NURS 570 Derm + Urticaria Exam With
Verified Solution
What is contact dermatitis? - ANSWER Skin gets exposed to a precipitant and has an
inflammatory reaction
What are common causes of contact dermatitis? - ANSWER Industrial chemicals,
detergents, fumes, tobacco smoke, paints, bleach, woolen fabrics, acidic foods,
astringents and other alcohol (excluding cetyl alcohol) containing skin care products,
some soaps and fragrances
Nickel, rubber, topical anesthetics, neomycin, antigens of poison ivy, oak
What areas of the body are commonly affected by contact dermatitis? - ANSWER Can be
anywhere
Distribution and location may provide clues about the irritant
How is contact dermatitis managed? - ANSWER Removal of the offending irritant
Antihistamines
Topical corticosteroids with potency based on site (4-6 for face and flexural sites, 1-3 for
hands and feet)
Systemic corticosteroids if >20% of body affected or if severe and disabling (typically
prednisone 0.5-1mg/kg for 5-7 days)
What is atopic dermatitis? - ANSWER Eczema
Caused by a genetic predisposition and environmental irritants
What are the clinical manifestations of atopic dermatitis? - ANSWER Course that waxes
and wanes depending on irritants/exposures
Intense pruritus, scratching, leading to lichenification of skin
Erythematous, scaly lesions that may have small weeping blisters
Usually present on neck, wrists, behind ears, flexor surfaces
Secondary staph/strep or herpes infections can develop
How is atopic dermatitis managed? - ANSWER Non-pharm: limit hot water exposure,
gentle soap, moisturize, use hypoallergenic detergent, wear gloves at night to prevent
scratching
, Pharm: topical corticosteroids (hydrocortisone, betamethasone), tacrolimus
What are the causes of acne vulgaris? - ANSWER Acne is a chronic inflammatory
disease involving the pilosebaceous unit
Multifactorial with usual onset in adolescence
Stress
Family history
Occlusion and pressure on skin
Drugs: steroids, androgens, lithium, phenytoin
Affects 90% of adolescents and most resolves by age 25
Women can have onset later, 20-35 years of age
What are the treatments for acne vulgaris? Hint: think of the 4 stages of lesion
development - ANSWER Follicular hyperproliferation and abnormal desquamation:
Topical retinoids, Oral retinoids, Azelaic acid, Salicylic acid, Hormonal therapies
Increased sebum production: Oral isotretinoin, Hormonal therapies
C. acnes proliferation: Benzoyl peroxide, topical and oral antibiotics, Azelaic acid
Inflammation: Oral isotretinoin, Oral tetracyclines, Topical retinoids, Azelaic acid
How are topical retinoids used in acne vulgaris treatment? - ANSWER Should be
included in the initial management of most patients as they are effective for both
comedonal and inflammatory acne
Apply a pea sized amount to the entire face every night (can start with 1-2 times per
week to decrease side effects and work up to once every day)
Start with the lowest concentration and increase the potency PRN
Side effects: erythema, dryness, burning, photosensitivity (worst during 1st month)
Avoid in pregnancy
True or false: topical retinoids alone are just as effective as topical retinoids used in
combination with topical antimicrobials in the treatment of inflammatory acne - ANSWER
FALSE. Combination therapy with a topical antimicrobial plus a topical retinoid appears
to be more effective than either agent alone, and adding an antimicrobial agent is
recommended when retinoids are used for the treatment of patients with inflammatory
acne.
Adding benzoyl peroxide reduces the development of antibiotic resistance
Verified Solution
What is contact dermatitis? - ANSWER Skin gets exposed to a precipitant and has an
inflammatory reaction
What are common causes of contact dermatitis? - ANSWER Industrial chemicals,
detergents, fumes, tobacco smoke, paints, bleach, woolen fabrics, acidic foods,
astringents and other alcohol (excluding cetyl alcohol) containing skin care products,
some soaps and fragrances
Nickel, rubber, topical anesthetics, neomycin, antigens of poison ivy, oak
What areas of the body are commonly affected by contact dermatitis? - ANSWER Can be
anywhere
Distribution and location may provide clues about the irritant
How is contact dermatitis managed? - ANSWER Removal of the offending irritant
Antihistamines
Topical corticosteroids with potency based on site (4-6 for face and flexural sites, 1-3 for
hands and feet)
Systemic corticosteroids if >20% of body affected or if severe and disabling (typically
prednisone 0.5-1mg/kg for 5-7 days)
What is atopic dermatitis? - ANSWER Eczema
Caused by a genetic predisposition and environmental irritants
What are the clinical manifestations of atopic dermatitis? - ANSWER Course that waxes
and wanes depending on irritants/exposures
Intense pruritus, scratching, leading to lichenification of skin
Erythematous, scaly lesions that may have small weeping blisters
Usually present on neck, wrists, behind ears, flexor surfaces
Secondary staph/strep or herpes infections can develop
How is atopic dermatitis managed? - ANSWER Non-pharm: limit hot water exposure,
gentle soap, moisturize, use hypoallergenic detergent, wear gloves at night to prevent
scratching
, Pharm: topical corticosteroids (hydrocortisone, betamethasone), tacrolimus
What are the causes of acne vulgaris? - ANSWER Acne is a chronic inflammatory
disease involving the pilosebaceous unit
Multifactorial with usual onset in adolescence
Stress
Family history
Occlusion and pressure on skin
Drugs: steroids, androgens, lithium, phenytoin
Affects 90% of adolescents and most resolves by age 25
Women can have onset later, 20-35 years of age
What are the treatments for acne vulgaris? Hint: think of the 4 stages of lesion
development - ANSWER Follicular hyperproliferation and abnormal desquamation:
Topical retinoids, Oral retinoids, Azelaic acid, Salicylic acid, Hormonal therapies
Increased sebum production: Oral isotretinoin, Hormonal therapies
C. acnes proliferation: Benzoyl peroxide, topical and oral antibiotics, Azelaic acid
Inflammation: Oral isotretinoin, Oral tetracyclines, Topical retinoids, Azelaic acid
How are topical retinoids used in acne vulgaris treatment? - ANSWER Should be
included in the initial management of most patients as they are effective for both
comedonal and inflammatory acne
Apply a pea sized amount to the entire face every night (can start with 1-2 times per
week to decrease side effects and work up to once every day)
Start with the lowest concentration and increase the potency PRN
Side effects: erythema, dryness, burning, photosensitivity (worst during 1st month)
Avoid in pregnancy
True or false: topical retinoids alone are just as effective as topical retinoids used in
combination with topical antimicrobials in the treatment of inflammatory acne - ANSWER
FALSE. Combination therapy with a topical antimicrobial plus a topical retinoid appears
to be more effective than either agent alone, and adding an antimicrobial agent is
recommended when retinoids are used for the treatment of patients with inflammatory
acne.
Adding benzoyl peroxide reduces the development of antibiotic resistance
