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Flashcards in RTS - Skin 1 Deck (44)
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what are emollients?

applied directly to the skin to reduce water loss - keep moisture.
They form a protective film and help manage dry, itchy skin conditions
Soften cracks in skin


What bases are- creams, ointments, lotions (emollients)

Creams - water based, thicker
Ointments - oil based
Lotions - pourable, water based


what are the 4 types of emollients?

1. occlusive - film over skin to prevent water evaporation (moisture) - diprobase
2. humectant containing - contain additives e.g urea, lactic acid, propylene glycol that holds water in the skin = double base
3. antipruritic - contains ingredients to stop itching = Eurax
4. antiseptic = contains ingredients to combat infection = dermol


what are topical corticosteroids?

used to treat inflammatory skin conditions - reduce skin irritation and inflammation. Help induce remission during a flare up


Name 2 examples of topical corticosteroids

1. hydrocortisone acetate 1% cream - HC45 (used for anything)
2. Clobetastone Butyrate 0.05% cream - eumovate. (only licensed for use in eczema/dermatitis, NOT redness/stinging)


What are the side effects of corticosteroids? (3)

skin thinning
vulnerable to infection
skin changing colour
(with long term use)


what are the legal restrictions imposed on the sale of topical corticosteroids?

1. PATIENT: patient must be >10 years for hydrocortisone, >12 years for clobetasone. Cannot be used in pregnancy/BF
2. Maximum of 7 days use and only applied twice a day
3. Can only sell a maximum of 15g at any one time
4. Cannot be used on - face, anogenital, broken or infected skin


How are topical corticosteroids applied?

The finger tip unit - One FTU is the amount of steroid squeezed out from a standard tube along the adults fingertip = very end of the finger to the first crease.
One FTU is enough to treat an area the size of the flat of an adults hand.


Indication Licensing for - hydrocortisone actetate 1% and clotbetasone butyrate 0.05% cream

hydrocortisone - on any inflammation/redness/stinging
Clobetasone - only for eczema and dermatitis


How do topical antifungals work?

(a) killing the fungal cells - affect their cell walls and cells leak out
(b) prevent growth - prevent them reproducing


Name examples of anti fungal treatments (4)

clotrimazole 1% - canesten
Ketoconazole 2% - daktarin intensiv
micronazole 2% - daktarin
Terbinafine 1% - lamisil


Name the different formulations of antifungals and why there are different ones

Sprays, creams, gels, powders
they can be used in different areas e.g athletes foot, some people may not be flexible enough to put cream on their feet so a spray is a more convenient way


what symptoms are we looking out for/ asking about?

broken skin?
hot to touch?
bleeding/ weeping?


General referral points for - rashes/eczema/dermatitis

signs of infection e.g yellow crusts
on face
children / pregnancy/ BF
bleeding, weeping
non blanching rash
broken skin


what is eczema?

Allergic condition - usually infants and children. They often have other sensitivities e.g hay fever and asthma.
Sensitisation cocues leading to an inflammatory response


Common aggravating factors of eczema?

pollen, sweat, detergents, cosmetics, rubber, dyes


Treatments for eczemA? and contact dermatitis

1- emollient use whenever -
2- topical corticosteroid twice a day for 7 days
(CD = remove the causative agent also)


lifestyle advice for eczema?

avoid triggers
avoid fabrics that can irritate the skin and wear soft fine weave/cotton
keep cool as heat aggravates
avoid soaps / detergents that can irritate
use soap substitutes e.g dermol that are unperfumed


what is contact dermatitis?

inflammatory response of the skin after exposure to an irritant - the severity of response depends on - type of irritant, the concentration, quantity and length of exposure


Symptoms of eczema and contact dermatitis

(contact = usually red around the area of contact)


what is psoriasis

relapsing inflammatory disorder - lesions, can present at any time in life but not common in infants and children.
It develops at sights of skin trauma, sunburnt areas, around cuts and stress


what is the location and symptoms of psoriasis?

usually symmetrical distribution - scalp, knees, elbows
Salmon pink lesions/silvery white scales, defined boundaries, usually a history of It


What are the OTC treatments for psoriasis?

ideally treatment should be initiated by Dr. But there are:
(a) emollients - moisturise
(b) coal tar based - management, capasal, cocos, T/Gel
(c) keratolytics - clearing, not much evidence, contains salicylic acid and urea


Lifestyle advice for psoriasis

keep up with treatment even if it feels better
regular dermatology reviews
healthy eating and exercise and stress relief


referral signs for psoriasis

extensive lesions
first time having
hair loss
abnormal lumps


what is chicken pox?

common childhood illness - varicella zoster virus, very contagious.
Present on the trunk, scabs form after 5 days and lasts around 14 days


Symptomatic treatments for chicken pox

pain - analgesic, paracetamol
fever- anti-pyretic - paracetamol (calpol)
itching - anti histamines (chlorphenamine - piriton), or cetirizine.
emollients e.g eurax
cooling gels e.g poxclin, viraschoothe, - keep In moisture
but they are expensive and usually paracetamol is best and will go alone in 14 days


referral signs for chicken pox

infected blisters
non blanching rash


lifestyle advice for chicken pox and shingles?

cool clothing - loose, cotton - stops it getting sore and irritated
stop the virus from spreading - sterilising, hygiene, wash clothes/bedding, don't share towels


what is shingles?

same virus as chicken pox - infection of nerves and skin - unilateral condition and painful
duration is 2-3 weeks

symptoms= burning, fever, malaise, nerve pain, blistering rash/red patches, crescent shape - radiates from ribcage down to belly button