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Skin Disorders Made by alaa belal OTC Products For.

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Presentation on theme: "Skin Disorders Made by alaa belal OTC Products For."— Presentation transcript:

1 Skin Disorders Made by alaa belal OTC Products For

2 Disorders Fungal Infections Hyperkeratosis Viral Infections Skin Infestations Secondary bacterial infections Canker sores

3 Fungal Infections

4 Tinea 5 Types Pedis Corporis Capitis Unguium Versicolor

5 1- Tinea pedis Athlete’s foot NOT just athletes !! But also: Diabetics Older than 60 Weak immune system

6 1- Tinea pedis Interdigital Athlete’s foot MoccasinVesicular Most common typeItchingMaceration & Foul odourScaling Burning Between two smallest toes

7 1- Tinea pedis Interdigital Athlete’s foot MoccasinVesicular ItchingDrynessAbsence of vesicles Involve the entire sole of the foot and extend onto the sides Scaling

8 1- Tinea pedis Interdigital Athlete’s foot MoccasinVesicular Least commonFluid-filled blisters Itching Scaling Patient can not walk

9 Differential diagnosis Tinea pedis Eczema Inflammation, endogenous cause Differences: Redness 1) Edema 2)Oozing Blister 3)No foul odour Similarities: Itching Crusting

10 3- Tinea corporis 1)Anywhere except face, feet, hands, groin 2)Outer part of the sore can be raised, scally red, may contain vesicles, middle part normal Ringworm Grows outwards, may overlap ItchingScaling

11 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 years

12 Differential diagnosis Tinea corporis Psoriasis Immunological problem Differences: Not contagious Red plaques covered with silvery- white scales Painful and sometimes crack &bleed Similarities: Itching Scaling

13 4- Tinea capitis Round, bald patches Scaling, itching Ringworm of the scalp More common in children

14 5- Tinea unguium 1)Turn yellow or white Onycholysis, fungal nail infection 2)Get thicker

15 6- Tinea versicolor Pityriasis versicolor Cosmetic concern Yeast pitysporum orbiculare Common in oily surfaces teenagers Not contagious

16 Differential diagnosis Tinea versicolor Vitiligo Found on fingers, toes, knees, and around the eyes and mouth Loss of all color (depigmentation) No scaling Flat Hypo- or hyperpigmentation Slight itching and scalling Not painful

17 Transmission of tinea Water Prevention 3. Wear shower sandals 2. Do not wear 1. Dry off well occlusive clothes at public showers and swimming pools

18 Transmission of tinea Indirect contact Prevention Do not share clothes, socks, towels, nail clippers

19 Transmission of tinea Direct contact Prevention Avoid contact with infected people or animals

20 Transmission of tinea Autoinfection

21 Treatment

22 Treatment of all fungal infections Objective Prevent recurrence Inhibit the growth of fungus Relieve itching, burning and other symptoms

23 Pharmaceutical Treatment Most fungal infections topical OTC cream, solution,spray, powder But : 1) nail 2)scalp oral prescription Example :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.liver heart Most fungal infections Topical OTC cream, solution, spray, powder Except Scalp Nail Oral prescription

24 Most fungal infections topical OTC cream, solution,spray, powder But : 1) nail 2)scalp oral prescription Example :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.liver heart Itraconazole

25 Oral prescription Most fungal infections topical OTC cream, solution,spray, powder But : 1) nail 2)scalp oral prescription Example :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.liver heart Fluconazole

26 Oral prescription Most fungal infections topical OTC cream, solution,spray, powder But : 1) nail 2)scalp oral prescription Example :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.liver heart Disadvantages Very expensiveSide effects

27 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 dermatologist

28 Treatment of nail infection (Tinea unguium) lamifen Oral Nail polish Ticonazole Surgically

29 Nail polish Cleaning Cutting Apply Twice daily, for 3 months

30 if Refer to a dermatologist Treatment of scalp infection (Tinea capitis) Swollen mass discharging pus Severe alopecia Swollen tender lymphocyte of the neck

31 Treatment of scalp infection (Tinea capitis) Oral prescription Preventing reinfection Shampoo If treated early, the hair will grow back

32 Treatment of tinea versicolor Skin may not regain its normal pigmentation Commonly comes back after treatment

33 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

34 Tinea unguium Tinea capitis Tinea versicolor

35 Treatment Azoles Miconazole nitrate 2% Thiocarbamates Allylamines Clioquinol Povidone iodine Undecylenic acid

36 Treatment Azoles Ketoconazole 2% Thiocarbamates Allylamines Clioquinol Povidone iodine Undecylenic acid

37 Treatment Azoles Broad spectrum antifungal Miconazole (Daktarin ® ) safe in pregnancy Available in all dosage forms Apply twice daily 2 weeks for skin infection 4 weeks for foot 6 weeks for scalp few months for nail infection Thiocarbamates Allylamines Clioquinol Povidone iodine Undecylenic acid

38 Treatment Azoles Thiocarbamates Allylamines Clioquinol Povidone iodine Tolnaftate 1% Undecylenic acid

39 Treatment Azoles Thiocarbamates Allylamines Clioquinol Povidone iodine Effective against most dermatophytes not only t.versicolor or candidiasis Cream and solution only Undecylenic acid

40 Treatment Azoles Thiocarbamates Allylamines Clioquinol Povidone iodine Terbinafine 1% Undecylenic acid

41 Treatment Azoles Thiocarbamates Allylamines Clioquinol Povidone iodine Cream, solution, spray tablets (but not otc) Cream 1-2 times: 1 week for T.pedis 2 weeks for T.corporis T.versicolor Not for children <16 or breast feeding mothers Undecylenic acid

42 Treatment Azoles Thiocarbamates Allylamines Clioquinol Povidone iodine Salt of aluminium clioquinol 3% Clioquinol + corticosteroid Undecylenic acid

43 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 acid

44 Treatment Azoles Thiocarbamates Allylamines Clioquinol Povidone iodine Undecylenic acid 10% and 25% Undecylenic acid Fungistatic Ointment at nighttime Powder at daytime

45 Treatment Azoles Thiocarbamates Allylamines Clioquinol Povidone iodine Povidone iodine 10%solution (Betadaine ® ) Undecylenic acid

46 Candidiasis

47 Most common type of yeast infection More than 20 species Candida albicans (Monilia) Most common Causes Oral thrush Vaginal candidiasis

48 Oral candidiasis (Oral thrush) (Moniliasis) Thick, white lacy patches on top of a red base Symptoms Where ?? Tongue Palate Or elsewhere inside the mouth

49 Treatment 1- Miconazole 2- Nystatin Topical oral antifungal

50 Treatment 1- Miconazole Daktarin ® oral gel Miconaz ® oral gel

51 Treatment 2- Nystatin

52 Quiz ?? Oral gelSuspension VS Oral gel is recommended rather than suspension or drops due to longer residence on the affected area, as it adheres to the mucosal lining “ ”

53 Dose ¼ spoonful½ spoonful InfantsAdults Treatment is continued for at least a week after symptoms have disappeared

54 Contraindication liver disfunction safety not assured

55 Canker sores Aphthous stomatitis

56 Symptoms 1- Size Minor 5-8 mm > 1 cm ???? Major 2- Shape Oval - round White - yellow 3- Color 4- Where ? Tongue, cheek and lip

57 Cause Unknown Canker sores is an idiopathic disease

58 Triggers Risk groups Oral trauma Stress Hormonal changes Smoking cessation Food Helicobacter pylori Being female Family history

59 Treatment Make sure it’s canker sores No other extreme conditions Then we will give our OTC consultancy

60 Differential diagnosis 1- Major canker sores Greater than or 1cm 10 separate, may coalesce into a single very large ulcer May take up to six weeks to heal and leave extensive scarring

61 Differential diagnosis 2- Herpetiform canker sores Clusters of 10 to 100 sores

62 OTC Treatment Local anaesthetic Topical oral analgesic Anti-inflammatory Antiseptic and disinfectant agent The magic drug

63 Viscous lidocaine Oracure ® oral gel Local anaesthetic Applied directly to the lesionsSpray is not suitable for children

64 Topical oral analgesic Mundisal ® gel

65 Topical oral analgesic BBC ® spray

66 Anti-inflammatory Kenalog ® in orabase

67 Antiseptic and disinfectant agent Corsodyl ® dental gel as chlorhexidine digluconate

68 The magic drug Self Healing

69 Patient counseling Rinse your mouth with salty solution Baking soda !! Ice !!

70 Skin infestations

71 Scabies A very common skin infection affects people of all races and social classes. Sarcoptes scabei called Microscopic mite Cause:

72 Symptoms 4 Itching Red papular rash Rash can also include vesicles Secondary 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

73 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? )

74 Head lice ( Pediculosis) Cause: Small wingless parasitic insect Pediculus humanus capitis

75 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?!)

76 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.

77 Treatment Pediculicides/scabicides Antipruritics Permethrin Malathion d-phenothrine Piperonal Topical antipruritics Systemic antihistaminics

78 Treatment Permethrin 2.5-5% PermethrinUp to 1% Permethrin Permethrine ® licid ® Ectomethrine ® Scabies Pediculosis

79 Treatment Malathion 0.5 lotion (Ovide ® ) d-phenothrine 0.4% Eradication of lice & nits from the scalp (head lice). (Item shampoo)

80 Precautions 1- Avoid application to wounded skin or scalp to avoid systemic absorption 2- Avoid scratching rash or vesicles & keep open sores clean Treatment

81 Pediculicides/scabicides Antipruritics Permethrin Malathion d-phenothrine Piperonal Topical antipruritics Systemic antihistaminics Treatment

82 Antipruritics Topical Helping provide relief of itching Systemic antihistaminic Calamine lotionCrotamitone lotionAtraxZyrtecPhenergan Treatment

83 Viral Cutaneous Infections

84 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

85 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.

86 Treatment Acyclovir Zovirax Penciclovir

87 Hyperkeratotic disorders Hypertrophy of the horny layer of the skin (excessive development of keratin)

88 Callus Skin lesions Over a broad area of skin caused by Excess friction

89 Callus Hand callus Feet callus Repeated handling of an object that puts pressure on the hand Pressure from footwear Lack a central core

90 Warts Skin growthHPVcaused by Very contagious Go away on their own within months or years

91 Warts Common Plantar Grow most often on the hands Grow on the soles of the feet Rough, shaped like a dome, and greyish-brown in color. Hard, thick patches of skin with dark specks

92 Treatment ??

93 Refer to a dermatologist diabetes mellitus peripheral circulatory disease hemorrha- ging oozing purulent materials rheumato- id arthritis Hair growth

94 Treatment ?? Salicylic acid Mechanism of action : It decreases keratinocyte adhesion It increases water binding,which leads to a hydration of keratin (keratolytic agent ) Dimethyl ether (freezed) Freezing method

95 Precautions NSAIDs Avoid using salicylic acid, if you are allergic to (aspirin, ibuprofen, ….); or if you have any other allergies

96 Secondary Bacterial Infection SBI

97 Which bacteria causes SBI Staphylococcus aureus Streptococcus pyogenes

98 Staphylococcus aureus Impetigo (school sores)

99 Staphylococcus aureus Folliculitis

100 Staphylococcus aureus Furunculosis (boils)

101 Which bacteria causes SBI Staphylococcus aureus Streptococcus pyogenes

102 Cellulitis

103 Streptococcus pyogenes Erysipelas

104 Streptococcus pyogenes Necrotising fasciitis

105 Treatment Bacitracin Zinc Neomycin Polymyxin B Sulfate Tetracycline Fusidic acid

106 Terramycin Fucidin TetracyclineFusidic acid

107 Thanks


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