PHRD5975 Self-Care - Scaly Dermatoses & Acne

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PHRD5975 Self-Care - Scaly Dermatoses & Acne
2014-04-29 13:54:08
Scaly Dermatoses acne

Scaly Dermatoses & Acne
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  1. dandruff cell turnover rate
    13-15 days (2x normal)
  2. non-pharm for dandruff tx
    wash hair & scalp w/ general purpose nonmedicated shampoo every day or daily
  3. seborrheic dermatitis cell turnover rate
    9-10 days
  4. differentiating factors of seborrheic dermatitis
    oily, yellow scales on red, itchy skin of the head, trunk (back, intertriginous areas in children)
  5. cause of seborrheic dermatitis
    elevated levels of Malassezia
  6. tx of seborrheic dermatitis
    medicated shampoo followed by emollient & hydrocortisone cream (0.5-1%)
  7. how long should tx w/ non-rx hydrocortisone NOT exceed
    7 days
  8. onset of psoriasis can be triggered by...
    • environmental factors
    • infections
    • rx drug use
    • psychological stress
    • hormonal changes
    • obesity
    • EtOH, tobacco
  9. psoriatic plaque cell turnover rate
    4 days
  10. differentiating factors of psoriasis
    • red, scaly plaques
    • on elbows, lower extremities, knees
  11. non-pharm tx of psoriasis
    • avoid psychological stress, &¬†physical,¬†UC, chemical injury of skin
    • lose weight if obese
    • cessation of tobacco, EtOH use
    • apply emollients w/in 3min of bathing
  12. MOA of anti-Malassezia agents (eg: pyrithione zinc, selenium sulfide, ketoconazole)
    reduce yeast count in scalp & skin
  13. MOA of coal tar
    cross-links DNA & arrests excessive skin cell proliferation
  14. directions for use of medicated shampoo for seborrheic dermatitis
    • use shampoo 2-3x/week x 4 weeks, w/ at least 3 days between each tx
    • once controlled, apply once per week to prevent relapse
  15. directions for use of medicated shampoo for treatment of dandruff
    use 2-3x/week for 2-3 weeks & thereafter once weekly or every other week
  16. MOA of keratolytic agents
    dissolve the cement that holds epidermal cells together to loosen & lyse keratin aggregates, facilitating removal from the scalp in smaller particles
  17. MOA of salicylic acid in tx of scaly dermatoses
    decreases skin pH leading to increased hydration of keratin & facilitating loosening & removal
  18. MOA of sulfur in tx of scaly dermatoses
    causes increased sloughing of cells & reduces corneocyte counts
  19. MOA of hydrocortisone in tx of scaly dermatoses
    anti-inflammatory, vasoconstrictive, immunosuppressive properties decrease redness & itching
  20. exacerbating factors of acne
    • local irritation
    • cosmetics
    • occupation
    • medications
    • stress/emotional extremes
    • high humidity/sweating
    • hormonal changes
  21. EXCLUSIONS for self-tx of acne
    • mod-severe acne (>10 comedomes)
    • pustules
    • meds that cause acne
    • 6 weeks of tx w/o improvement
    • acne mechanica
    • possible rosacea
  22. non-pharm tx of acne
    • eliminate exacerbating factors
    • cleanse skin w/ mild/nonsoap cleanser BID
    • stay well hydrated
    • consider dietary changes (cut down on HGL)
    • oil sheets
    • pore strips
  23. MOA of benzoyl peroxide (BPO)
    • generates free radicals that attack & inhibit growth of P. acnes
    • bacteriocidal, keratolytic, comedolytic
  24. counseling point for use of BPO
    • may experience mild erythema, scaling & acne may get worse in first few days -> but subsides w/in 1-2 weeks
    • contact w/ hair, clothes may cause bleaching
    • can cause sun sensitivity
  25. MOA of BHA's (eg: salicylic acid) in tx of acne
    lipid soluble keratolytic agent
  26. role of sulfur in acne tx
    included in acne products as a keratolytic & antibacterial agen
  27. MOA of sulfur/resorcinol combo products
    • fcn primarily as keratolytics fostering cell turnover & desquamation
    • also antibacterial & comedolytic
  28. why gel formulations are best in acne tx
    astringent + remains on skin longest
  29. how to treat neonatal acne
    use clean fingertips or washcloth to wash baby's skin w/ mild soap & water
  30. MOA of tea tree oil in tx of acne
    disturbs cytoplasmic membranes of S. aureas & weakens cells' ability to fight of other cytocidal agents
  31. MOA of oral zinc in tx of acne
    bacteriostatic against P. acnes, inhibits chemotaxis
  32. sx of rosacea
    acne lesions persist beyond mid-20s, or develop in mid-20s
  33. MOA of light-based tx
    porphyrin from p.acnes absorbs light & becomes excited -> produced oxygen & free radicals damage P. acnes cell wall lipids
  34. when to refer for dandruff
    resistant to 4-8 weeks of appropriate use/tx
  35. season seborrheic derm is exacerbated in
    winter, colder months
  36. age non-rx steroid cream can be used for seborrhea tx
  37. types of scaly dermatoses topical steroids can be indicated for
    seborrhea, psoriasis
  38. when to refer for seborrhea
    conditions worsen or sx persist longer than 7 days after tx
  39. initial tx of seborrhea for infants/children
    gently massage scalp w/ baby oil, followed by nonmedicated shampoo to remove scales