BPHM3125_RTS_in_Skin_Disorders_I_and_II_20250214_20250221_V2

Course Information

• Course Code: BPHM3125

• Course Title: Pharmacy Practice: Community Pharmacy Responding to Symptoms Skin Disorders

• Instructor: Marco Lee

• Email: marcolt@hku.hk

• Faculty: HKU LKS Faculty of Medicine, Department of Pharmacology

Learning Outcomes

• Understand and implement the general approach to skin disorders

• Describe characteristics of various skin disorders:

  • Morphology, signs, and symptoms

  • Differentiate types of skin disorders in responses to symptoms

• Suggest pharmacological treatments and counsel appropriately:

  • Pharmacological therapies

  • Non-pharmacological and lifestyle modifications

• Referral: When to refer cases exceeding pharmacists' capabilities

Topics to be Covered

• Psoriasis

• Fungal Infections (skin and nail)

• Lichen Simplex Chronicus

• Herpes Zoster

• Acne Vulgaris

• Cold Sores

• Rosacea

• Scabies

• Warts and Verrucas

• Dandruff

• Corns and Calluses

• Seborrheic Dermatitis

General Approach for Diagnosis

History Taking

• Differential Diagnosis Criteria:

  • Location: Affected areas, distribution, natural history

  • Associated Symptoms: Redness, itchiness, etc.

  • Exposure History: Travel, occupation, contact, etc. (TOCC model)

  • Personal Factors: Past medical history, drug allergies, social and family history, sex, age.

Observation of Lesions

• Lesion Morphology and Characteristics:

  • Types of Distribution: Symmetrical, asymmetrical, unilateral, localized

  • Arrangement: Discrete, coalescing, grouped

  • Feel of Lesions: Smooth or rough

Conditions Covered

1. Psoriasis

• Clinical Presentation:

  • Locations: Various body parts, especially the scalp, elbows, knees

  • Symptoms: Characteristic salmon-pink lesions with silvery-white scales

  • Associations: Depression and autoimmune diseases

• Pathophysiology:

  • Immune-mediated, exact cause unclear; genetic influence

  • Triggering Factors: Physical trauma, psychological stress, infections, alcohol/smoking, and drugs (e.g., beta blockers)

• Pharmacotherapy:

  • Keratolytic Agents: Salicylic acid for scale removal

  • Topical Steroids and Vitamin D3 Analogues

  • Systemic Therapy: Retinoids, anti-metabolites, immunosuppressive drugs, and biologics

2. Lichen Simplex Chronicus

• Clinical Presentation:

  • Solid plaques due to chronic scratching; common areas: wrists

• Management:

  • Topical steroids and oral antihistamines to relieve itch

3. Acne Vulgaris

• Clinical Presentation:

  • Affects face, chest, and back

  • Symptoms include blackheads, whiteheads, papules, and pustules

• Pathophysiology:

  • Excessive sebum production, follicular keratinization, P. acnes proliferation

• Pharmacotherapy: Benzoyl peroxide, topical and oral antibiotics, hormonal treatments, and isotretinoin

4. Rosacea

• Clinical Presentation:

  • Symptoms include facial flushing and papules without comedones

  • High prevalence in adults aged 30-50

• Management:

  • Topical metronidazole, brimonidine for erythema

5. Warts and Verrucas

• Clinical Presentation:

  • Raised papules caused by HPV

  • Self-limiting nature related to age group

• Pharmacotherapy:

  • Salicylic acid for treatment, cryotherapy, and topical imiquimod

6. Corns and Calluses

• Clinical Presentation:

  • Hard corns primarily on toes; soft corns between the toes

• Management:

  • Removal of improper footwear and usage of protective pads

7. Fungal Skin Infection

• Clinical Presentation:

  • Types include athlete’s foot, jock itch, and ringworm

• Pharmacotherapy:

  • Topical antifungals like terbinafine, clotrimazole.

8. Onychomycosis

• Pathophysiology and Management:

  • Fungal nail infection requiring treatments such as amorolfine and oral terbinafine

9. Herpes Zoster

• Patient Assessment:

  • Includes prodromal pain, unilateral rashes

• Pharmacotherapy:

  • Oral antivirals like acyclovir

10. Scabies

• Clinical Presentation:

  • Intense pruritus, especially at night, with burrowed lesions

• Pharmacotherapy:

  • Topical permethrin and malathion solutions

11. Cold Sores/Eruptions

• Clinical Presentation:

  • Triggered symptoms with sudden eruptions due to herpes simplex virus

• Pharmacotherapy:

  • Acyclovir cream application