Made by alaa belal OTC Products For Disorders Fungal Infections Hyperkeratosis Viral Infections Skin Infestations Secondary bacterial infections Canker sores Fungal Infections ID: 155900
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Slide1
Skin Disorders
Made by
alaa
belal
OTC Products For Slide2
Disorders
Fungal Infections
Hyperkeratosis
Viral
Infections
Skin
Infestations
Secondary bacterial infections
Canker soresSlide3
Fungal Infections Slide4
Tinea
5
Types
P
edis
Corporis
Capitis
Unguium
V
ersicolorSlide5
1- Tinea
pedis
Athlete’s foot
NOT
just athletes !!
But also:
Diabetics
Older than 60
Weak immune systemSlide6
1-
Tinea
pedis
Interdigital
Athlete’s foot
Moccasin
Vesicular
Most
common
type
Itching
Maceration & Foul
odour
Scaling
Burning
Between
two smallest toesSlide7
1-
Tinea
pedis
Interdigital
Athlete’s foot
Moccasin
Vesicular
Itching
Dryness
Absence
of vesicles
Involve
the entire sole of the foot and extend onto the sides
ScalingSlide8
1-
Tinea
pedis
Interdigital
Athlete’s foot
Moccasin
Vesicular
Least
common
Fluid-filled
blisters
Itching
Scaling
Patient can not walk Slide9
Differential diagnosis
Tinea
pedis
EczemaInflammation, endogenous causeDifferences:Redness 1) Edema 2)Oozing Blister 3)No foul
odour Similarities:Itching CrustingSlide10
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
RingwormGrows outwards, may
overlap
Itching
ScalingSlide11
Differential diagnosis
Tinea
corporis
Discoid eczema
Differences :
1)Occurs on arms, hands & feet
2)smaller
3)Middle part is not normal
4)Rare in patients under 20 yearsSlide12
Differential diagnosis
Tinea
corporis
Psoriasis
Immunological
problem
Differences:Not contagiousRed plaques covered with silvery-white scales
Painful and sometimes crack &bleed
Similarities:Itching
ScalingSlide13
4-
Tinea
capitis
Round, bald
patchesScaling, itching Ringworm of the scalp
More common in childrenSlide14
5-
Tinea
unguium
1)Turn yellow or white
Onycholysis, fungal nail infection2)Get thickerSlide15
6
-
Tinea versicolor
Pityriasis
versicolor
C
osmetic concern
Yeast
pitysporum orbiculare
Common in oily surfaces
teenagers
Not contagious Slide16
Differential diagnosis
Tinea
versicolor
Vitiligo
Found
on fingers, toes, knees, and around the eyes and mouth
Loss of all color (depigmentation)
No scaling
FlatHypo- or hyperpigmentation
Slight itching and scallingNot
painfulSlide17
Transmission of tinea
Water
Prevention
3. Wear shower sandals2. Do not wear
1. Dry off wellocclusive clothes
at public showers and
swimming poolsSlide18
Transmission of tinea
Indirect contact
Prevention
Do not share clothes, socks, towels, nail clippersSlide19
Transmission of tinea
Direct contact
Prevention Avoid contact with infected people or animals Slide20
Transmission of tinea
AutoinfectionSlide21
TreatmentSlide22
Treatment of all fungal infections
Objective
Prevent recurrence
Inhibit the growth of fungus
Relieve itching, burning and other symptomsSlide23
Pharmaceutical Treatment
Most fungal infections topical OTC cream , solution ,spray , powder
But :1) nail 2)scalp oral prescriptionExample :itraconazole (
sporanox ®) and fluconazole (diflucan ®), terbinafine (lamifen®) Disadvantages of oral antifungal:
1)most very expensive. (lamifen52 LEsporanox 42LE diflucan 1 tablet for 27LE ) 2) side effects. contraindicated in patients with liver or heart problems. Most fungal infections
Topical OTC cream, solution, spray, powder
Except
Scalp
Nail
Oral
prescriptionSlide24
Oral prescription
Most fungal infections topical OTC cream , solution ,spray , powder
But :1) nail 2)scalp oral prescriptionExample :itraconazole (
sporanox ®) and fluconazole (diflucan ®), terbinafine (lamifen®) Disadvantages of oral antifungal:
1)most very expensive. (lamifen52 LEsporanox 42LE diflucan 1 tablet for 27LE ) 2) side effects. contraindicated in patients with liver or heart problems. ItraconazoleSlide25
Oral prescription
Most fungal infections topical OTC cream , solution ,spray , powder
But :1) nail 2)scalp oral prescriptionExample :itraconazole (
sporanox ®) and fluconazole (diflucan ®), terbinafine (lamifen®) Disadvantages of oral antifungal:
1)most very expensive. (lamifen52 LEsporanox 42LE diflucan 1 tablet for 27LE ) 2) side effects. contraindicated in patients with liver or heart problems. Fluconazole Slide26
Oral prescription
Most fungal infections topical OTC cream , solution ,spray , powder
But :1) nail 2)scalp oral prescriptionExample :itraconazole (
sporanox ®) and fluconazole (diflucan ®), terbinafine (lamifen®) Disadvantages of oral antifungal:
1)most very expensive. (lamifen52 LEsporanox 42LE diflucan 1 tablet for 27LE ) 2) side effects. contraindicated in patients with liver or heart problems. Disadvantages
Very expensive
Side effectsSlide27
Treatment of nail infection
(Tinea
unguium)
diabetes mellitus
Under 18 years Nail dystrophy or destruction
peripheral circulatory disorders
More than 2 infected nails
Pregnancy or breast feeding
Deficiency in immune system
Unrespon-siveness
treatment
if
Refer to a dermatologistSlide28
Treatment of nail infection
(Tinea
unguium)
lamifen
Oral
Nail polish
Ticonazole
SurgicallySlide29
Nail polish
Cleaning
Cutting
Apply
Twice daily, for 3 months Slide30
if
Refer to a dermatologist
Treatment
of scalp infection
(Tinea capitis)
Swollen mass discharging pus
Severe alopecia
Swollen tender lymphocyte of the neck Slide31
Treatment of scalp infection
(Tinea
capitis)
Oral prescription Preventing
reinfection Shampoo
If treated early, the hair will grow back Slide32
Treatment of tinea
versicolor
Skin
may not regain its normal pigmentation Commonly comes back after treatmentSlide33
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 Slide34
Tinea
unguium
Tinea
capitis
Tinea versicolorSlide35
Treatment
Azoles
Miconazole
nitrate 2%
Thiocarbamates
Allylamines
Clioquinol
Povidone
iodine
Undecylenic
acidSlide36
Treatment
Azoles
Ketoconazole 2%
Thiocarbamates
Allylamines
Clioquinol
Povidone
iodine
Undecylenic
acidSlide37
Treatment
Azoles
Broad
spectrum
antifungalMiconazole (Daktarin®) safe
in pregnancy Available in all dosage forms
Apply twice daily 2 weeks
for skin infection4 weeks for foot
6 weeks for scalpfew months for nail infection
Thiocarbamates
Allylamines
Clioquinol
Povidone
iodine
Undecylenic
acidSlide38
Treatment
Azoles
Thiocarbamates
Allylamines
Clioquinol
Povidone iodine
Tolnaftate
1%
Undecylenic
acidSlide39
Treatment
Azoles
Thiocarbamates
Allylamines
Clioquinol
Povidone iodine
Effective
against most
dermatophytes not only t.versicolor or candidiasis
Cream and solution
only
Undecylenic acidSlide40
Treatment
Azoles
Thiocarbamates
Allylamines
Clioquinol
Povidone iodine
Terbinafine
1%
Undecylenic
acidSlide41
Treatment
Azoles
Thiocarbamates
Allylamines
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
acidSlide42
Treatment
Azoles
Thiocarbamates
Allylamines
Clioquinol
Povidone iodine
Salt of
aluminium
clioquinol 3%
Clioquinol
+ corticosteroid
Undecylenic
acidSlide43
Treatment
Azoles
Thiocarbamates
Allylamines
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
acidSlide44
Treatment
Azoles
Thiocarbamates
Allylamines
Clioquinol
Povidone iodine
Undecylenic
acid 10% and 25%
Undecylenic
acid
Fungistatic
Ointment at
nighttime
Powder at daytime Slide45
Treatment
Azoles
Thiocarbamates
Allylamines
Clioquinol
Povidone iodine
Povidone
iodine 10%solution (
Betadaine
®)
Undecylenic
acidSlide46
Candidiasis Slide47
Candidiasis
Most common type of yeast infection
More than 20 species
Candida albicans
(Monilia)
Most common
Causes
Oral thrush
Vaginal
candidiasisSlide48
Oral
candidiasis (Oral thrush) (
Moniliasis
)Thick, white lacy patches on top of a red base
SymptomsWhere ??
TonguePalateOr elsewhere inside the mouthSlide49
Treatment
1-
Miconazole
2- Nystatin
Topical oral antifungalSlide50
Treatment
1- Miconazole
Daktarin
®
oral
gel Miconaz® oral gelSlide51
Treatment
2- Nystatin Slide52
Quiz
??
Oral gel
Suspension
VSOral gel is recommended rather than suspension or drops due to
longer residence on the affected area , as it adheres to the mucosal lining
“
”Slide53
Dose
¼
spoonful
½ spoonful
Infants Adults
Treatment is continued for at least a week after symptoms have disappeared Slide54
Contraindication
liver
disfunction
safety not assuredSlide55
Canker sores
Aphthous
stomatitisSlide56
Symptoms
1- Size
Minor
5-8
mm
>
1 cm
????
Major
2- Shape
Oval - round
White - yellow
3- Color
4- Where ?
Tongue, cheek and lipSlide57
Cause
Unknown
Canker sores is an
idiopathic disease Slide58
Triggers
Risk groups
Oral
trauma
StressHormonal changes Smoking cessation
Food Helicobacter pylori
Being femaleFamily
historySlide59
Treatment
Make sure it’s canker sores
No other extreme conditions
Then we will give our OTC consultancy Slide60
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 scarringSlide61
Differential diagnosis
2- Herpetiform canker sores
Clusters of 10 to 100 soresSlide62
OTC Treatment
Local
anaesthetic
Topical oral analgesic
Anti-inflammatory
Antiseptic
and disinfectant agent
The magic drug Slide63
Viscous
lidocaine
Oracure® oral gel
Local anaestheticApplied directly to the lesionsSpray is not suitable for childrenSlide64
Topical oral analgesic
Mundisal
®
gel Slide65
Topical oral analgesic
BBC
® spraySlide66
Anti-inflammatory
Kenalog
® in orabaseSlide67
Antiseptic and disinfectant agent
Corsodyl
® dental gel as chlorhexidine digluconateSlide68
The magic drug
Self Healing Slide69
Patient counseling
Rinse your mouth with salty solution
Baking soda !!
Ice !!Slide70
Skin infestations Slide71
Scabies
A very common skin infection affects people of all races and social classes.
Sarcoptes
scabei
calledMicroscopic mite Cause:Slide72
Symptoms
4
Itching
R
ed
papular rash
Rash can also include vesiclesSecondary bacterial infection
Greyish “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 inSlide73
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? )Slide74
Head lice
( Pediculosis)
Cause: Small wingless parasitic insect
Pediculus humanus capitis Slide75
Head lice
Symptoms
4
Feeling 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?!)Slide76
Head lice
Transmission
Common way
Uncommon way
By person-to-person contact.
By contact with clothes or other personal items used by infected persons.
Most common among preschool children, elementary school children and between household members.
Animals such as dogs and cats do not play a role in transmission of human head lice.Slide77
Treatment
Pediculicides
/
scabicidesAntipruritics
Permethrin Malathion d-phenothrine
Piperonal Topical antipruritics
Systemic antihistaminicsSlide78
Treatment
Permethrin
2.5-5% Permethrin
Up to 1% PermethrinPermethrine®
licid
®
Ectomethrine
®
Scabies
Pediculosis Slide79
Treatment
Malathion
0.5 lotion(Ovide®)
d-
phenothrine
0.4%Eradication of lice & nits from the scalp (head lice).
(Item shampoo)Slide80
Precautions
1
- Avoid application to wounded skin or scalp to avoid systemic absorption
2
- Avoid scratching rash or vesicles & keep open sores clean
TreatmentSlide81
Treatment
Pediculicides
/
scabicidesAntipruritics
Permethrin Malathion d-phenothrine
Piperonal Topical antipruritics
Systemic antihistaminics
TreatmentSlide82
Antipruritics
Topical
Helping provide relief of itching
Systemic antihistaminic
Calamine lotion Crotamitone lotion
Atrax
Zyrtec
Phenergan
TreatmentSlide83
Viral Cutaneous InfectionsSlide84
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 Slide85
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.Slide86
Treatment
Acyclovir
Zovirax
PenciclovirSlide87
Hyperkeratotic disorders
Hypertrophy
of the horny layer of the skin (excessive development of keratin)Slide88
Callus
Skin lesions
Over
a broad area of skin
caused byExcess friction Slide89
Callus
Hand callus
Feet callus
Repeated handling of an object that puts pressure on the hand
Pressure from footwearLack a central coreSlide90
Warts
Skin
growth
HPVcaused by
Very contagiousGo away on their own within months or yearsSlide91
Warts
Common
Plantar
G
row most often on the handsGrow on the soles of the feetRough
, shaped like a dome, and greyish-brown in color.
Hard
, thick patches of skin with dark specksSlide92
Treatment
??Slide93
Refer to a
dermatologist
diabetes
mellitus
peripheral circulatory disease
hemorrha-ging
oozing purulent materials
rheumato
-id arthritis
Hair growthSlide94
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 methodSlide95
Precautions
NSAIDs
Avoid using salicylic acid, if you are
allergic to(aspirin, ibuprofen, ….); or if you have any other allergiesSlide96
Secondary Bacterial Infection
SBISlide97
Which bacteria causes SBI
Staphylococcus aureus
Streptococcus pyogenes Slide98
Staphylococcus aureus
Impetigo (school sores) Slide99
Staphylococcus aureus
FolliculitisSlide100
Staphylococcus aureus
Furunculosis (boils)Slide101
Which bacteria causes SBI
Staphylococcus aureus
Streptococcus pyogenes Slide102
Streptococcus pyogenes
Cellulitis Slide103
Streptococcus pyogenes
Erysipelas Slide104
Streptococcus pyogenes
Necrotising fasciitis Slide105
Treatment
Bacitracin Zinc
NeomycinPolymyxin
B SulfateTetracyclineFusidic acidSlide106
Terramycin
Fucidin
Tetracycline
Fusidic
acidSlide107
Thanks