Treatment of Skin Disorders

Treatment of Skin Disorders is further divided into

Sunscreens and Prevention of Skin Cancer

» List some of the important facts about skin cancer.
» How does skin type affect the risk for skin cancer?
» What are the other risk factors for skin cancer?
» Do hereditary factors affect skin cancer risk?
» What age or sex factors are important in skin cancer risk?
» What should physicians teach patients about skin cancer prevention?
» What warning signs of possible skin cancer should be looked for in the self-skin exam?
» How is ultraviolet light classified?
» List the 13 basic facts regarding sun protection.
» What type of clothing is considered sun-protective?
» What are sunscreens?
» Compare the advantages and disadvantages of the physical and chemical sunscreens.
» What chemicals are used in chemical sunscreens?
» What factors should be considered in selecting a sunscreen?
» How is an SPF determined?
» How much sunscreen should be applied? How often should it be reapplied?
» Can sunscreens be safely used in children?
» Why are sunglasses included in sun-protection recommendations?
» Are tanning pills safe to use?
» What about “tan-in-a-bottle” lotions?
» What about “tan-in-a-bottle” lotions?
» If UVB is required for vitamin D metabolism, how would one maintain normal vitamin D levels with restricted sun exposure? How much sun exposure is necessary?
» What is proper sunburn treatment?




Topical Steroids

» When were corticosteroids discovered? When were they first used therapeutically?
» Describe the basic steroid nucleus.
» How is the potency of topical steroid medications determined?
» How do topical steroids inhibit cutaneous inflammation?
» How are topical corticosteroids classified as to potency?
» How many topical steroid medications are available in the United States?
» What are the differences between brand name and generic topical steroid products?
» With so many products available, how do you decide which product to prescribe for your patient?
» What specific directions should be provided when prescribing super-, high-, and midpotency topical steroids?
» Why is the vehicle important when recommending a topical corticosteroid?
» Are certain vehicles preferred for particular types of lesions or anatomic sites?
» A patient has 5% total body surface area (TBSA) involvement. How much topical steroid should be prescribed for twice daily application for a 1-week-on and 1-week-off treatment cycle? The patient will return in 4 weeks for follow-up.
» How should the FTU application technique be applied to children?
» When are combination topical steroid and antiinfective products indicated?
» What is tachyphylaxis and how can it be prevented?
» What are the local cutaneous side effects of topical steroids?
» What are the effects of topical steroids on the epidermis?
» What are the effects of topical steroids on the dermis?
» What are the systemic side effects of topical steroid therapy?
» Are there topical steroid addicts?
» What is periorificial dermatitis?
» What is tinea incognito?
» Can topical steroid medications cause contact dermatitis?
» Mrs. Jones brings her 9-month-old infant with moderate atopic dermatitis to your office. What topical steroid do you prescribe?
» A 40-year-old woman presents with a 5-year history of chronic dermatitis on her palms. Lesions are plaques with abundant scale. What topical steroid do you prescribe?
» A 35-year-old woman with moderate psoriasis presents with scalp, facial, and body plaque lesions. What topical steroid do you prescribe?
» Mrs. Smith brings her 6-month-old infant with a 2-week history of diaper dermatitis to your office. What topical steroid do you prescribe? Would you recommend any other topical therapy?
» List some common mistakes that are made when prescribing a topical steroid.




Fundamentals of Cutaneous Surgery

» What does the term “dermatologic surgery” embrace?
» Local anesthetics can be broadly classified into one of two groups. Name these two groups and give a few examples of each.
» How do the local anesthetics work?
» What are the onset of action and the duration of action of the most commonly used local anesthetics in skin surgery?
» How are the amide and ester anesthetics metabolized?
» What is the greatest practical drawback of the ester anesthetics?
» What are the maximum total dosages for 1% lidocaine (10 mg/mL) in adults and children?
» What are the symptoms and signs of lidocaine toxicity and how is it treated?
» Do true allergic reactions to local anesthetics exist?
» Describe the clinical features of true local anesthetic allergy. How is this best treated?
» What is the clinical presentation of patients with a vasovagal response to local anesthesia? How is this presentation best treated?
» How does one manage the patient who refuses, or is truly allergic to, both the ester and the amide anesthetics?
» What concentrations of epinephrine are the most effective for skin surgery? What is the safe maximum total dose?
» What is the onset of action for epinephrine?
» What are the clinical features of epinephrine toxicity?
» Are allergic reactions to epinephrine possible?
» When should epinephrine be used with great caution?
» Which local anesthetics are “the safest” to use in pregnancy?
» Describe measures that can be employed to diminish the pain associated with the injection of local anesthetics.
» Discuss injection techniques that can be used to diminish pain.
» What are the two most commonly used skin preparation antiseptics in dermatologic surgery?
» Describe the mechanisms of action and spectra of coverage for these two preparations.
» What are the most important advantages and disadvantages of povidone-iodine and chlorhexidine gluconate?
» What is meant by absorbable and nonabsorbable suture material?
» How does multifilament suture differ from monofilament suture?
» Which types of suture material are best suited for subcutaneous stitches?
» Which types of suture material are best suited for cutaneous stitches?
» Which sutures are good choices for mucosal surfaces, the vermilion lip, and intertriginous areas?
» How is suture sized?
» Which suture needles are best suited to skin surgery?
» What are the indications for a punch biopsy?
» Describe how a punch biopsy should be performed.
» What is the preferred technique for removing the punch biopsy?
» What is meant by electrosurgery, electrocautery, and electrocoagulation?
» Describe what is meant by electrofulguration and electrodesiccation.
» What precautions need to be taken in patients with pacemakers who require electrosurgery?
» Is it necessary to discontinue anticoagulant medications before elective surgery of the skin?
» What are the so-called relaxed skin tension lines (RSTLs)? Why are they important?
» How does one determine the direction of the RSTLs in planning a surgical wound closure?
» Which areas of the body typically scar worst?
» What is the superficial muscular aponeurotic system (SMAS)?
» Describe the boundaries of the danger area for transecting the temporal branch of the facial nerve.
» Describe the clinical signs of damage to this nerve.
 

Cryosurgery





Mohs Surgery





Lasers in Dermatology

» What does the term “laser” stand for?
» What does “stimulated emission of radiation” mean?
» How is the light amplified in the laser system?
» What types of medium are used in laser systems?
» What are the special features of laser light?
» Why is monochromatic light useful?
» What is selective photothermolysis?
» What is an ablative laser?
» What is a nonablative laser?
» What is Q-switching?
» What is a fractional laser?
» How are the types of dermatologic lasers classified?
» What lasers have historic interest but are seldom used?
» What are the basic features of the carbon dioxide (CO2) laser?
» What are some uses for the standard carbon dioxide laser?
» How is the CO2 laser used for resurfacing?
» What precautions must be used with the CO2 laser?
» What are the basic features of the erbium:YAG laser?
» What are pulsed dye lasers?
» What is the flashlamp pulsed dye vascular lesion laser used to treat?
» What is nonablative resurfacing and how does a pulsed dye laser accomplish this?
» What are the disadvantages of the pulsed dye laser?
» What is an Nd:YAG laser?
» How are the long-pulsed Nd:YAG (1064-nm) lasers used?
» How are the long-pulsed KTP lasers used?
» How are the Q-switched Nd:YAG lasers used?
» What is the alexandrite laser?
» How are the alexandrite lasers used?
» What is the ruby laser?
» How are the ruby lasers used?
» What is a diode laser?
» How are the diode lasers used?
» What are nonablative fractional lasers, and for what are they used?
» What are ablative fractional lasers, and how are they used?
» What is an intense pulse light machine?
» What are IPL machines used to treat?
» Are there any risks for IPL use?
» What is radiofrequency resurfacing?
» Are there any risks with radiofrequency treatments?
» What new technologies will soon be available?




Therapeutic Photomedicine

» What is phototherapy?
» What diseases can be treated with phototherapy?
» How does traditional phototherapy work?
» How is phototherapy administered?
» Compare the induction phase, maintenance phase, and tapering phase for various forms of phototherapy.
» What advantages does narrowband UVB have over broadband UVB?
» What advantages does narrowband UVB have over PUVA?
» What is targeted laser phototherapy?
» What is UVA1 phototherapy and why is it used?
» What is the Soret band?
» What is balneophototherapy?
» What do MED and MPD mean and why are they important?
» What is Goeckerman therapy?
» What are the most common acute UVB phototherapy side effects?
» What are the most common long-term UVB phototherapy side effects?
» What is PUVA phototherapy?
» What are psoralens?
» How do the psoralens work?
» Are there contraindications to using PUVA?
» What is bath PUVA?
» What is RePUVA?
» What is photopheresis?
» Which diseases have been treated with extracorporeal photopheresis?
» How is photodynamic therapy used in dermatology?
» What is blue-light phototherapy?




Retinoids

» What are retinoids?
» How do vitamin A and retinoids exert their effect at a molecular level?
» Which retinoids are prescribed for the treatment of skin diseases?
» Are there any retinoids found in topical over-the-counter (OTC) products?
» What are the clinical indications for using topical tretinoin?
» What is the mechanism of action of tretinoin in acne vulgaris?
» How should topical tretinoin be used to treat acne vulgaris?
» After starting topical tretinoin for acne vulgaris, the patient reports that her acne is worse. Should she immediately discontinue the drug?
» Is topical tretinoin cream really useful in treating photoinduced wrinkles?
» Is there clinical evidence that topical retinoids improve melasma?
» What are the side effects of topical tretinoin?
» Is topical tretinoin safe to use during pregnancy or when nursing?
» What are the clinical indications for tazarotene?
» What are the clinical indications for alitretinoin?
» Do retinoids have any role in the treatment or prevention of cancer?
» What are the clinical indications for oral isotretinoin?
» What is the mechanism of action of oral isotretinoin in acne vulgaris?
» Are there any contraindications to the use of oral isotretinoin?
» How is oral isotretinoin administered for the treatment of acne vulgaris?
» What are the side effects of oral retinoid therapy?
» Are there any strategies or treatments that reduce the dry skin and lips associated with retinoid therapy?
» Are the clinical indications for acitretin the same as for isotretinoin?
» What is the mechanism of action of acitretin?
» How is acitretin administered for the treatment of psoriasis?
» What are the contraindications for using oral acitretin?

 

 

 

 

 

 

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