Skin Disorders Made by alaa belal OTC Products For.

Skin Disorders Made by alaa

belal

OTC Products For

Disorders

Fungal Infections Hyperkeratosis

ViralInfection

s SkinInfestations Secondary

bacterial infections

Canker sores

Fungal Infections

Tinea

5Types

PedisCorporisCapitis

UnguiumVersicolor

1- Tinea pedisAthlete’s foot

NOT just athletes !!

But also:

Diabetics

Older than 60

Weak immune system

1- Tinea pedis

Interdigital

Athlete’s footMoccasin Vesicular

Most common type

Itching Maceration & Foul odourScalingBurningBetween two smallest

toes

1- Tinea pedis

Interdigital


Itching Dryness Absence of vesiclesInvolve the entire sole of the foot and extend onto the sides

Scaling

1- Tinea pedis

Interdigital


Least common Fluid-filled blisters Itching Scalin

g

Patient can not walk

Differential diagnosisTinea pedis Eczema

Inflammation, endogenous cause

Differences:Redness 1) Edema 2)Oozing Blister 3)No foul odour Similarities:Itching Crusting

3- Tinea corporis

1)Anywhere except face, feet, hands, groin2)Outer part of the sore can be raised, scally red, may contain vesicles, middle part normal

Ringworm

Grows outwards, may overlap ItchingScaling

Differential diagnosisTinea corporis Discoid eczema

Differences :1)Occurs on arms, hands & feet2)smaller 3)Middle part is not normal

4)Rare in patients under 20 years

Differential diagnosisTinea corporis Psoriasis

Immunological problemDifferences:Not contagiousRed plaques covered with silvery-white scales Painful and sometimes crack &bleedSimilarities:Itching Scaling

4- Tinea capitis

Round, bald patchesScaling, itching

Ringworm of the scalp

More common in children

5- Tinea unguium

1)Turn yellow or white

Onycholysis, fungal nail infection

2)Get thicker

6- Tinea versicolorPityriasis versicolor

Cosmetic concern

Yeast pitysporum orbiculare Common in oily surfacesteenagers

Not contagious

Differential diagnosisTinea versicolor Vitiligo

Found on fingers, toes, knees, and around the eyes and mouthLoss of all color (depigmentation)No scaling

FlatHypo- or hyperpigmentationSlight itching and scallingNot painful

Transmission of tinea

Water

Prevention

3. Wear shower sandals

2. Do not wear1. Dry off well

occlusive clothes

at public showers and swimming pools


Indirect contact

Prevention Do not share clothes, socks, towels, nail clippers


Direct contact

Prevention

Avoid contact with infected people or animals


Autoinfection

Treatment

Treatment of all fungal infections

Objective

Prevent recurrence

Inhibit the growth of

fungus

Relieve itching, burning and other

symptoms

Pharmaceutical Treatment

Most fungal infections

Topical OTC cream, solution, spray, powder

Except

ScalpNail

Oral prescription

Oral prescriptionItraconazole

Oral prescriptionFluconazole

Oral prescription

Disadvantages

Very expensive Side effects

Treatment of nail infection(Tinea unguium)

diabetes

mellitus

Under 18

years

Nail dystroph

y or destructi

on

peripheral

circulatory

disorders

More than 2 infected nails

Pregnancy or

breast feeding

Deficiency in

immune system

Unrespon-

siveness treatme

nt

ifRefer to a dermatologist

Treatment of nail infection(Tinea unguium)

lamifen Oral

Nail polish

Ticonazole

Surgically

Nail polish

Cleaning Cutting

Apply

Twice daily, for 3 months

ifRefer to a

dermatologist

Treatment of scalp infection(Tinea capitis)

Swollen mass

discharging pus

Severe alopecia

Swollen tender

lymphocyte of the neck

Treatment of scalp infection(Tinea capitis)

Oral prescription

Preventing reinfection Shampo

o

If treated early, the hair will grow back

Treatment of tinea versicolor

Skin may not regain its normal pigmentation Commonly comes back after treatment

Treatment of tinea versicolor

Selenium sulfide

Sulfiselen® Tinasel®

Areas affected lathered by selenium sulfide for about 2-5 mins then washed thoroughly

Used daily for up to 2 weeks

Tinea unguium

Tinea capitis

Tinea versicolor

Treatment

AzolesMiconazole nitrate 2% Thiocarbamate

sAllylamines

Clioquinol

Povidone iodine

Undecylenic acid

Treatment

AzolesKetoconazole 2% Thiocarbamate

sAllylamines

Clioquinol

Povidone iodine

Undecylenic acid

Treatment

Azoles

Broad spectrum antifungal

Miconazole (Daktarin®) safe in pregnancy

Available in all dosage forms

Apply twice daily 2 weeks for skin infection4 weeks for foot6 weeks for scalpfew months for nail infection

Thiocarbamates

Allylamines

Clioquinol

Povidone iodine

Undecylenic acid

Treatment

AzolesThiocarbamate

sAllylamines

Clioquinol

Povidone iodine

Tolnaftate 1%

Undecylenic acid

Treatment

AzolesThiocarbamate

sAllylamines

Clioquinol

Povidone iodine

Effective against most dermatophytes not only t.versicolor or candidiasis

Cream and solution only

Undecylenic acid

Treatment

AzolesThiocarbamate

sAllylamines

Clioquinol

Povidone iodine

Terbinafine 1%

Undecylenic acid

Treatment

AzolesThiocarbamate

sAllylamines

Clioquinol

Povidone iodine

Cream, solution, spray tablets (but not otc)

Cream 1-2 times:1 week for T.pedis2 weeks for T.corporis

T.versicolor

Not for children <16 or breast feeding mothers

Undecylenic acid

Treatment

AzolesThiocarbamate

sAllylamines

Clioquinol

Povidone iodine

Salt of aluminium clioquinol 3%

Clioquinol + corticosteroid

Undecylenic acid

Treatment

AzolesThiocarbamate

sAllylamines

Clioquinol

Povidone iodine

Lotion, cream, ointment

Side effects of clioquinol:• May cause itching,

allergic contact dermatitis

• Interfere with thyroid function

Do not use <2 years

Undecylenic acid

Treatment

AzolesThiocarbamate

sAllylamines

Clioquinol

Povidone iodine

Undecylenic acid 10% and 25%

Undecylenic acid

Fungistatic

Ointment at nighttime Powder at daytime

Treatment

AzolesThiocarbamate

sAllylamines

Clioquinol

Povidone iodine

Povidone iodine 10%solution (Betadaine®)

Undecylenic acid

Candidiasis

Candidiasis Most common type of yeast infectionMore than 20 species

Candida albicans (Monilia)

Most common

Causes Oral thrushVaginal candidiasis

Oral candidiasis (Oral thrush) (Moniliasis)

Thick, white lacy patches on top of a red base

Symptoms

Where ??TonguePalateOr elsewhere inside the mouth

Treatment

1- Miconazole

2- Nystatin

Topical oral antifungal

Treatment

1- Miconazole

Daktarin® oral gel Miconaz® oral gel

Treatment

2- Nystatin

Quiz

??Oral gel

SuspensionVS

Oral gel is recommended rather than suspension or drops due to longer residence on the affected area , as it adheres to the mucosal lining

“”

Dose

¼ spoonful ½ spoonful

Infants Adults

Treatment is continued for at least a week after symptoms have disappeared

Contraindication

liver disfunction safety not assured

Canker sores

Aphthous stomatitis

Symptoms 1- Size Minor 5-8 mm > 1

cm????Major

2- ShapeOval -

round

White - yellow

3- Color

4- Where ?Tongue,

cheek and lip

CauseUnknown

Canker sores is an idiopathic disease

Triggers Risk groups

Oral trauma StressHormonal changes Smoking cessationFood Helicobacter pylori

Being femaleFamily history

Treatment

Make sure it’s canker sores

No other extreme conditions

Then we will give our OTC consultancy

Differential diagnosis

1- Major canker sores

Greater than or 1cm10 separate, may coalesce into a single very large ulcerMay take up to six weeks to heal and leave extensive scarring

Differential diagnosis

2- Herpetiform canker sores

Clusters of 10 to 100 sores

OTC Treatment Local

anaestheticTopical oral analgesic

Anti-inflammatoryAntiseptic and disinfectant agentThe magic drug

Viscous lidocaine Oracure® oral gel

Local anaesthetic

Applied directly to the lesions Spray is not suitable for children

Topical oral analgesic

Mundisal® gel

Topical oral analgesic

BBC® spray

Anti-inflammatory

Kenalog® in orabase

Antiseptic and disinfectant agent

Corsodyl® dental gel as chlorhexidine digluconate

The magic drug

Self Healing

Patient counseling

Rinse your mouth with salty solutionBaking soda !!

Ice !!

Skin infestations

Scabies

A very common skin infection affects people of all races and social classes.

Sarcoptes scabei

calledMicroscopic mite

Cause:

Symptoms

4Itching

Red papular rash

Rash can also include vesiclesSecondary bacterial infectionGreyish “pencil-like” burrows

Take from 4 to 8 weeks

Scabies

patients who have not been infected previously

Take from 1 to 4 days Patients who have scabies before

to appear in

to appear in

Transmission

Direct way

Prolonged skin-to skin contact

Indirect way

By sharing articles

Scabies spreads rapidly in crowded places

As: hospitals, schools and prisons.

Animals such as dogs and cats are not a source of spread of human scabies.

Scabies

( Why do you think? )

Head lice( Pediculosis)

Cause: Small wingless parasitic insect

Pediculus humanus capitis

Head lice

Symptoms

4Feeling of something moving in the hair.Itching due to allergic reaction because of lice saliva.

Irritability and diffulity sleeping.

Sores on the head caused by scratching.(Secondary bacterial infection?!)

Head lice

Transmission

Common way

Uncommon way

By person-to-person contact.

By contact with clothes or other personal items used by infected persons.

1. Most common among preschool children, elementary school children and between household members.

2. Animals such as dogs and cats do not play a role in transmission of human head lice.

Treatment

Pediculicides/scabicides

Antipruritics

Permethrin Malathion

d-phenothrine

Piperonal

Topical antipruriticsSystemic antihistaminics

Treatment

Permethrin

2.5-5% Permethrin

Up to 1% Permethrin

Permethrine®

licid®Ectomethrine®

Scabies Pediculosis

Treatment

Malathion 0.5 lotion

(Ovide®)

d-phenothrine 0.4%

Eradication of lice & nits from the scalp (head lice).

(Item shampoo)

Precautions

1- Avoid application to wounded skin or scalp to avoid systemic absorption

2- Avoid scratching rash or vesicles & keep open sores clean

Treatment

Treatment

Pediculicides/scabicides

Antipruritics

Permethrin Malathion

d-phenothrine

Piperonal

Topical antipruriticsSystemic antihistaminics

Treatment

Antipruritics

Topical

Helping provide relief of itching

Systemic antihistaminic Calamine lotion Crotamitone

lotion Atrax Zyrtec Phenergan

Treatment

Viral Cutaneous Infections

HSV-1causes:

HSV-2 causes:

Herpes simplex(Cold sores or sun blisters)

Herpetic whitlow

Herpetic labialis (cold sores)

Herpetic keratitis

genital lesions and the virus is never eliminated from the body because The virus stays in the ganglia in an inactive form.

Genital lesions

Prevention

A vaccine called Zostavax to reduce the risk of shingles in people ages 60 and over. Varivax is the live attenuated vaccine that produces persistent immunity against chicken pox.

Killed and sub unit vaccine may be used to prevent recurrence of herpes simplex virus.

Treatment

Acyclovir

Zovirax

Penciclovir

Hyperkeratotic disorders

Hypertrophy of the horny layer of the skin (excessive development

of keratin)

CallusSkin lesions

Over a broad area of skin

caused by

Excess friction

CallusHand callus Feet callus

Repeated handling of an object that puts pressure on the hand Pressure from footwearLack a central core

Warts

Skin growth HPVcaused by

Very contagious

Go away on their own within months or years

WartsCommon Plantar

Grow most often on the hands Grow on the soles of the feetRough, shaped like a dome, and greyish-brown in color.

Hard, thick patches of skin with dark specks

Treatment

??

Refer to a dermatologist

diabetes

mellitus

peripheral

circulatory

disease

hemorrha-ging

oozing purulent material

s

rheumato-id

arthritis

Hair growth

Treatment

??

Salicylic acidMechanism of action :

It decreases keratinocyte adhesionIt increases water binding ,which leads to a hydration of keratin

(keratolytic agent )

Dimethyl ether (freezed)Freezing method

Precautions

NSAIDs

Avoid using salicylic acid, if you areallergic to

(aspirin, ibuprofen, ….); or if you have any other allergies

Secondary Bacterial Infection

SBI

Which bacteria causes SBI

Staphylococcus aureus

Streptococcus pyogenes

Staphylococcus aureus Impetigo (school sores)

Staphylococcus aureus Folliculitis

Staphylococcus aureus Furunculosis (boils)

Which bacteria causes SBI

Staphylococcus aureus

Streptococcus pyogenes

Streptococcus pyogenes Cellulitis

Streptococcus pyogenes Erysipelas

Streptococcus pyogenes Necrotising fasciitis

Treatment

Bacitracin ZincNeomycin

Polymyxin B Sulfate

TetracyclineFusidic acid

Terramycin Fucidin

Tetracycline Fusidic acid

Thanks

Skin Disorders Made by alaa belal OTC Products For.

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