Chapter 43

Chapter 43

Agents Used in the Treatment of Skin Disorders

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The Skin

The largest organ Several functions

Protective barrier—microbials and trauma Senses temperature changes Secretes wastes through sweat glands Stores fat Synthesizes vitamin D Provides a site for drug absorption

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Drug Classification of Dermatological Agents

Emollients Keratolytics Local anesthetic agents Local antipruritic agents Antibacterial agents

(continues)

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Drug Classification of Dermatological Agents

Antiviral agents Antifungal agents Anti-inflammatory agents Antiparasiticidal agents

(continued)

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Additional Dermatologic Agents

Debriding agents Antineoplastic agents Burn treatment agents Eczema agents Psoriasis agents Topical hair agents Agents for diabetic foot ulcer

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Topicals

Ointment Gel or jelly Oil Cream

Vaginal cream

Paste Aerosol foam Aerosol spray Lotion Powder

Available in a variety of forms

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Dermatologic Classifications

This presentation will discuss three dermatologic classifications:

Topical debriding agents Eczema treatments Psoriasis treatments

Several classifications, such as antimicrobials, were discussed in previous chapters and are not discussed here.

Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

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Topical Debriding Agents

Purpose Remove dead skin Promote healing

(continues)

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Topical Debriding Agents

Made of enzymes General action

Digest dead necrotic tissue Specific action

Made of enzymes that digest: Collagen: collagenase (Santyl) Fibrin in a blood clot: fibrinolysin (Elase)

(continued)

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Eczema

S & S of acute or chronic conditions Area appears inflamed Skin may be dry and may include wet or

weepy drainage Definition

Inflammatory skin condition. Symptoms are pustules, redness, vesicles, crusts, skin thickening, and persistent itching and burning.

(continues)

Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

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Eczema

Drug agent Pimecrolimus (Elidel) Topical immunomodulator Adverse effects

Site irritation Headache

(continued)

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Psoriasis

A chronic skin condition Consists of painful reddened papules that form

plaques with distinct borders Other patches appear as silvery yellow-white

scales Usually located

Elbows, scalp, knees, and genitalia

(continues)

Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

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Psoriasis

Drug agent Alefacept (Amevive)

Immunosuppressant Stops the activity of T lymphocytes Given intramuscularly Adverse effects

• Infection

(continued)

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Topical Application Methods

Depend on the etiology of the skin problem

Require thorough cleansing of the skin before the agent is applied or reapplied

Must be applied appropriately or the agents will not work