exam 3 (scaly dermatoses)

dandruff

mildly inflammatory scalp disorder that results in excessive scalp scaling

in how much of the population does dandruff occur?

50%

what yeast results in dermatitis?

malassezia yeast

what are the intrinsic exacerbating factors of dandruff?

psychological stress or fatigue (hormone levels)

what are the extrinsic exacerbating factors of dandruff?

cold, dry weather (skin moisture)

seborrheic dermatitis is what and where does it predominantly occur?

chronic inflammatory disorder that occurs predominantly in the areas of greatest sebaceous gland activity (scalp, face, chest)

what are the risk factors for seborrheic dermatitis?

immunosuppressive disorders, chronic neurological disorders

cradle cap

infantile form of a seborrheic dermatitis

cradle cap treatment

-gently message scalp with baby oil

-wash hair and scalp with nonmedicated shampoo

What type of disease is psoriasis?

Chronic autoimmune disease

How does psoriasis typically present on the body?

Typically symmetrical

What are the symptoms of psoriasis?

Itchy and inflammatory

What is the initial form of psoriasis lesions?

Small papules

What do psoriasis papules grow into?

Plaques

order seborrheic, psoriasis, and dandruff in order of least to most severe

dandruff --> seborrheic dermatitis --> psoriasis

which of these are curable? dandruff, seborrheic dermatitis, and psoriasis

all incurable and following waxing/waning course

which scaly dermatoses presents on the face?

seborrheic dermatitis

which scaly dermatoses presents in the lower extremities

psoriasis

which scaly dermatoses presents with silvery white scales?

psoriasis

what are the exclusions for dandruff, seborrheic dermatitis, and psoriasis

-<2 years of age

-worsening or no improvement of disorder after 2 weeks of proper use of OTC medications

What is the exclusion criterion for psoriasis related to body surface area (BSA)?

More than 5% involvement of BSA

What is an exclusion criterion for psoriasis involving facial skin?

Involvement of the face

What exclusion criterion for psoriasis is associated with joint symptoms?

Presence of joint pain

What is an exclusion criterion for psoriasis regarding the number of lesions?

More than a few lesions

What is the size exclusion criterion for a single psoriasis lesion?

One lesion larger than the size of a quarter

what are the nonpharm options for dandruff and seborrheic dermatitis?

-wash hair and scalp areas with nonmedicated shampoo qd or qod

-avoid sodium lauryl sulfate

psoriasis nonpharm treatment

emollients: AAA liberally up to QID

for treatment of dandruff what is the drug of choice?

anti-malassezia agents

list anti-malassezia agents

-pyrithione zinc

-selenium sulfide

-ketoconazole

what is the application of shampoo for dandruff?

shampoo the hair with medicated shampoo for 5 minutes 2--3 times per week taper to lowest effective dose

pyrithione zinc brand

head and shoulders

ketoconazole brand

nizoral

selenium sulfide brand

selsun blue

coal tar brand

neutrogena t-gel shampoo

list keratolytic agents

-salicyclic acid

-sulfur

MOA of anti-malassezia agents

reduces the yeast count on the scalp and skin

what is an ADE of selenium sulfide?

hair discoloration

what is an ADE of ketoconazole?

hair loss, skin irritation, abnormal hair texture, dry skin

cytostatic agents MOA

decreases the rate of epidermal cell replication

cytostatic agents ADE

-staining of skin and hair

-odor

-folliculitis

-photosensitization

-irritant contact dermatitis

keratolytic agent MOA

-loosen and slough off keratin aggregates on the outer layer of skin

-limited efficacy and very slow acting

keratolytic agent ADE

-alter hair appearance

-irritating and drying to skin

what is the DOC for psoriasis?

anti-inflammatory agents

anti-inflammatory agents MOA

-anti-inflammatory

-vasoconstriction

-immunosuppression

anti-inflammatory agents ADE

-atrophy with prolonged use

-increased risk of infection