| Why would astringents be helpful for xerosis | slow any discharge from cracked or bleeding skin |
| What is a humectant | hydrating agent such as glycerin |
| Why is urea useful for treating xerosis | keratolytic and increases water uptake in skin |
| Why is alpha hydroxy acid good for treating xerosis | lactic acid increases skin hydration |
| When wouldn't you have a patient self treat for xerosis | severe condiont with pruritis large area affected less than 2 has concurrent skin infection |
| Crisco with an occlusive dressing such as saran wrap is effective for treating what condition | xerosis |
| What are the common names and types of scaly dermatoses | dandruff, seborrhea, psoriasis |
| diffuse scaling of white or gray scales that affects the crown of the head most commonly | dandruff |
| Dull oily well demarcated scaly area on red skin flaky scales on eyelids, cradle cap in infants, ears in adults | seborrhea |
| symmetrical lesions with limited pruritis, plaques, and other types guttae, pustular, and erythrodermic | psoriasis |
| Treatment for dandruff | medicated shampoo with scrubber, pyrithione, selenium, coal tar, ketoconazole. leave on scalp for at least 5 min |
| Treatment for seborhea | medicated shampoo with scrubber, pyrithione, selenium, coal tar, ketoconazole. leave on scalp for at least 5 min along with salicylic acid 5% to remove crusts, hydrocortisone (key difference) |
| How do you treat psoriasis with OTC | control inflammatory response |
| What should you avoid with coal tar | direct sun for 24hrs |
| Two types of contact dermatitis | Irritant Contact dermatitis- most common exposure to chemicals or solvents Allergic contact dermatitis- jewelry, cosmetics, poison ivy/oak |
| What are the signs and symptoms of contact dermatitis | red and swollen skin at exposed sites itching burning and pain at site blister formation in more advanced cases severe dermatitis |
| What are the goals in treating contact dermatitis | protect wash area during acute phase minimize pruritis prevent spreading and secondary infections |
| What are the non drug treatments for contact dermatitis | remove allergen as soon as possible remove exposed clothing if possible cleanse/wash the exposed area cool compress |
| what OTC drug measures are useful for contact dermatitis | antipuritics anesthetics antihistamines corticosteroids astringents urushiol binders |
| Antipruritics are effective for contact dermatitis how | depresses skin sensory receptors (phenol/menthol) |
| why are anesthetics used to treat contact derm | used to relieve itching |
| why are astringents good to treat contact derm | reduce oozing examples are al acetate, calamine, zinc salts |
| what do you need to be wary of in giging anesthetics to contact dermatitis patients | systemic absorption through open skin |
| should a patient with contact dermatitis take a shower or bath after exposure to irritant | shower wash away irritants |
| if the problem is with jewelry what could help | clear nail polish |
| why is diaper dermatitis less common in breast fed babies | less alkaline feces |
| what are the signs and symptoms of diaper dermatitis | red shiny wet appearing patches on the skin may extend beyond diaper boarder may occur almost spontaneously may take weeks to resolve |
| What are the treatment goals in diaper dermatitis | relieve symptoms, eliminate rash, prevent recurrence |
| what are good preventions for diaper dermatitis | frequent diaper changes use a mild soap for bathing moisture alarms |
| What drug therapy is good for diaper dermatitis | protectants, zinc oxide, cod liver oil |
| what is the classic sign and symptom of an insect bite or sting | wheal and flare |
| What is also a concern apart from primary infection with insect bites and stings | secondary infections like impetigo or vector transferred illnesses like lyme disease or west nile virus |
| What is the best approach to insect bites/stings | avoidance practices |
| waht is some pharmacotherapy for insect bites/stings | ice pack, external analgesic, topical antihistamines, counterirritants, topical steroids, skin protectants |
| What is the rule for fleas | clusters of threes |
| What is pediculosis 3 types | head lice, body lice, pubic lice |
| What are the signs and symptoms of pediculosis | wheal, localized papule, pruritic, adult lice hard to see, nits/eggs, and casings are used to diagnose, |
| Treatment for pediculosis | permithrins, or pyrethins, and avoidance and clean up disenfect house |
| what is the NUVO method for treating pediculosis | cover head in thick ointment and then cover with oclusive dressing let dry to smother lice |
| what else should you test for with patients with pubic lice | sexually transmitted diseases |
| what should patients avoid with pediculosis | using hair conditioner |
| what are the exclusion for self treatment of pediculosis | hypersensitivity to chrysanthemums or ragweed, secondary infections, infestastion of eyelid or eyebrows, pregnant or breast feeding, presence of active tumor, less than 2 |
| what are the exclusions for self treatment of insect bite or sting | hives or excessive swelling, significant rxn away from site, family history of seasonal allergies, concurrent skin infection, suspected spider bite from black widow or brown recluse, history of prior hypersensitivity rxn, less than 2 yrs old |
| why is there an increase in acne with an increase in androgen prodcution | abnormal kertinization of infunidibulum cells increased sebum production propionibacterium acnes growth increases inflammation |
| when an acne pimple ruptures what does it become | papule |
| If the papule enlarges and fills with pus what does it become | pustule |
| what can happen if the acne penetrates deep past the epidermis into the dermis | necrotic, purulent, noduler lesions that can cause scaring |
| what are the four grades of acne | 1 comedonal acne, 2 papular acne, 3 pustular acne, 4 severe pustulocystic acne, after that severe cystic acne |
| what is the goal in acne treatment | unblock pilosebaceous ducts, keep orifice open |
| What are the exclusions for self treatment for acne | greater than grade 1 acne, no improvement despite treatment, comorbidity- immune deficiency, asthma, systemic infection, and less than 2 y/o |
| what are the OTC drug treatments for acne | benzoyl peroxide, salicylic acid, alpha hydroxy acids, |
| what strength of benzoyl peroxide is most effective for treating acne | all are equally effective although 5% has been proven equally effective as rx clindamycin and erythomycin |
| how does salicylic acid help treat acne | provides topical desquamation, can cause hyperpigmentation though |
| how do alpha hydroxy acids treat acne | decreases corneocyte cohesion promotes epidermolysis |
| have antibacterial soaps shown any clinical advantages to treating acne | no |
| what type of soap may help with treating inflammatory acne | abrasive soaps |
| what concentration of benzoyl peroxide has been equally effective as clindamycin or erythromycin | 5% |
| Does poor hygiene cause acne | no |
| Does diet affect acne | no |
| does anxiety causes acne | nope |
| name the three types of UV rays which ones causes most reactions | UVA, UVB, and UVC, UVB is most reactive |
| What are the 4 conditions of sunburns | polymorphous light eruption systemic lupus erythematosus solar urticaria porphyrias |
| WHat amount of photodamage has already occured by age 20 | 50-80% |
| 3 major types of skin cancers | malignant melanoma basal cell carcinoma squamous cell carcinoma |
| what type of solar radiation penetrates down to dermis nad causes histologic and vascular damage | UVA |
| Radiation that causes sunburns, most active wavelength for causing wrinkles, cancers, collagen damage and on the flip side is needed for vit D3 synthesis | UVB |
| what amount of UVB is needed to make vit D | 10 min 3x a week |
| Germicidal wavelength with minimal natural impact | UVC |
| most common sunburn with mild erythema, tenderness, pain and edema | 1st degree sunburn |
| Sunburn with blisters, bullae, fever, chills, weakness, shock peeling 3-8 days post exposure | 2nd degree sunburn |
| what is most important with regards to sunburns | avoid them in the first place |
| what is the rule for sunburn prevention | rule of 45 spf 45 apply 45 min before swimming reapply 4-5 hours |
| treatment for sunburns | cool wet soaks or baths ibuprofen (if appropriate) Moisturizing cream or 1% HC lotion |
| Sunburn self care exclusion | hypersensitivity or allergy to sun protectant agents, history of xeroderma pimentosum, less than 6months old |
| Can suntanning boothes be beneficial | yes they are 96%UVA 4%UVB always wear goggles though to avoid cataracts |
| can you still burn with cloud cover | yes only filters 10% of rays |
| does UVB penetrate glass | no |
| What do TCN, Sulfa, Hypoglycemics, thiazides, phenothiazines all have in common with relation to the sun | they cause photosensitivity |
| by what factor does one childhood sunburn increase your chances of skin cancer | 2x |
| does aloe hasten healing | no but it does moisturize |
| where does tinea capatis infect | scalp |
| where does tinea corporis infect | body |
| where doe tinea cruris infect | groin |
| where does tinea pedis infect and another name for it | feet, or athletes foot |
| where does tinea unguium infect | nails |
| name the 3 dermatophyte genus | trichophyton, microsporum, epidermophyton |
| What stratum do the fungal skin infections affect | stratum corneum |
| What are the 4 signs and symptoms of tinea pedis | chronic interdigital- fissures, scales, malodourus, pruritic stinging Chronic papulsquamous- moccasin like scales, Vesicular- small vesicles instep and plantar surfaces Acute ulcerative- macerated, denuded weeping ulcers on foot soles |
| What are the s/sx of tine unguium | nails lose shiny luster go opaque gradually thicken and separate from nail bed |
| what are the s/sx of tinea corporis | single or multiple ring shaped lesions with clear centers and red scaly borders chief complaint pruritis |
| What are the s/sx of tinea cruris or jock itch | pain when sweating, acute lesions are bright red, chronic lesions hyperpigmented |
| OTC treatments for fungal infections | aluminum acetate, clotrimazole/miconazole terbinafine tolnaftate undecylenic acid |
| exclusions for self care with fungal infections | patient has tinea unguium or capitis no improvement despite treatment comorbidity- DM, immune deficiency, asthma, systemic infection face, mucous membrane or genitalia are affected extensive condition presence of purulent material age less than 2 |
| what can help in atheletes foot treatments | vinegar soaks before applying antifungal |
| clinical pearls for fungal infections | undecyclenic acid- alcohol may burn patient consider obesity when selecting product use separate towel when drying creams and solutions are most effective Al salts should be used before antifungal Tx with oozing lesions |
| what is helpful in treating onychomycosis | topical vicks vapor rub bid x 1 month |
| what causes warts | HPV with 150 subtypes |
| what are the three criteria for developing warts | presence of HPV Dermal opening for access immune system susceptibility |
| HOw are warts spread | direct patient to patient contact fomite contact shared floors/pool decks |
| how long does it take warts to incubate | 1-24months average 4-5 |
| Steps to prevent warts | wash hands before and after touching a wart use a dedicated towel to dry avoid walking barefoot prevent reinfection prevent transmission |
| Treatment for warts | salicylic acid 17% for common warts 40% for plantar wars Cryotherapy- dimethly ether and propane |
| Self care exclusions for warts | affected area includes face, toenails, anus or genitalia, excessive warts in a single area painful plantar warts co morbid- diabetes, PVD inability to follow directions concurrent administration of immunosupressive agents salicylate allergy |
| How does duct tape therapy work | causes irritation at site of wart and immune reaction to get rid of wart |
| What is a problem with salicylic acid treatment for warts | may destroy neighboring healthy tissue |
| What is alopecia | loss of hair |
| What are the non scarring alopecias | androgenic alopecia(male pattern baldness) Alopecia areata-spot baldness Telogen effluvium- reapid shedding of resting hair Trichotillomania- compulsive pulling of hair |
| What are the scarring alopecias | discoid lupus erythematosus lichen planus sarcoid syphilis |
| what is the anagen phase of hair growth | growing phase |
| what is the telogen phase of hair growth | resting/shedding phase |
| What is meant by the paradoxical site specific effects of adrogens | causes terminal hair growth in pubic, axillary, chest and face while scalp follicles develop vellus hair |
| S/Sx of adrogenic alopecia | gradual hair loss w/o inflamation variable progression rate long process 15-25 years frontal hairline recession with vertex thinning, |
| S/Sx of alopecia areata | presence of point hairs, short frayed exclamation point appearance |
| Can alopecia be prevented | nope |
| Alopecia treatment goals | restore appearance topical minoxidil |
| alopecia self treatment exclusion | less than 18 pregnant or breast feeding no family hx of hair loss sudden or patchy hair loss concurrent skin lesions known cause ideopathic loss of eyebrows or eyelashes |
| is minoxidal a curing agent | no it only suppress hair loss |
| do cosmetics cause faster hair loss | no |
| why should oily products be avoided in hair loss | may cause folliculitis |
| can depression cause hair loss | there is a link |
| how long should self care be tried | 4-6months |
Created by:
smaxsmith
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