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Terms in this set (75)
water suspended in oil. Best for dry areas. Not good in hairy area, very greasy
oil emulsified in water. Used on non-hairy areas, more asthetically pleasing than ointment. Most commonly used
powder-in-water preparation. Hairy areas, large treatment areas
Water in combination with various medications
Oil-in-water, semisolid emulsion with alcohol in the base. Transparent, colorless, liquefies on contact with skin. Best for hairy body areas.
Group 1 topical corticosteroids
clobetasol, betamethasone (ointment), halobetasol
thinner areas (axilla, groin, face, eyelids)
Where should you not use groups 1 - 4 corticosteroids on the skin?
used for the reduction of inflammatory response, vasoconstriction, and the decrease of collagen synthesis.
Group 2 topical corticosteroids
fluocinonide, mometasone (ointment)
Group 3 topical corticosteroids
triamcinolone (ointment), betamethasone (cream)
Group 4 topical corticosteroids
mometasone (cream), triamcinolone (cream)
Group 5 topical corticosteroids
Group 6 topical corticosteroids
Group 7 topical corticosteroids
hydrocortisone lotion 2.5%/cream 0.5% or 1% (available OTC)
Psoriasis, severe eczema, resistant eczema
What would groups 1 and 2 topical steroids be used for?
Atopic dermatitis, nummular eczema, seborrheic dermatitis, tinea (briefly to control inflammation)
What would groups 3 - 5 topical steroids be used for?
Dermatitis (eyelids, diaper area, face)
what would groups 6 - 7 topical steroids be used for?
Elidel (pimecrolimus topical)
Topical immunosuppressive agent, sometimes use for mild-moderate facial eczema. Reduces inflammation
topical immunosuppressive agent, sometimes use for moderate to severe eczema. reduces inflammation
cephelexin, dicloxacillin, clindamycin for uncomplicated skin/soft tissue infections
What are the 3 most commonly prescribed antibiotics for soft tissue skin infections?
Treatment of skin and soft tissue infections (should cover streptococcus pyogenes/GABHS and staphylococcus aureus/MSSA)
What should treatment of skin and soft tissue infections cover?
tinea capitis, onychomycosis (tinea unguium)
When would you use a oral anti fungal agent?
azoles: Indicated for dermatophytes, tinea versicolor, and Candida
Topical antifungals "azoles" are indicated for what type of infections?
Indicated for dermatophytes and tinea versicolor
The Allylamines which are naftifine and terbinafine are indicated for what type of infections?
Benzylamine: Indicated for dermatophytes and tinea versicolor
The Benzylamines which are butenafine, Mentax, Lotrimin Ultra are indicated for what type of infections?
Polyene (Nystatin); Treats candida infections only
What does Polyene (Nystatin) treat?
Treats dermatophytes, tinea versicolor, and candid
what does ciclopirox (Loprox) treat?
Treats only dermatophytes and candida, not as effective as other options for dermatophytes
what does olnaftate (Tinactin) treat?
NO!!! (azole, allylamines, benzylamine)
Can you give a nystatin for ringworm?
1. Griseofulvin 2. terbinafine 3. itraconazole 4. fluconazole
What are the oral antifungals named?
What is the oral anti fungal that is the 1st line agent?
Labs must be done before oral antifungals are used (CBC, CMP)
What must be done before oral antifungals are used?
These meds can be hepatotoxic, cause granulocytopenia, leukopenia, nephrosis GI bleed, etc
What side effects do oral antifungals have?
Useful in the differential diagnosis of tinea of the scalp, which fluoresces bright yellow-green
A lamp emitting long wave UVA used to examine the skin pigmentary changes and fluorescent infections such as tine
Scrape skin off of suspected area of fungal infection, then place directly on slide, cover with potassium hydroxide, gently heat over a flame, place under microscope to read.
What also must be covered in a skin bite?
Augmentin 875/125 BID for 3 to 5 days
What is the first line therapy for prophylactic treatment for animal or human bite?
Augmentin 875/125 BID 7 - 14 days of soft tissue and 21 days when its bones or joints
What is the first line treatment for infected bite wounds?
1. clindamycin + doxycycline
2. Bactrim DS
What is alternative antibiotic treatment if patient is allergic to penicillins and has gotten bit by a human or animal?
20U/kg of rabies immune globulin injected around the wound and proximal to the wound (gluteal or deltoid area)
Rabies vaccine on days 0, 3, 7, and 14 (not on same site as rabies IG)
If rabies is suspected with a bite wound wash the wound with soap and water and give the injection this way:
gives you passive immunity
What does the rabies Igg do?
1st degree burn (superficial or partial thickness)
Involve only the epidermis, which becomes glossy, red, and painful
2nd degree burn (partial thickness)
Involve the dermis, which may present as dull or glossy with variable pigmentation - are painful
3rd degree burn
Burn extends into the subcutaneous fat. Burned area has no sensation - nerves are burned off
Hallmark is that the burn site insensate*
For any breaks in the skin (including burns)
When do you give tetanus prophylaxis?
don't touch it!!!
If there is a blister from a burn that is not ruptured.. what do you do?
An acute infection of the dermis which immerses deeply into the subcutaneous tissue
mainly B streptococci and staphylococcus aureus
What are the common causative agents of cellulitis
lower extremities, ears, and face
Where are common sites for cellulitis to occur?
A superficial form of cellulitis that involves the lymphatic system. Palpation of the border is possible
1. Sharply demarcated, indurated border
2. Lymphagitic streaking toward a regional lymph node
Erysipelas is characterized by:
lower legs, face, and ears
Where is erysipelas most common?
can also be caused by staph or MRSA
What are the causative agents of Eryspieals?
Warmth, erythema, edema, and tenderness
What are the hallmark features of cellulitis?
cellulitis particularly following a puncture wound involving the foot or hand (causative agent)
in children with facial cellulitis (Causative agent)
Anaerobes Eikenella, Streptococcus viridans from
human bites (causative agent)
Pasteurella multocida from
cat or dog bites (causative agent)
Vibrio vulnificus from
salt water exposure e.g. following coral injury (causative agent)
nodules, areas of ulceration, and frank abscess formation
in clinical practice the division between cellulitis and abscess is not distinct
Frequently, the macular erythema of cellulitis coexists with
Often the hallmark of staph infection is
1st line ORAL treatment for non purulent cellulitis
1st line IV treatment for non purulent cellulitis (MSSA and beta strep)
Oral treatment options for MRSA
doxycycline, bactrim etc
If a person is getting cephalexin but you decide you want to cover for MRSA also what could you add?
2. Amoxicillin + Bactrim DS
3. Amoxicillin + Doxycycline
4. Amoxicillin + Minocycline
5. Amoxicillin + Linezolid
6. Amoxicillin + Tedizoloid
Oral therapy for treatment of MRSA + Beta strep
3. Linezolid (Divox) IV
IV treatment for MRSA in adults
Oral antibiotic therapy for Erysipelas
1. Ceftriaxone (Rocephin)
2. Cefazolin (Ancef)
IV antibiotic therapy for Erysipelas
a superficial bacterial infection of the hair follicles with purulent material in the epidermis.
a coalescence of several inflamed follicles into a single inflammatory mass with purulent drainage from multiple follicles.
the epidermis but not the deeper soft tissue
Both folliculitis and carbuncles involve
A furuncle (or "boil")
an infection of the hair follicle in which purulent material extends through the dermis into the subcutaneous tissue, where a small abscess forms.
a collection of pus within the dermis and deeper skin tissues
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