Dermatology in primary care setting
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Dermatology in primary care setting
- 1. Dermatology in primary care setting Domina Petric, MD
- 2. FUNGAL SKIN INFECTIONS AND ANTIMYCOTICS FOR LOCAL USE I.A
- 3. Nail fungus (onychomycosis) • Can be treated with antimycotic nail lacquer. For example: • Amorolfinum 50 mg/mL PurNail.com
- 6. Tinea corporis, Tinea pedis, Tinea cruris • Treatment: antimycotic cream locally once a day during one week. • The cream should be applicated on previously cleaned affected area. Examples: • Terbinafinum 10 mg/g cream (not for children under the age of 12 years)
- 7. Other creams • Terbinafinum gel or skin spray • Clotrimazolum cream, gel or skin spray • Miconazolum cream • Naftifinum cream • ...
- 8. Other indications for application of antimycotic crem/gel/spray • Skind candidiasis: once a day during one week. ePainAssist.com
- 9. Other indications for application of antimycotic crem/gel/spray • Pityriasis versicolor: once a day (or twice) during two weeks. MedicineNet.com
- 10. Ketokonazolum shampoo (20 mg/g) Disease Dose Pityriasis versicolor Once a day during 5 days Seborrhoeic dermatitis and Pityriasis capitis Twice a week during 2 to 4 weeks Pityriasis capitis symplex (Emaze.com)
- 12. Terbinafinum 250 mg (Lamisil, Mycocur, Terbinax...) • Tinea pedis: once a day (250 mg per os) during 2-6 weeks • Tinea corporis: 250 mg per os a day during 4 weeks • Tinea cruris: 250 mg per os a day during 2-4 weeks • Onychomycosis: 250 mg per os a day during 6 weeks to three months (can be prolonged to six months if
- 15. Side effects: • loss of appetite • anxiety • depression • headaches • ...
- 17. Linola Fett cream (unsaturated fatty acids) For treatment of mild to moderately severe forms of atopic dermatitis: • twice a day on dry skin Qsota.com
- 19. Dexpanthenolum (Pantexol 5% cream or gel) • scrathes • hyperkeratosis • minor lesions • after surgical procedures • burns • pruritus • mild dermatosis Once or twice a day!
- 20. Contractubex gel • For scars, burns, after surgical procedures... • It is applied below the bandage for old scars during night. • Can be applied in children.Treatment duration can be weeks or months.
- 21. ANTIPRURITIC DRUGS FOR LOCAL APPLICATION IV.
- 22. Dimentidenum (Fenistil 1 mg/g) gel • dermatosis, urticaria, skin burns, insects bites, first degree burns • two to four times a day • for short term use (usually three days)
- 23. Chloropyraminum (Synopen 10 mg/g) unguent • urticaria, insect bites • two or three times a day • applied in thin layer • it is not recommended for big skin areas • for short term use (three days)
- 25. Calcipotriolum + betamethasonum • Daivobet 50 mcg/g + 0,5 mg/g gel • Enstilar 50 mcg/g + 0,5 mg/g skin foam Indications: • scalp psoriasis in adults • mild to moderate psoriasis vulgaris with plaques
- 28. Treatment Once a day during: • 4 weeks for scalp psoriasis • 8 weeks on other locations
- 30. Mupirocinum • For example: Betrion 20 mg/g unguent • Primary skin infections: impetigo, folliculitis, furunculosis, ectima. • Secondary skin infections: infected dermatoses and infected skin injuires.
- 33. Neomycinum, bacitracinum • Bivacyn 3500 IU/g + 500 IU/g unguent • Primary and secondary skin infections: two to four times a day. • Not recommended for children under the age of two
- 34. Acidum fusidicum • Fusicutan 20 mg/g unguent and cream • Primary infections • Secondary infections caused with sensitive bacteria: Staphylococcus aureus, Streptococcus spp. i Corynebacterium minutissimum. • Three to four times a day!
- 35. Gentamicinum Garamycin 1 mg/1 g unguent • primary and secondary skin infections • infected venous ulcers of lower leg • infected burns and frostbites of smaller skine area
- 37. Sulfadiazinum argentum (Dermazin 10 mg/g cream) • Main indication is prevention and treatment of infections in the patients with burns. • Other indications: prevention and treatment of infected ulcers, wounds, incisions... • The burn must be cleaned and then Dermazin should be applicated in a thick layer (2-4 mm) and covered with
- 38. Sulfadiazinum argentum (Dermazin 10 mg/g cream) • It should be applicated at least once a day, but for more severe burns can be used more then once. • Before putting a new layer, the burn/wound should be cleaned with aseptic solution. • Steril gauze is not obligatory.
- 39. Contraindications: peanuts and soya allergy preterm babies and neonates (kernicterus) pregnant women that are close to childbirth (kernicterus) It should not be used during first trimester and during lactation of the baby up to two months of life.
- 40. Aciclovirum (Herplex 50 mg/g cream) • Herpes simplex type one infections! • It should be applied five times a day (every four hours) and only during the day. • Treatment duration is 4-10 days. • It is indicated for skin of the face and lips.
- 41. Zovirax 5% aciclovirum cream Caution with immunodeficient patients.
- 42. Docosanulum (Erazaban 100 mg/g cream) • Only for immunocompetent adults and children older then 12 years. • For reccurent HSV 1 infection of the lips. • It should be applied only in early stage of herpes infection (prodromal stage) in a thin layer 5 times a day (not during night).
- 44. Methylprednisoloni aceponas • Advantan 1 mg/g cream and unguent Indications: • atopic dermatitis, neurodermitis • contact, degenerative, numular and other eczema • eczema in children
- 45. Methylprednisoloni aceponas • The drug should be applicated once a day in a thin layer on the affected area during max. 12 weeks in adults. • It should not be used for children under the age of 3 years. • Duration of treatment for children older then 3 years should not be more then 4 weeks.
- 46. Contraindications: • hypersensitivity • tuberculous or syphilitic changes near the affected area • chikenpox, herpes zoster • rosazea, perioral dermatitis • atrophic skin diseases, skin ulcers
- 47. Contraindications: • postvaccinational skin changes near the affected area • acne rosacea • acne vulgaris • bacterial and fungal skin diseases
- 49. Aclometasonum Afloderm cream and unguent • dermatoses on sensitive skin areas (face, intertriginous area) • chronic dermatoses in children and older people (sensitive skin) • treatment of larger skin area, especially in children • continuation of treatment after strong CS
- 50. Application
- 51. Contraindications: • hypersensitivit y • acne • skin tuberculosis • HSV infections • perioral dermatitis • rozacea • bacterial and fungal infections
- 52. Betamethasonum Beloderm 0,5 mg/g unguent and cream • all types of dermatoses and eczema • chronic plaques psoriasis of hands and feet • scalp psoriasis • ONE to TWO times a day (for
- 53. Betamethasonum • Cream is usually applied for wet dermatoses and unguent for dry lesions. • Treatment duration should not be longer then 2 weeks. • If used in children, treatment should be maximum 5 days long.
- 54. Cream/unguent/solution Cream Wet dermatoses Unguent Dry dermatoses Skin solution is for hairy skin are
- 55. Mometasonum Elocom 1 mg/g cream and unguent • for inflammatory and pruritic symptoms of dermatoses • psoriasis, atopic dermatitis, irritational dermatitis, allergic dermatitisApplication is once a day.
- 58. Mild CS and AB: Oxytetracyclinum, hydrocortisonum Geocorton 30 mg/g + 10 mg/g unguent • infected eczema • primary irritational dermatitis • allergic seborrhoeic dermatitis
- 61. Bethametasonum + gentamicinum • Belogent/Diprogenta 0,5 mg + 1 mg/g cream and unguent • Cream: infflamatory manifestations of dermatoses. • In adults application is 1-2 times a day and in children only 1 time a day. • Treatment duration: 7 days (children) up to 10 days (adults). • Application max. on 10% of body
- 62. Bethametasonum + gentamicinum Contraindicated in pregnancy! Not recommended during lactation.
- 63. Bethametasonum + gentamicinum • Unguent: indicated for skin infections (bacteria sensitive on gentamicinum) if the affected skin area is small. • For examle: external ear canal
- 64. Betamethasonum, clotrimazolum, gentamicinum Triderm cream and unguent • Secondary bacterial infection: tinea pedis, tinea cruris, tinea corporis, candidiasis,
- 65. CS for scalp (infflamation, dermatoses) • Alpicort solution (prednisolonum, acidum salicylicum) • Belosalic solution (betamethasonum, acidum salicylicum)
- 66. ANTISEPTICS IX.
- 67. Antiseptics and disinfectants: • Bepanthen Plus (dexpanthenolum, chlorhexidinum) • Betadine (povidonum iodinatum): Betadine unguent, Betadine 7,5% solution and 10% solution • Octanisept (octenidinum,
- 69. For acne: • Aknet solution (clindamycinum) • Dercome Clear skin suspension (benzolis peroxydum cum acqua) • Roaccutane capsules 10 mg • Sona gel and cream (adapalenum) • ...
- 70. Literature: • Mediately.com • HALMED • PurNail.com • Galderma SA • DermQuest.com • Healthool.com • GeneralHealth • ePainAssist.co m • MedicineNet.c om • Emaze.com • Qsota.com • WebMD.com