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Pharm -2- Dermatology Self Care

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
What is dermatology made easy   dry hydrate it, moist dry it  
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what is the common name for atopic dermatitis or dyshidrosis   eczema  
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Where does atopic dermatitis usual affect   face, inside of knees and elbows, as well as neck  
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What is the most common skin condition in children   atopic dermatitis  
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What is the atopic triade   asthma, allergic rhinitis, & atopic dermatitis  
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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  
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what are the three clinical forms of atopic dermatitis   Acute, subacute, chronic  
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What is Acute atopic dermatitis like   pruritic papules and vesicles with excoriation and exudate  
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What is subacute atopic dermatitis like   same as Acute but add scaling papules  
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What is chronic atopic dermatitis like   add thickened plaques plus all the same stuff from acute and subacute  
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What is the vicious cycle of Atopic Dermatitis   Scatching (excoriation) with lichenification  
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How do you prevent Atopic Dermatitis   Avoid allergens, irritants, infections  
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What is the main treatment for atopic dermatitis   Hydration  
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What is an emollient   skin softener  
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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)  
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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.  
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What is another term for dry skin   xerosis  
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what is the minimum needed humidity for normal balance   10%  
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what is the most common cause of pruritis   xerosis dry skin  
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What are major causes of dry skin   natural aging, detergent use, malnutrition, skin damage, hot showers, bar soaps, wind exposure  
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What is the rule of 3   bathe every other day, 3 min, no more than 3 degrees warmer than body temp,  
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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  
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Why would astringents be helpful for xerosis   slow any discharge from cracked or bleeding skin  
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What is a humectant   hydrating agent such as glycerin  
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Why is urea useful for treating xerosis   keratolytic and increases water uptake in skin  
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Why is alpha hydroxy acid good for treating xerosis   lactic acid increases skin hydration  
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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  
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Crisco with an occlusive dressing such as saran wrap is effective for treating what condition   xerosis  
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What are the common names and types of scaly dermatoses   dandruff, seborrhea, psoriasis  
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diffuse scaling of white or gray scales that affects the crown of the head most commonly   dandruff  
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Dull oily well demarcated scaly area on red skin flaky scales on eyelids, cradle cap in infants, ears in adults   seborrhea  
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symmetrical lesions with limited pruritis, plaques, and other types guttae, pustular, and erythrodermic   psoriasis  
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Treatment for dandruff   medicated shampoo with scrubber, pyrithione, selenium, coal tar, ketoconazole. leave on scalp for at least 5 min  
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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)  
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How do you treat psoriasis with OTC   control inflammatory response  
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What should you avoid with coal tar   direct sun for 24hrs  
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Two types of contact dermatitis   Irritant Contact dermatitis- most common exposure to chemicals or solvents Allergic contact dermatitis- jewelry, cosmetics, poison ivy/oak  
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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  
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What are the goals in treating contact dermatitis   protect wash area during acute phase minimize pruritis prevent spreading and secondary infections  
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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  
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what OTC drug measures are useful for contact dermatitis   antipuritics anesthetics antihistamines corticosteroids astringents urushiol binders  
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Antipruritics are effective for contact dermatitis how   depresses skin sensory receptors (phenol/menthol)  
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why are anesthetics used to treat contact derm   used to relieve itching  
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why are astringents good to treat contact derm   reduce oozing examples are al acetate, calamine, zinc salts  
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what do you need to be wary of in giging anesthetics to contact dermatitis patients   systemic absorption through open skin  
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should a patient with contact dermatitis take a shower or bath after exposure to irritant   shower wash away irritants  
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if the problem is with jewelry what could help   clear nail polish  
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why is diaper dermatitis less common in breast fed babies   less alkaline feces  
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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  
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What are the treatment goals in diaper dermatitis   relieve symptoms, eliminate rash, prevent recurrence  
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what are good preventions for diaper dermatitis   frequent diaper changes use a mild soap for bathing moisture alarms  
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What drug therapy is good for diaper dermatitis   protectants, zinc oxide, cod liver oil  
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what is the classic sign and symptom of an insect bite or sting   wheal and flare  
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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  
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What is the best approach to insect bites/stings   avoidance practices  
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waht is some pharmacotherapy for insect bites/stings   ice pack, external analgesic, topical antihistamines, counterirritants, topical steroids, skin protectants  
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What is the rule for fleas   clusters of threes  
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What is pediculosis 3 types   head lice, body lice, pubic lice  
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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,  
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Treatment for pediculosis   permithrins, or pyrethins, and avoidance and clean up disenfect house  
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what is the NUVO method for treating pediculosis   cover head in thick ointment and then cover with oclusive dressing let dry to smother lice  
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what else should you test for with patients with pubic lice   sexually transmitted diseases  
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what should patients avoid with pediculosis   using hair conditioner  
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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  
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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  
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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  
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when an acne pimple ruptures what does it become   papule  
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If the papule enlarges and fills with pus what does it become   pustule  
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what can happen if the acne penetrates deep past the epidermis into the dermis   necrotic, purulent, noduler lesions that can cause scaring  
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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  
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what is the goal in acne treatment   unblock pilosebaceous ducts, keep orifice open  
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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  
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what are the OTC drug treatments for acne   benzoyl peroxide, salicylic acid, alpha hydroxy acids,  
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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  
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how does salicylic acid help treat acne   provides topical desquamation, can cause hyperpigmentation though  
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how do alpha hydroxy acids treat acne   decreases corneocyte cohesion promotes epidermolysis  
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have antibacterial soaps shown any clinical advantages to treating acne   no  
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what type of soap may help with treating inflammatory acne   abrasive soaps  
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what concentration of benzoyl peroxide has been equally effective as clindamycin or erythromycin   5%  
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Does poor hygiene cause acne   no  
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Does diet affect acne   no  
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does anxiety causes acne   nope  
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name the three types of UV rays which ones causes most reactions   UVA, UVB, and UVC, UVB is most reactive  
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What are the 4 conditions of sunburns   polymorphous light eruption systemic lupus erythematosus solar urticaria porphyrias  
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WHat amount of photodamage has already occured by age 20   50-80%  
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3 major types of skin cancers   malignant melanoma basal cell carcinoma squamous cell carcinoma  
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what type of solar radiation penetrates down to dermis nad causes histologic and vascular damage   UVA  
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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  
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what amount of UVB is needed to make vit D   10 min 3x a week  
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Germicidal wavelength with minimal natural impact   UVC  
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most common sunburn with mild erythema, tenderness, pain and edema   1st degree sunburn  
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Sunburn with blisters, bullae, fever, chills, weakness, shock peeling 3-8 days post exposure   2nd degree sunburn  
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what is most important with regards to sunburns   avoid them in the first place  
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what is the rule for sunburn prevention   rule of 45 spf 45 apply 45 min before swimming reapply 4-5 hours  
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treatment for sunburns   cool wet soaks or baths ibuprofen (if appropriate) Moisturizing cream or 1% HC lotion  
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Sunburn self care exclusion   hypersensitivity or allergy to sun protectant agents, history of xeroderma pimentosum, less than 6months old  
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Can suntanning boothes be beneficial   yes they are 96%UVA 4%UVB always wear goggles though to avoid cataracts  
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can you still burn with cloud cover   yes only filters 10% of rays  
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does UVB penetrate glass   no  
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What do TCN, Sulfa, Hypoglycemics, thiazides, phenothiazines all have in common with relation to the sun   they cause photosensitivity  
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by what factor does one childhood sunburn increase your chances of skin cancer   2x  
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does aloe hasten healing   no but it does moisturize  
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where does tinea capatis infect   scalp  
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where does tinea corporis infect   body  
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where doe tinea cruris infect   groin  
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where does tinea pedis infect and another name for it   feet, or athletes foot  
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where does tinea unguium infect   nails  
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name the 3 dermatophyte genus   trichophyton, microsporum, epidermophyton  
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What stratum do the fungal skin infections affect   stratum corneum  
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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  
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What are the s/sx of tine unguium   nails lose shiny luster go opaque gradually thicken and separate from nail bed  
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what are the s/sx of tinea corporis   single or multiple ring shaped lesions with clear centers and red scaly borders chief complaint pruritis  
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What are the s/sx of tinea cruris or jock itch   pain when sweating, acute lesions are bright red, chronic lesions hyperpigmented  
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OTC treatments for fungal infections   aluminum acetate, clotrimazole/miconazole terbinafine tolnaftate undecylenic acid  
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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  
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what can help in atheletes foot treatments   vinegar soaks before applying antifungal  
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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  
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what is helpful in treating onychomycosis   topical vicks vapor rub bid x 1 month  
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what causes warts   HPV with 150 subtypes  
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what are the three criteria for developing warts   presence of HPV Dermal opening for access immune system susceptibility  
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HOw are warts spread   direct patient to patient contact fomite contact shared floors/pool decks  
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how long does it take warts to incubate   1-24months average 4-5  
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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  
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Treatment for warts   salicylic acid 17% for common warts 40% for plantar wars Cryotherapy- dimethly ether and propane  
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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  
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How does duct tape therapy work   causes irritation at site of wart and immune reaction to get rid of wart  
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What is a problem with salicylic acid treatment for warts   may destroy neighboring healthy tissue  
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What is alopecia   loss of hair  
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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  
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What are the scarring alopecias   discoid lupus erythematosus lichen planus sarcoid syphilis  
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what is the anagen phase of hair growth   growing phase  
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what is the telogen phase of hair growth   resting/shedding phase  
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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  
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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,  
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S/Sx of alopecia areata   presence of point hairs, short frayed exclamation point appearance  
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Can alopecia be prevented   nope  
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Alopecia treatment goals   restore appearance topical minoxidil  
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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  
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is minoxidal a curing agent   no it only suppress hair loss  
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do cosmetics cause faster hair loss   no  
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why should oily products be avoided in hair loss   may cause folliculitis  
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can depression cause hair loss   there is a link  
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how long should self care be tried   4-6months  
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