Dermatology ABC

Dermatology ABC. FOR THE PHARMACIST. A close up of a skin with red spots Description automatically generated.

60% ECZEMA 20% FUNGAL INF 10% BACTERIAL INF 10% VIRAL INF.

*Urticaria / angioedema /pruritus /hive Cortisone Lotion Cleansing Omega3 Zinc gluconate Oral prednisolone (20%of body)1mg/kg MAX 60mg.

Not use omega if fish allergies / use blood thinner omega dose (EPA/DHA)1500mg in healthy patients 500mg in patients taking blood thinner as aspirin 75 or Plavix Pediatric dose is ½ adult dose Omega works *increase lipid content under skin *increase humidity *as natural glucocorticoids.

When add omega /zinc to regimen??. abstract.

Pityriasis rosea.

Etiology. It is self-limiting, usually last for 6-8 weeks, but may last 3-6 months The main causes :- URIs( upper tract respiratory inf) , immunocompromised pts, many drugs( asprin /captopril/bismuth,,,, etc ).

DerHNekNZ.org. UR Suhonen.

PR is a single pink patch which gradually expand , and called herald patch Scattered lesions after 1 or 2 weeks and then remitted spontaneously Usually in spring Non-contiguous Pruritus is common.

Differential diagnosis. Psoriasis Hard scaly area Silvery-white patch No herald Itchy rate in psoriasis is very high Appear in body folds.

Differential diagnosis. Tinea corporis Circular patch with high border , the middle is clear Increase with time in diameter Tinea spots overlap with time No herald patch.

Differential diagnosis. eczema Happens at the time of allergen exposure The scales in eczema appear after resolution not from the first eruption like PR No herald patch.

Differential diagnosis. syphilis Often in palms of hands and the soles of feet RPR (rapid plasma regain test) No herald patch.

treatment. Lotion for sensitive skin fragrance free+topical CS TWICE DAILY FOR 2 MONTHS Lotion only Zovirax Pseud cream with calamine or zinc oxide.

TOLERIANE is a range of products specifically formulated to answer the needs of sensitive to allergy-prone skin: hydrate, soothe and protect sensitive to allergy-prone skin. Fragrance- and alcohol-free.

BIODERMA Atoderm. Once or twice a day The 3.6.9 method is a new method to systemize application. It has been developed in order to indicate the right dose of Atoderm Intensive baume to use, and then to create a routine and systematize application of the cream for better results in the long term and for a better observance. STEP 1 Cleanse skin with Atoderm Intensive gel moussant . STEP 2 Apply Atoderm Intensive baume to skin. STEP 3 Gently massage until absorbed. 3 pumps for a BABY: 1 pump for face, neck and chest - 1 pump for both arms and back - 1 pump for both legs. 6 pumps for a CHILD: - 1 pump for face and neck - 1 pump for chest - 1 pump for back - 1 pump for both arms - 1 pump per leg (x2). 9 pumps for an ADULT: - 1 pump for face and neck - 1 pump for chest - 1 pump for back - 1 pump per arm (x2) - 2 pumps per leg (x2)..

What if we use systemic corticosteroids ??!. A cartoon character leaning on a red question mark Description automatically generated.

Patient counselling. Non-contagious Avoid scratching Hygiene Refer:- pregnancy // organ transplantation.

Tinea corporis.

etiology. Tinea is a superficial fungal infection Tinea corporis- cruris- pedis-capitis ) It is called ring worm Spreading ways may be:-(house pets-from house hold member) The incubation period is 1-3 weeks, the dermatophyte invades and spread the stratum corneum, not able to invade deeper layer in healthy skin..

•xalens!A 0. Raised scaly marked edge The center is clear Itchy May overlap.

Differential diagnosis. Pityriasis rosea Scales disappeared from center gradually No herald patch The overlap in the border The lesion increase with time.

Differential diagnosis. psoriasis Very hard scales No overlap No herald patch.

Differential diagnosis. Eczema No herald patch Tinea is elevated from the border not hole patch The symptoms appear after short time of exposure to trigger.

Differential diagnosis. Tinea/pityriasis versicolor No oval marked border The white color due to a chemical produced by Malassezia The pink or brown is mildly inflamed.

Treatment. Disinfectants Loose fitting light clothing Examination of household member and pets.

Topical antifungal (ketoconazole)+ terbinafine spray once or clotrimazole twice For 1:2 weeks after rash is cleared Oral antifungal(if no resolution after month).

Diflucan itraconazole terbinafine 150mg po/7days for 4 week 100mg/day for 2 week 125mg/12 hr for 2 up to 4 week 200mg/day for a week 250mg/24 hr for 2 up to 4 week CI if a defect found in liver or heart or pregnant <25 kg 125mg daily 25:35kg 187.5mg daily >35kg 250mg daily for 6 weeks of terbinafine.

Patient education. A dog with its mouth open Description automatically generated.

Pityriasis versicolor.

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counselling. Hygiene Cold water New sponge No hair removal Cotton towel cleaned separately Iron the pads Separate bathroom Inform the patient if the fungal go to head the hair will fall temporarily.

Pityriasis alba.

diagnosis. Common in young ages 3-16 Y. Affect cheek mostly Diameter about 4 cm 4-20 lesions Its color is pink then turned to white ,it is just like a low grade of dermatitis with fine scales.

etiology. Unknown cause Abuse of corticosteroids Xerosis Contact dermatitis Extreme temperature exchange Non-contiguous.

Differential diagnosis. Vitiligo No scales Poorly defined pale area Wood lamp examination *.

Differential diagnosis. Pityriasis versicolor The center of patch is fainter than edges in p.versicolor Affect mostly back and shoulders Potassium hydroxide test *.

Differential diagnosis. psoriasis Psoriasis in face concentrated over eyebrow not in cheeks The scales is very hard.

treatment. Multivitamins iron and copper for 2 months Moisturizing cream may improve the dry appearance Hydrocortisone cream twice daily for a month If no response:- tacrolimus 0.03% once daily for 6weeks Sunscreen is a must.

Alopecia areata. Non-scaring.

Alopecia areata. It is autoimmune disorder Non-scaring type 1.A.areata 2.A.totalis 3.A.universalis.

diagnosis. No symptoms Patches of A.areata can affect any hair bearing area Sudden loss of hair.

etiology. Atopic dermatitis Vitiligo Hashimoto disease DM Stressful life Some drugs( valproic , ACIs , OCP , catbimazole ,,,).

Differential diagnosis. Tinea capitis Scaring type.

Differential diagnosis. Trichotillomania Someone cannot reist the urge to pull out their hair No complete hair loss.

Differential diagnosis. Telogen effluvium Not marked patch.

Differential diagnosis. Androgenic alopecia Make a pattern.

Main lines treatment. It is imp to know it is self limiting Cosmetically treatment (80% recovery) Topical immunosuppressant (glucocorticoids) Blood supply improvement Minerals and vit.

Blood supply improvemnt. Topical potent contact allergen https://www.ducray.com/en-gb/tonifying-gel/tonifying-gel.

glucocorticoids.