Skin PDF

11/4/24, 2:25 PM OneNote Skin Thursday, October 17, 2024 10:42 AM https://www.youtube.com/watch?v=nCzGflPoHa0 Acne: Abnormal keratinization of skin cells in follicular canal (excess skin growth...

11/4/24, 2:25 PM OneNote Skin Thursday, October 17, 2024 10:42 AM https://www.youtube.com/watch?v=nCzGflPoHa0 Acne: Abnormal keratinization of skin cells in follicular canal (excess skin growth) Sebum (oil) Colonization with P. acnes Inflammation Can also be non-inflammatory with minimal P. acnes present Topical Treatments for Acne Benzoyl peroxide: ○ Generic and brands: Benzac, Clearasil, Neobenz, OTC and Rx ○ Antibacterial ○ SE: Localized irritation and photosensitivity Retinoids: ○ Tretinoin (retin A), adapalene (Differin – OTC), tazarotene (Tazorac) ○ Stimulate skin cell turnover to restore normal keratinization, dec sebum prodcution, dec inflammation by dec immune response ○ SE: localized irritation and photosensitivity Antibiotics like clindamycin, erythromycin, sodium sulfacetamide ○ Decrease P. acnes bacteria ○ For prevention of future lesions ○ Use in combo with other topical treatments to reduce risk of resistance Others ○ Salicylic acid, resorcinol, sulfur ○ Dapsone only if over age 12 ○ Also combo products Oral Meds for Acne: Antibiotics: tetracycline, minocycline, erythromycin ○ Not more than 90 days at a time minimize resistance ○ Photosensitivity; do not take with dairy or calcium Oral contraceptives to balance hormone levels Isotretinoin (Accutane, Amnesteem, Claravis, Sotret) https://owlssouthernct-my.sharepoint.com/personal/calom1_southernct_edu/_layouts/15/Doc.aspx?sourcedoc={901a17cb-e5f9-4518-a7a8-20ca0a7ed… 1/3 11/4/24, 2:25 PM OneNote ○ Limited to severe acne ○ Severe side effects: dry skin/lips, dec night vision, mild muscle symptoms, risk of birth defects ○ IPledge program iPledge Program for Isotretinoin (Accutane, Amnesteem, Claravis, Sotret): 2 neg pregnancy tests Use 2 forms of birth control 1 month before, during, and 1 month after therapy Bloodwork to monitor cholesterol, liver function, and confirm not pregnant Patients evaluated for depression Only 1 month dispensed at a time, no refills Pharmacy must go to iPledge (online or telephone) and receive an RMA number and do not fill after date before filing. It must be written on face of prescription. If not picked up by 'do not fill date' or canceled, you must reverse in the iPledge system Applies to males as well Eczema (atopic dermatitis): Common in children with asthma and allergies, may persist to adulthood Itching, redness, swelling Triggers: allergens, irritants, humidity, dry skin, infection, stress Treatments for Eczema: Keep body and skin hydrated, bathe in mild non-soap cleanser, wear loose- fitting clothes Topical corticosteroids ○ Betamethasone, fluocinolone, hydrocortisone Tacrolimus (Protopic) ○ Suppress immune response Oral antihistamines ○ Diphenhydramine (Benadryl), cetirizine, loratadine May need astringent or antibiotics if develop oozing lesions Sunburn: Some meds can cause photosensitivity: ○ tetracyclines, furosemide, hydrochlorothiazide, some topicals and others on page 660, Table 5 Wear hats, shirts, use umbrellas and avoid the sun from 10am-2pm Sunscreens: Broad spectrum covers both UVA and UVB ○ UVA causes burns, cancer, aging; UVB causes burns SPF indicates how well UVB is filtered/screened Apply very generously Q2-3 hours; allow 15-30 mins to work Physical suncreens: Zinc oxide or titanium dioxide ○ Can be used if allergic to chemical sunscreens Chemical sunscreens ○ Oxybenzone and preservatives methylparaben and butylparaben can harm coral reefs ○ These chemicals are banned at some beaches/countries Sunburn Treatment: Cool compress, soak skin in cool water for 15-30 mins, drink lots of water Protectants: aloe vera, cocoa butter, moisturizers https://owlssouthernct-my.sharepoint.com/personal/calom1_southernct_edu/_layouts/15/Doc.aspx?sourcedoc={901a17cb-e5f9-4518-a7a8-20ca0a7ed… 2/3 11/4/24, 2:25 PM OneNote If sunburn blisters or is infected – use topical antibiotics over a small area of intact skin only Oral OTC NSAIDs – ibuprofen, naproxen Go to MD if in pain for more than 7 days or burn covers more than 2% of body Psoriasis: Chronic disorder where skin cells are produced too quickly Plaques may be itchy or painful, appear dry, scaly, red, silvery First symptoms usually seen at age 15-30 Symptoms usually come and go with seasons Psoriasis Treatment: Topical corticosteroids or retinoids Calcipotriene (Dovonex) ○ Form of Vit D that slows down skin growth For severe psoriasis ○ DMARDS (Disease-Modifying Anti-rheumatic Drugs) like methotrexate, etanercept (Enbrel), adalimumab ○ Acitretin (Soriatane) - retinoid https://owlssouthernct-my.sharepoint.com/personal/calom1_southernct_edu/_layouts/15/Doc.aspx?sourcedoc={901a17cb-e5f9-4518-a7a8-20ca0a7ed… 3/3