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| anti-inflammatory steroid |
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| Rx of Excessive Hair Growth in Women: |
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| Mupirocin ointment intra-nasally TID x 5 days for eradication of colonization of _____(comes in 1g single use tubes to prevent contamination) |
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| Impetigo caused by Staph aureus and group A β-hemolytic strep - Treat with ____ ointment or cream |
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Acne vulgaris - Treat w/:
_____ with benzoyl peroxide (Benza Clin) gel
____ gel
____ with benzoyl peroxide (Benzamycin) |
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Clindamycin
Erythromycin
Erythromycin |
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| Candidal Vaginitis - Treat w/: (3) |
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Miconazole (Monistat)
Clotrimazole (Lotrimin)
Nystatin |
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| Dermatophytosis, candidiasis, seborrheic dermatitis, and tinea - Treat w/ (2): |
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Ketoconazole (Nizoral)
Ciclopirox olamine 1% cream and lotion (Loprox) |
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| Ciclopirox olamine 8% lacquer (not very effective) |
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| Other anti-dermatophyte medications: (3) |
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Terbinafine (Lamisil)
Vutenafine (Mentax)
Tolnaftate (Tinactin) |
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| Other candidal medications (2): |
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Nystatin - may be swished orally in oral candidiasis (thrush)
Amphotericin B (“ampho-terrible”) |
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Fluconazole (Diflucan)
Itraconazole (Sporonax)
Ketoconazole (Nizoral) |
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| Chronic mucocutaneous candidiasis Tx: (3) |
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Ketoconazole
Fluconazole
Itraconazole |
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Itraconazole (pulse dosing for 2 months/12 weeks)
Monitor hepatic function!
Terbinafine (6 weeks/12 weeks) |
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| Candidal vaginitis Tx: (1) |
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| Fluconazole (Diflucan) - One time treatment |
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Griseofulvin
- Most effective with tinea
- Also effective with infx of fingernails (4 months), but not toenails due to duration of therapy (8-18 months) |
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| Oral HSV (types 1 and 2) Tx: (2) |
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Acyclovir (Zovirax) 5% ointment
Penciclovir (Denavir) 1% cream |
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| Scabies (Sarcoptes scabiei) Tx: (4) |
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Permethrin 5% (Elemite) cream -> One time application from the neck down x 8-14 hours and rinse
Lindane (Kwell) can be used but toxicity may be a concern (outlawed in California)
Crotamiton (Eurax)
Sulfur is an alternative in children and pregnant women (rarely used) |
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| Lice (Pediculosis humanus, Pthirus pubis) Tx: (3) |
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Definition
–Permethrin 1% (Nix) cream
•Apply for 10 minutes and rinse
–Lindane (Kwell) shampoo
•Apply to dry hair on scalp or genitalia x 4 minutes and rinse
•Reapplication may be required
–Malathion (Ovide) 0.5% lotion
•Apply to hair when dry; comb out nits 4-6 hours later |
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•Anogenital warts (external only) Tx: (1) |
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–Imiquimod (Aldara)
•MOA likely due to stimulation of peripheral mononuclear cells to release interferon-α and stimulation of macrophages to produce interleukins-1, -6, -8, and TNF- α
•Apply 3x per week (MWF) and leave on skin 6-10 hours; wash off with soap and water
•Also used for actinic keratoses (twice weekly) on face and scalp and some 1° BCC’s (5x/week) |
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•Atopic dermatitis (eczema) Tx: (2) |
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–Macrolide immunosuppressants
•Tacrolimus (Protopic)
•Pimecrolimus (Elidel) |
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•Keratotic lesions Tx. : (8) |
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–Podophyllum resin
•Condyloma acuminatum or other verrucae
•Cytotoxic; use on warty tissue only; wash off in 2-3 hours; contraindicated in pregnancy; usually only in office application limited to 3-5 times
–Podofilox 0.5%
•Lower concentration limits potential for toxicity
•Self administration BID x 3 days followed by 4 day free period
–Fluorouracil 0.5%, 1%, 2%, 5%
•Inhibits thymidylate synthetase interfering with DNA synthesis; most noticeable in rapidly proliferating cells
•Treatment progression: erythema => vesiculation => erosion => ulceration => necrosis => reepitheliaization
•Actinic keratosis
–Salicylic acid 3%-6%
•MOA not understood; keeps stratum corneum intact
–Propylene glycol 40%-70%
•Increases water content of stratum corneum
•Icthyosis, keratodermas, psoriasis, pityriasis rubra pilaris, keratosis pilaris, hypertrophic lichen planus
–Urea 2%-20%
•Increases water content of stratum corneum
•In most creams and lotions; decreases oily feel
•Icthyosis vulgaris, hyperkeratosis, xerosis, keratosis pilaris
–NSAID’s (diclofenac 3%)
•MOA not understood
•Actinic keratosis
–Aminolevulinic Acid (ALA)
•Precursor of porphyrin metabolites
•Topical application causes protoporphyrin IX accumulation in cell; exposure to light results in cytotoxic radicals
•Usually apply ALA 20% and 14-18 hours later blue light illumination causes redness, swelling, and crusting of actinic keratoses resolving over 3-4 weeks |
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–Retinoic acid (tretinoin), multiple brand names
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–Adapalene (Differin)
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–Tazarotene (Tazorac)
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–Benzoyl Peroxide
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–Azelaic Acid (Azelex, Finacea)
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•Balding (alopecia) Tx (2) |
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–Minoxidil (Rogaine)
•MOA unknown
•Reverses miniaturization of terminal scalp hairs associated with androgenic alopecia
•More effective in vertex balding than frontal balding
•Cessation of treatment will lead to hair loss
•May systemically affect blood pressure
–Finasteride (Propecia)
•5α-reductase inhibitor (blocks conversion of testosterone to dihydrotestosterone)
•Promotes hair growth and prevents further hair loss
•May decrease libido and cause ED
•Risk of hypospadias in developing male fetuses |
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•Excess facial hair Tx (2) |
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–Eflornithine (Vaniqa)
•Inhibits ornithine decarboxylase (catalyzes biosynthesis of polyamines)
•Affects rate of hair growth
•Topical application reduces facial hair growth in 30% of women over the course of 6 months
•Hair growth returns after discontinuation
–Spironolactone
•Unapproved use in hirsutism
•50-200mg PO daily |
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•Acitretin (Soriatane)
•Tazarotene (Tazorac)
•Calcipotriene (Dovonex)
•Tar compounds
•T-cell modulators and TNF-α inhibitors
–Alefacept (Amevive)
–Efalizumab (Raptiva)
–Etanercept (Enbrel) |
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Topical Corticosteroid Indications: (3)
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–Psoriasis
–eczema (atopic dermatitis)
–Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP’s) |
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