Lecture 5

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Questions and Answers

What is the appropriate amount of a topical medication for daily application to the entire face for one month?

80 grams

45 grams

60 grams

30 grams (correct)

Which type of topical medication is generally the most moisturizing?

Lotion

Gel

Ointment (correct)

Cream

What should not be assumed about 'hypoallergenic' products?

They are formulated with medical supervision.

They are guaranteed to be safe for all users. (correct)

They are entirely free of irritants.

They may still contain fragrances.

When prescribing a topical steroid for a rash covering more than 50% of the body, which size tube is inappropriate for twice daily use for two weeks?

30 grams Signup and view all the answers

Which vehicle is described as having no oil and is considered drying?

Gel Signup and view all the answers

What is the main function of the long chain molecules in soaps and shampoos?

To bind oily substances and dissolve them in water. Signup and view all the answers

For the most effective moisturizing regimen after bathing, which product is recommended?

Ceramide-based cream Signup and view all the answers

Which type of topical product is described as potentially irritating due to its formulation?

Gel Signup and view all the answers

What undesirable effect can result from chronic use of soap on hair?

Formation of soap scum on hair shafts Signup and view all the answers

What is the primary purpose of conditioners used after shampooing?

To restore sebum lost during shampooing Signup and view all the answers

Which anti-dandruff ingredient is most commonly preferred by patients?

Zinc pyrithione Signup and view all the answers

What is the recommended practice for daily bathing in patients with dry skin?

Wash only the face, groin, and axillary areas with soap Signup and view all the answers

What potential issue is associated with the continued use of antibacterial soaps?

Development of bacterial resistance Signup and view all the answers

What characteristic distinguishes facial cleansers from regular soaps?

They are less drying and less irritating Signup and view all the answers

What is the main function of sunscreens?

To block ultraviolet radiation Signup and view all the answers

Which type of soap should individuals with dry skin particularly avoid?

Deodorant soaps Signup and view all the answers

How is SPF determined?

By dividing the time in sun necessary to burn with and without the product Signup and view all the answers

What is the primary type of ultraviolet light that SPF measures?

UVB Signup and view all the answers

Which of the following sunscreens is likely to be less irritating to the skin?

One with physical blockers like zinc oxide Signup and view all the answers

What percentage of UVB does an SPF 15 product block?

93.3% Signup and view all the answers

Which of the following statements best describes UVC light?

It does not significantly reach the Earth due to the ozone layer. Signup and view all the answers

What is the minimum SPF recommended for sunscreen use?

15-30 Signup and view all the answers

When should individuals avoid sun exposure for safety?

From 11am to 2pm Signup and view all the answers

Which is NOT a recommendation to enhance sun safety?

Applying sunscreen with chemical blockers only Signup and view all the answers

What is a potential risk associated with the long-term use of topical steroids on the face?

Addiction leading to severe eruptions upon cessation Signup and view all the answers

Which topical steroid is recommended for use on thick skin or severe rashes?

Clobetasol 0.05% ointment Signup and view all the answers

What is a known side effect of using Protopic (tacrolimus)?

Burning sensation upon application Signup and view all the answers

When should 'not daily dosing' be considered when using topical steroids?

If the medication begins to lose effectiveness Signup and view all the answers

What is a key advantage of using Protopic and Elidel compared to topical steroids?

They do not carry a risk of local side effects with chronic use Signup and view all the answers

What should be avoided to reduce the risk of side effects from topical steroids?

Using them for more than two weeks continuously Signup and view all the answers

For which conditions should Protopic and Elidel be primarily reserved?

Facial or groin dermatoses requiring chronic treatment Signup and view all the answers

What is one of the significant long-term risks associated with Protopic and Elidel as per their FDA black-box warning?

Potential for lymphoma development Signup and view all the answers

What is the primary indication for Aldara (imiquimod)?

Genital warts Signup and view all the answers

Which treatment is recommended for severe acne in addition to moderate treatments?

Accutane Signup and view all the answers

What is a suitable treatment option for mild rosacea?

Metronidazole cream Signup and view all the answers

Which regimen is appropriate for treating shampoo-based seborrheic dermatitis?

Head and Shoulders shampoo Signup and view all the answers

What is the first-line treatment for perioral dermatitis?

Clindamycin Signup and view all the answers

What is the correct dosing strategy for prednisone in severe poison ivy cases?

1 mg/kg daily, taper over 3 weeks Signup and view all the answers

Which treatment should be avoided to manage perioral dermatitis?

Topical steroids Signup and view all the answers

What is recommended for xerosis management after showering?

Ceramide-based creams Signup and view all the answers

What is the recommended frequency for applying miconazole or econazole cream for intertrigo?

Twice a day for 2-3 weeks Signup and view all the answers

Which treatment is indicated for thrush?

Mycelex troches Signup and view all the answers

What is the treatment regimen for onychomycosis in non-diabetic patients?

Terbinafine 250 mg QD for 12 weeks Signup and view all the answers

When should patients with zoster be warned about transmissibility?

Even when no lesions are present Signup and view all the answers

What is the preferred treatment for scabies in most cases?

5% Permethrin applied to the entire body Signup and view all the answers

What is the primary method of treating genital warts?

Aldara 3-7 times a week Signup and view all the answers

What instruction should be given regarding treatment for warts after applying Compound W?

Wrap with duct tape overnight Signup and view all the answers

What is the appropriate follow-up treatment for tinea corporis once improvement is noticed?

Reduce to once a week to prevent recurrence Signup and view all the answers

Study Notes

Topical Therapy Principles

Topical medications come in various sizes (30g, 45g, 60g, 80g tubes or 454g jars).
Prescribe appropriate amounts; 30g for face for 1 month, 60g for two full body applications.
Avoid 30g tubes for rashes covering more than 50% of the body, requiring twice daily applications for two weeks.
Terms like "hypoallergenic", "unscented", and "sensitive skin" are marketing, not medical, terms. They don't guarantee no allergic reaction, fragrance-free products may contain fragrance, and sensitive skin products may be irritating.
Moisturizers and vehicles: Ointments, Creams, Lotions, Gels, and Solutions differ in moisture content with Ointments being very greasy and moisturizing, followed by creams and lotions. Gels are minimally moisturizing and drying, while solutions are very drying.
Effective moisturization: Apply a ceramide-based cream or petroleum jelly immediately after bathing before drying.
Soaps and shampoos are hydrophilic/hydrophobic molecules that bind oil, dissolve it in water for rinsing. This process removes natural oils, resulting in dryness and irritation.
Shampoos are formulated to prevent residue accumulation on hair but soaps are not.
Anti-dandruff shampoos usually contain zinc pyrithione, selenium sulfide, salicylic acid, sulfur, or tar.
For routine daily bathing, patients with dry skin should use soap/shampoo on face, groin, and axillary areas only.

Sunscreens

Sunscreens block UV radiation, categorized by SPF (Sun Protection Factor).
SPF calculation: Time in sun to cause sunburn with product / Time in sun to cause sunburn without product.
UV light types: UVC (blocked by ozone), UVB (measured by SPF), UVA.
Chemical blockers absorb UV light, converting it to infrared (heat).
Physical blockers (zinc oxide/titanium dioxide) reflect/scatter UV light, are stable and usually non-irritating.

Anti-Fungals

Two major classes: Allylamines (Terbinafine, Butenafine) good for dermatophyte infections, and Azoles (Ketoconazole, Econazole, Clotrimazole) which are effective for candida infections. Nystatin is effective for candida but not dermatophytes.

Acne Therapy

Match vehicle (gel/solution/cream) to skin type; retinoids are used at bedtime, and topical antibiotics in the morning.
Topical antibiotics include clindamycin, erythromycin, benzoyl peroxide-clindamycin (combination products), and metronidazole.
Topical steroids (Class 1-7) used for initial treatment. Ointments are stronger than creams, lotions, and solutions.

Other Treatments

Various treatments for different conditions (poison ivy, Xerosis, psoriasis, intertrigo, thrush, scabies, warts, molluscum, drug rash, etc.) are listed, including specific medications, frequencies, duration, and precautions.

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Description

Test your knowledge on topical medications, their applications, and skin care practices. This quiz covers various types of medications, their uses, and important considerations for effective skin care regimens. Perfect for anyone learning about dermatology or pharmacy.