Dermatology
The skin is the largest organ of the human body. Functions: protection sensation maintain temperature vitamin synthesis The image to the left shows an image of skin cells and the proteins which connect them.
Dermatitis = inflammation of the skin Usually involves red, itchy areas of skin There are many types of dermatitis Contact dermatitis Atopic dermatitis Seborrheic dermatitis
Contact dermatitis from direct contact with a skin irritant (soap, lotion, fabric, etc) Ex: poison ivy Atopic dermatitis also called eczema ; associated with hay fever & allergy to pollen, mold, etc; rash comes & goes over a lifetime Seborrheic dermatitis dandruff ; involves itchy, flaking areas of the scalp
Topical steroids reduce inflammation, itching & redness Available in many vehicles for application ointments creams lotions solutions gels sprays most potent least potent
Steroids are classified by their potency Group I most potent Group VII least potent This group includes OTC hydrocortisone side effects usually limited to local area of application & include irritation from the steroid, thinning of the skin, skin color changes, excessive drying of the skin
Brand Name Cortisone/Anusol/ Westcort Generic Name hydrocortisone Aristocort/Kenalog triamcinolone Lotrisone betamethasone + clotrimazole
Skin can become infected by bacteria, viruses, or yeasts & fungi Infections can be in the top layers of the skin or go deep into the tissue Bacterial impetigo (a staph infection of the upper layers of skin), cellulitis (infection of deeper skin tissue) Viral herpes simplex, shingles Fungal/yeast tinea pedis ( athletes foot )
Antibiotic preparations allow infections to heal more quickly & prevent spread to other areas of the body mupirocin (RX), polymyxin/neomycin/bacitracin combination (OTC) are among the most common neomycin is extremely nephrotoxic so it is limited to topical use extensive skin infections like cellulitis or MRSA are often also treated with systemic antibiotics
Rosacea is a skin condition treated with topical antibiotics red, sometimes swollen, skin (especially areas of the cheeks, nose, and forehead) tiny blood vessels over the nose & cheek areas adult acne Treatment usually involves metronidazole topical as well as other oral (systemic) medications
When skin is damaged from a burn, infection can rapidly set in silver sulfadiazene (SSD) is used to prevent infection in delicate burn tissue Recent evidence suggests that SSD may actually increase healing times
Brand Name Bactroban Metrogel Neosporin Silvadene Generic Name mupirocin metronidazole neomycin/polymyxinb/bacitracin silver sulfadiazene
2 types of acne: 1. non-inflammatory these can be whiteheads & blackheads 2. inflammatory these can be papule, pustule, nodules and/or cysts generally large, red areas of congestion on the skin Acne results when pores become blocked & oil accumulates
Severe acne is often treated with systemic antibiotics (doxycyline, minocycline) Also treated with a topical antibiotic retinoids interfere with the production of skin cells Examples: Differin, Retin-A These can actually bring pimples & redness to the face as it heals so condition may get worse before it gets better usually applied QHS to skin that is clean & DRY (must wait an hour after washing to ensure skin is completely dry) can also cause irritation, excessive redness or drying
Scabies is a topical skin infection caused by a mite the mite burrows into the skin & this causes an allergic reaction symptoms: intense itching, especially at night red rash highly contagious & spread by close personal contact - bedding, towels, toilet seats (mites can live for several days away from human skin)
permethrin 5% (Elimite) is used to treat scabies in adults and infants applied from head to toe before bedtime, left on for 8-14 hours (overnight) and washed off in the morning one application is usually sufficient in severe cases, application must be repeated after 1 week