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Session 2 Pharm2

Pharm -2- Dermatology Self Care

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