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25 Cards in this Set
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- Back
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Dry Skin (Xerosis)
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Loss of water content of skin leading to abnormal loss of cells in stratum corneum
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More prevalent
- in older adults (>50) -in arid, windy, cold environment - in people who take prolonged, hot showers/baths -in patients with malnutrition or dehydration |
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Dry Skin Clinical Presentation
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Characterized by more than one symptoms:
1) Roughness 2) Scaling 3) Loss of flexibililty 4) Fissures 5) Inflammation 6) Pruiritis |
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Dry Skin Tx Goals
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1) Restore skin hydration
2) Restore skin's barrier function 3. Educate patient about this chronic condition |
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Self-care for dry skin
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Pharmacological Tx (more severe)
1) Urea or Lactic acid containing product 2) Ammonium lactate 12% for cracks/fissures 3) alpha hydroxy acids to normalize stratum cornium 4) Short term Antipruiritics |
Non-pharmacologic therapies
1) use of moisturizers 2) modify bathing practices (oatmeal and bath oil) 3) Increase humidity 4) Adequate hydration |
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Pharmalogic Tx: Itching
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1) Hydrocortisone
2) Counterirritatns 3) Oral antihistamines 4) Topical antihistamines |
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Hydrocortisone
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- Suppress cytokines associated with inflammation and itching
- Use 0.5-1%. Apply sparingly 3-4x/day (tachyphylaxis possible-inc. dose req. for same effect) - Do not apply to infected skin |
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Counterirritatns
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-Add menthol or camphor to emollient
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Topical antihistamines
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-Compete with histamine at H1 and produce local anesthetic effect
-3-4x day x7 days |
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Oral antihistamines
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-Histamine already at site, takes a while for anti-histamine to displace
- could simply be sedative effect |
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Dermatosis
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A disease of the skin, esecially one not characterized by inflammation
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Dermatitis
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non-specific disorder of the skin usually with erythema (redness of skin) and inflammation; can be caused by allergens, irritants, infections, or other factors
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Eczema
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Inflammatory skin condition of unknown etiology; used interchangeably with dermatitis
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Atopy
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Genetically mediated perdisposition to have an (excessive) IgE reaction;p a tendency to be "hyperallergic"
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Atopic Dermatitis
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Exaggerated skin and mucosal reactivity in response to environmental stimuli
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Features of atopic dermatitis
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- Erythematous
- Pruritic - Dry, flaky, scaly - Edematous - Crusted - Vesicular - Lichenified |
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Diagnosis of atopic dermatitis
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Pruritic skin PLUS 3 or more of the following:
- onset <2 years - Involvement of skin creases (or history of) - Hx dry skin - Hx AD (or in a relative if < 4 yr old) - Visible flexural dermatitis (or cheeks,m outer limbs in children <4 years old) |
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Triggers for AD
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1) Dry skin, heat
2) Sudden changes in temperature 3) Fragrances, irritants 4) Allergens (eg, detergents, food) 5) Stress 6) Knowing what sets off a flare can help with prevention |
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AD treatments
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1) Bathing practices: bath oils, oatmeal products, mild cleansers
2) Moisturizing agents: petrolatum, lotion, creams 3) Keratin softening agents: Urea, alpha hydroxy acids 4) Humectants (draw water into skin): Glycerin, propylene glycol 5) Topical hydrocortisone: for itching 6) Oral antihistamine: for itching |
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Wet lesions: astringents
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1) Burrow's Solution (Al Acetate): dilute 1:10 to 1:40 with water
2) Witch Hazel 3) Alternatives: 1tsp NaCl in 2c H2O; 1/4c vinegar+ 1pint H2O |
Instructions:
- Soak BID-QID for 15-30 mins - Compress: wet and reapply Q few mins x 20-30 mins; 4-6 daily |
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Contact Dermatitis
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Not associated with dry skin
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Seborrheic dermatitis
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Nonpruiritic, greasy scale, different characteristic distribution
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Psoriasis
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Well-defined plaques, silvery white scale, involves extensor surfaces of extremities, involvement of scalp extends onto forehead (SD stops at scalp margin)
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Tinea Corporis (ring worm)
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Ring-shaped lesions (usually); scale at peripheral border
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Scabies
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involves genitalia, axillae, finger webs
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Dandruff products
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1) Cytostatic Shampoo:
- Coal tar - Pyrithione zinc - Selenium sulfide - Ketoconazole - Tea tree oil (natural product) 2) Keratolytic agents: salicylic acid, sulfur |
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