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Slide 2 Derm drugs are used to treat diseases of the Skin Slide 3 Diseases/Conditions Include: Acne Vulgaris Acne Rosacea Psoriasis Infections- Bacterial Fungal Yeast Viral Dermatitis Poison ivy Diaper rash Alopecia Scabies Vitiligo Pediculosis Burns Skin ulcers Slide 4 Because of the superficial nature and location to most dermatologic conditions they respond well to topical treatments and drug therapy. Gel Cream Liquid Lotion Mousse Shampoo ointment Slide 5 Types of Drugs Topical drugs for the skin can include: Keratolytic Antibiotic Vitamin A Vitamin D Coal tar drugs Psoralen Antifungal Antihistamine Antipruritic Slide 6 This is the type of acne that is common during adolescence. Large amounts of oil harden and block the pores forming reddish papules. As bacteria feed on the oil, they cause infection. DRUGS to TREAT- Keratolytic/ Astringent=remove oil & dead skin to cleanse the pores Slide 7 OTC TRICLOSAN RX Clearsil Oxy Stri-Dex Pro Active Clindamycin PanOxyl Erythromycin Many of the Rx drugs contain benzoyl peroxide Slide 8 TRICLOSAN Triclosan is a common ingredient in many products. It is also found in Slide 9 ANTIBIOTIC DRUGS Abx drugs for Acne can be Topical or Oral Many of them contain Salicylic Acid (ASA) Oral Drugs, which can provide a systemic effect They travel through the blood to kill bacteria in the deep layers of the skin. Doxycycline Minocycline Tetracycline Slide 10 AKA- RETINOIC ACID ORAL DRUGS CAN BE PRESCRIBED FOR SEVERE ACNE VULGARIS A deficiency of Vitamin A can produce abnormal changes in the epithelial cells of the skin. These cause the epidermal cells to multiply more rapidly preventing pores from clogging. These drugs also decrease inflammation. Slide 11 ADULT FORM OF ACNEROSY RED CHEEKS Characterized by constant blotchy redness of the cheeks. Caused by dilated blood vessels and excessive oil on the face. Exacerbated by heat, stress, skin irritation Treated with topical Abx Slide 12 Psoriasis Psoriasis is a chronic autoimmune disorder that is characterized by scaly, raised, silvery-red patches on the skin. It is often resistant to treatment. With this condition, the skin is abnormal at the cellular level, exhibiting abnormally accelerated rate of epithelial cell division and an abnormality of the keratin producing epi cells. =Keratinocytes Heart brake of heartbrakesoriasis Topical Coal Tar Drugs OTC such as Neutrogena & T-Gel Cleanse away dead skin & decrease itching Coal Tar is a by product of the processing of bituminous coal used for over 200 years Slide 13 Topical Vitamin A Treats Adeficiency Oral Vitamin A Acts systemically to treat severe cases Topical Vitamin D Activiates receptors in the keratinocytes to slow their abnormal cell growth Topical Corticosteroids- Reduce inflammation & itching Slide 14 Other Drugs- Adalimumab-Humira Cyclosporin Efalizumab- Raptiva Inflizimab- Remicade Sirolimus Rapamune Tacrolimus Protopic Other topical & oral drugs can be used for moderate to severe cases. They are prescription only and can act as an immunosuppressant to suppress the activity of the T- lymphcytes and the immune system. Psoralen- treats severe disabling psoriasis by exposure to ultraviolet light Slide 15 Can occur with breaks in the skin that allow bacteria to enter. Can be treated with topical Abx drugs such as; Bacitracin, Neosporin, Gentamicin Betadine, Polysporin- All OTC For serious widespread bacterial infections of the skin, oral or intravenous Abx that work systemically are prescribed. Slide 16 CONVENIENT, BUTDEADLY? The Soap and Detergent Assoc. reports that 45%- 75% of hand & body wash products contain antibacterial compounds. Widespread use of these products and routine use of Abx drugs in animal feed are believed to have contributed to the rise of antibiotic resistant bacteria. MRSA-found in the noses of healthcare workers who passed the bacteria to their patients who could not fight it off. Slide 17 FUNGAL INF YEAST INF -conazole- common to generic antifungal Tx Like to grow in warm, dark, moist environments Ringworm Athletes Foot Nail fungus Candida Albicans Mouth, nails, vaginal, diaper rash Treated with anti-yeast drugs that disrupt the cell wall of the fungus Fungi & yeast are closely related Slide 18 Herpes Simplex Virus type 1-cold sores Herpes type 2-STD causes genital herpes Herpes Zoster Virus Chicken pox & shingles HPV-Human Papilloma Virus causes- genital warts cancer Type 1- Acyclovir (Zovirax) Docosanol (Abreva) Penciclovir Type 2- Valacyclovir (Valtrex) Slide 19 Herpes Zoster Virus can be prevented with a vaccine Chicken Pox Vaccine Shingles Vaccine They keep the virus From reproducing By working systemically in the blood Warts (Verrucae)can be treated with OTC and Rx drugs Slide 20 OTC & Rx Poison ivy, insect bites, seborrhea, eczema, as well as yeast, fungal & psoriasis. Treat inflammation & itching Hydrocortisone 1st topical corticosteroid drug approved as OTC Corticosteroids can be given, intradermally, injected directly into an infected site, orally, which exhibits a systemic effect and topically which gives a local effect. Slide 21 Zingo is a new form of delivering the anesthetic lidocaine to the skin prior to IV administer. The device is held firmly to the skin. When the start button is pushed, the powder form drug is administered with a loud popping sound like a zing! Slide 22 Hair Loss- Alopecia Affects both men & women Male pattern baldness can be caused by low testosterone levels Hormone changes in women during menopause can cause hair to thin as well. Drugs to treat Alopecia include :Minoxidil (Rogaine) Finasteride (Propecia) They work by blocking enzymes that cause hair loss and dilate arteries in the scalp to increase blood flow to stimulate hair growth. Slide 23 WRINKLES Drugs used to treat wrinkles include topical Vitamin A type drugs, Injected Muscle relaxant drugs, or filler drugs to reduce the appearance of wrinkles. Botulinum Toxin Type A= Botox relaxes the muscles so that wrinkles smooth away Botox is Clostridium botulinum= the bacterium that causes food poioning. Slide 24 Botulinum Toxin Eating spoiled food that contains this bacterium results in muscle paralysis & eventually death from respiratory arrest. Botox parties have become popular. Food, drinks and botulinum. Hurray! Slide 25 Scabies- Caused by tiny parasites called mites that tunnel under the skin and cause tiny lesions. They lay eggs which hatch in a week. Can be transmitted through furniture, clothing, towels, as well as contact. Rx drugs are necessary- Elimite, Lindane Pediculosis- Infestation of lice and their eggs (nits) that can be found on the body, hair & pubic area. They feed on blood. Their bites cause itching. Treated with the same meds, and OTC drugs such as RID The nits must be completely removed and the area treated. It can be a painstaking process- Slide 26 A parasite or a louse Is shaped like a crab. The infestations sometimes referred to As crabs The phrase nit-picking refers to pointing out tiny details, comes from the process of picking out the nits from the hair looking for lice eggs. Slide 27 Can be difficult to manage medically. May contain necrotic (dead) tissue which must be debrided (removed) may contain exudate (drainage) prone to infection Some OTC drugs contain seaweed and manuka honey which has been used since the Ancient Egyptians discovered it over 4,000 years ago. Slide 28 Autoimmune disorder in which pigment cells in the skin are slowly destroyed resulting in patchy, whitish areas which slowly spread. Drugs can be used to produce pigment (color) Benoquin, Oxsoralen, Chromelin all Rx