Slides Dermatology.pptx - ECTOPARASITIC INFECTIONS ECTOPARASITICIDES Parasites live on surface of host Scabies(Sarcoptes scabiei

DERMATOLOGY

ACNE

ACNE • Nonpharmacological • Gentle cleansing 2-3 times a day • Avoid • Irritation • Vigorous scrubbing or abrasives • Oil-based products • Dietary measures don’t help

TREATMENT FOR ACNE • Nondrug therapy • Cleansing • Drug therapy • Benzoyl peroxide • Antibiotics • Topical: clindamycin • Oral: tetracycline antibiotics, isotretinoin, hormonal agents • Retinoids • Tretinoin (Retin-A) • Adapalene (Differin)

Treatment algorithm for acne.

ACNE - TOPICAL • Benzoyl peroxide effective for mild-moderate acne • Suppresses growth of P. acnes • Effect seen within days • No resistance seen • Topical tretinoin [Retin-A] effective for inflammatory and non-inflammatory lesions in mild and moderate acne • Cornerstone of acne therapy; Great for comedomal acne • Reduce inflammation and improve penetration of other topical (thins the stratum corneum) • ADR: induce blistering, peeling, crusting, burning, and edema • D/C keratolyicc agents prior to using topical tretinoin • Apply at night, exposure to the sun increases irritation • Topical clindamycin [Cleocin] and erythromycin effective for inflammatory lesions in mild, moderate, or severe acne • Suppresses growth of P. acnes • Monotherapy quickly leads to resistance • Azelaic acid [Finacea] effective for inflammatory and non-inflammatory lesions in mild to moderate acne • suppresses growth of P. acnes and by decreasing proliferation of keratinocytes, thereby decreasing the thickness of the stratum corneum. • ADR: hypopigmentation

ORAL DRUGS FOR ACNE • Antibiotics • Agents of choice • Doxycycline (Vibramycin), minocycline (Minocin) • Alternatives (resistance is common) • Tetracycline (Sumycin), erythromycin (Ery-Tab) • Isotretinoin (Accutane) • Teratogenic • Triglyceride levels must be monitored • Hormonal agents

ACNE - ORAL • Antibiotics (doxycycline & minocycline; alternatives: tetracycline & erythromycin due to resistance) • PO antibiotics for moderate – severe acne • suppress growth of P. acnes and directly suppress inflammation. • Benefits takes 3- 6 months • Isotretinoin [Accutane, Amnesteen, Claravis] • Derivative of vitamin A; treat severe nodulocystic acne vulgaris • The drug decreases sebum production, sebaceous gland size, inflammation, and keratinization. • Half-life: 10-20 hours • ADR: nosebleeds (80%), inflammation of the lips (90%) & eyes (40%), drying/itching of the skin, nose and mouth (80%), depression • Pregnancy category X • Monitor: Baseline CBC, LFTs, cholesterol/triglycerides, pregnancy

ECTOPARASITIC INFECTIONS

ECTOPARASITICIDES • Parasites live on surface of host • Scabies (Sarcoptes scabiei) • Pediculosis—lice (Pediculus humanus) • Pubic area (pubis) • Head (capitis) • Body (corporis)