Dermatotherapy

7/23/2019 Dermatotherapy

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TOPICAL DERMATOTHERAPYTOPICAL DERMATOTHERAPY

Dr. dr. Farida Tabri, Sp.KK(K)


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The main requirement for

topical dermatotherapy is

selection of the suitable base,

also called vehicle.


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Vehicle is used for those

substance that bring

specific drugs into contact

with the skin.


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The most important vehicles

for topical use divided into :

I. Monophasic Vehicles.

II. iphasic Vehicles.

III. Triphasic Vehicles.


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!"#$%&

!"#$%&

"I' ( )*T

"I' ( )*T 'I+I$

'I+I$

-ool

!asta

-ool

!asta!*T*

!*T* '"TI"/

'"TI"/

MPORTANT BASES FOR TOP CAL

TREATMENT

%M'TI"/ :

-&%*M 0" ( #1"I/TM%/T 0# ( "1

%M'TI"/ :

-&%*M 0" ( #1"I/TM%/T 0# ( "1


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*. ' I + I $*. ' I + I $

. Monophasic Vehicles

2. aths :

%ffect cleansing effect

0crusts, scales, secretions1.


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%3ample : full bath, sit bath,

foot bath, hand bath.

ide effect : maceration

0limited 45 minutes1.

!reparation:

ol acid salicyl.

ol kalium permanganate.


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6. #et $ressing

Type:

"pen wet dressing

rapid evaporation.

-losed wet dressing

retards evaporation.


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Indicated : superficial,

inflammatory, crusted, 7erosive skin lesions.

%ffect:

-ooling.

&educes swelling.

*nti8inflammatory.

oftening 7 removing

accretion.


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ide %ffect:

Maceration.

Increase in bacterial

growth.


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%ffect:

-overing protective.

-ooling.

*nti8frictional.

uperficial anti8inflammatory.

$rying.

. ! " # $ % &. ! " # $ % &


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Indicated:

uperficial $ermatoses.

%rythematous %3anthema.

Vesicle or bullae

protective.

-ontraindicated : Madidans

lesion.


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pecifics drugs contain:

9inc o3ide.

Magnesium o3ide.

Titanium o3ide.

ismuth subnitrate0preputial area1.


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ynonyms : shake lotion,

liquid powder mi3ture.

$efinition : suspensions of

solid material in water or

ethanol two phase systems.

. Biphasic Vehicles

*. ' " T I " /*. ' " T I " /


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%ffects:

-ooling.

*stringents.

$rying.

uperficial anti8inflammatory.


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Indicated:

*cute, sub8acute 7

superficial inflammatory

dermatoses.

eborrheic 7 intertrigenousdermatoses.


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ide effect:

$rying action indicatedfor short term use.

*brasive the powderparticle may clump.

-ommercial preparations:

-alamine !.

-aladryl lotion.


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ynonym: hydrophilic cream.

$efinition : emulsion of oil in

water 0" ( #1, a two phase

systems of water 7 fatty

substances.

. - & % * M. - & % * M


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%ffects :

-ooling.

*nti8inflammatory effect.

Moisturiing 7 emollient

effect.

&apidly penetrate the skin.

#ater washable.


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Indicated:

$ermatitis acute ( sub8

acute.

-osmetic indication

0cleansing or bodylotion1.


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-ontraindicated:

$ry skin condition.Madidans lesion.

ide effect:!romote drying 0prolong

application1.

!ruritic effect 0because

evaporated tendency1


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ynonym: lipophilic cream.

$efinition : emulsions of

water in oil 0# ( "1, a two

phase systems of fat and a

limited amount of water

0about 45;1.

-. " I / T M % / T-. " I / T M % / T


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%ffect:

-overing.

oftening scales 7

crusts.


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-ontraindicated:

eborrheic condition.

*cute inflammatory skin

0Madidans lesion1. ide effect:

!romote inflammation

occlusion effect.

!romote dyhidrosis.


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$efinition : ointment into

which 65 8 =5; powder, atwo phase system or as

highly concentratedsuspensions.

$. ! * T *$. ! * T *


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%ffects:

-ooling.

*nti8inflammatory.

ecretion > absorbing

0drying1.

kin protective action.


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Indicated :

lcers.

-hronic e3udative

dermatoses.

Thick lichenified plaque.

econdary bacterial

infection.


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-ontraindicated :

*cute inflammatory

skin.

calp skin.


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$efinition : triphasic

vehicles that consist of oil

> water > powder mi3tures

in varying proportions.

. Triphasic Vehicles

-""'I/< !*T*-""'I/< !*T*


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B.POWDER :

%ffects:

oothing.

-ooling.

#eeping skin.

The basic formula for cooling

pasta : inc o3ide, calcium

hydro3ide solution, 7 oil.


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2. Tars.

6. ?eratolytic drug.

4. *ntibiotic drugs.

@. *nti8fungal drugs.

=. !arasiticides.

A. -orticosteroids.

Specific Topical Treatment


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$efinition : are produces

by dry distillation of coal,

wood, or peat.

2. T * &2. T * &


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%ffects :

*nti8pruritic.*nti8inflammatory.

?eratoplastic.

*nti8infective actions.

Indicated:

-hronic lichenified.

*topic ecema.

!soriasis vulgaris.


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-ontraindicated : e3udative

or infection dermatoses. ide effects:

!hototo3ic dermatitis.Tar folliculitis.

Tar acne.-arcinogenicity of coal

tar 0long term use1.


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a. alicylic acid

*t 'ow concentrations 05.= 8

6;1, it has an antiseptic,

keratoplastic, an anti8

inflammatory action.

6. ?%&*T"'BTI- $&


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*t a concentration of 4 8

25;, it has keratolytics,loosen scales in psoriasis or

hyperkeratotic ecema.

ide effect : to3ic effect is

used in large area

0especially : children1.


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b.ulfur

%ffect :

*stringent action 06 8 25;1.

*n anti8fungal 025;1.

-osmetic 7 medical facial

7 scalp preparation 0no

sebum suppressive effect1.


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c. &esorcinol

%ffect:

$rying.

*stringent.

?eratolytics effect 0highconcentration1.

Indicated:

caling dermatoses.-omedones acne 0by Vit *

acid1.


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a. !enicillin can not

recommend because oftheir high potential for

contact sensitiation 7 not

absorbed.

4. */TII"TI- $&


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b.Tetracyclines :

bacteriostatic


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d.


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f. !olymy3in : very broad

pectrum, especially 0%.-oli, !seudomonas *1

g./itrofuraone : bactericidal

7 bacteriostatic


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h.-lindamycin : broad

spectrum of !enicillin

resistant 7 treatment for

acne.

%g : cleocin, sobelin.


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a. Tolnaftate : anti8fungal drug

for all dermatophytes.

%g : aftate, tinactin, tonoftal.

@. */TI)/


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b.b. TolciclateTolciclate : analogue of: analogue of

tolnaftate.tolnaftate.%g : fungifos.%g : fungifos.

c.c. Imidaole derivatesImidaole derivates : for: fordermatophytoses,dermatophytoses, -andida-andida

albicans, !ityriasis versicolor.albicans, !ityriasis versicolor.

%g : canesten, mycospor,%g : canesten, mycospor,

micatin.micatin.


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d.*mphotericin : anti8fungal

antibiotic, especially for

superficial infections.

%g : fungione, ampho8

moronal.


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e. /ystatin: no systemic action,

minimally absorbed from


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a. enyl enoate : anti8

scabies for infants 7

children.

=. !*&*ITI-I$%=. !*&*ITI-I$%


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b.De3achlorocyclohe3ane :

antiscabies, antipediculosis,

antiphtriasis.

%g : lindane 0gamene, kwell,

scabene1.


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c. -rotamiton : scabies,

phtriasis, demode3folliculitis, 7 antipruritic

drug.

%g : eura3 lotion, crotamite3

gel.

c. Thiabendaole : creepingeruption, scabies 0E F5;

cases are cleared1.


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%ffects:

*nti8inflammatory.

*nti8pruritic.


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a. Mild corticosteroid :

hydrocortisone 5.2 > 6.=;.

b.Moderate corticosteroid :

clobetasone 5.5=;.

@ group classification of

topical corticosteroid :


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c. !otent corticosteroid :

triamcinolone * 5.2;

betamethasone 2G valerate

5.=;.

d.Digh potency corticosteroid:

fluocinolone acetonide 5.6;.


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ide effects corticosteroid:

*llergic contact dermatitis.

*trophy 7 thinning of the

epidermis.

teroid acne.teroid striae.


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'eucoderma.

teroid ulcer 0chronic

venous insufficiency1.

&ebound effect 0psoriasis

vulgaris1.


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