Dermatology (look at podcast)
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What is dermatology?
Skin conditions - common
Discuss Eczema
Common in children Redness Scaling + dryness Itchy (release of histamine) (bleeding) Thickening of skin Scratching leads to breaking of skin Can get vesicles - blistering Can get infected - bacterial
What is the treatment of Eczema?
To reduce itching to reduce scratching Emollients = moisturisers (E45) Topical steroids
What is Atopic Eczema?
Irritant contact dermatitis e.g. washing hands frequently Irritant response to cheap jewellery, detergents, cosmetics Causes sore, dry skin, itchy splits in skin
How do you treat atopic eczema?
Treat w/ emollients Apply liberally + frequently
What is allergic contact dermatitis?
Allergic reaction Cause blistering
How to treat allergic contact dermititis?
Emollients + topical steroids
Name a mild topical steroid
1% hydrocortisone
Name a moderate topical steroid
Clobetasone butyrate
Name a potent topical steroid
Betamethasone
Name a very protein topical steroids
Clobetasol propionate
How do you use topical steroids
Apply once daily On the affected areas Not sparingly - finger tip rule
What is Psoriasis?
Common skin disease Autoimmune disease Causes abnormal rapid growth of skin cells Red, flaky, crusty patches with silvery scale E.g. elbows, knees, scalp, ears, hairline Can be nail + joint movement
Treatment of psoriasis
Vit. D analogues (+/- potent steroid) Emollients Coal tar Topical steroid monotherapy (special circumstances) Dithranol (topical retinoid)
Second line treatment for Psoriasis
Phototherapy Acitretin Immunosuppressants (cyclosporin, methotrexate, fumaric acid esters) Biological agents (anti-TNFalpha, ustekinumab)
Downfalls of psoriasis treatment
Steroid Tachyphylaxis Sudden withdrawal of potent topical steroids/oral steroid causes rebound Oral steroids never used for psoriasis Drugs that exacerbate psoriasis: • beta-blockers • lithium • interferon
What is Urticaria?
They are like hives Either allergic/non-allergic Caused by release of histamine Treat w/ oral antihistamine Occurs w/ morphine - displaces histamine from mast cells Nettle stings - oral antihistamine Pruritus (itching) - calamine, crotamiton
Further treatment on asthma
Immunosuppression Phototherapy Alitretinoin Topical calcineurin inhibitor
What causes acne
Increased sebum secretion Blocked pores Colonisation with Propionibacterium acnes Inflammation
How to diagnose acne
Non-inflammatory lesions Open and closed comedones Inflammatory lesions Pustules Papules Nodules Scars
Topical treatment for acne
Benzoyl peroxide Azelaic acid Retinoids Antibiotics
Systemic treatment for acne
Antibiotics Oral contraceptive pill - reduce androgens in the body which cause sebum Isotretinoin