BASICS OF DERMATOLOGY (8) COMMON TREATMENTS IN DERMATOLOGY 11. COMMON TREATMENTS IN DERMATOLOGY

DERMATOLOGY FOR THE USMLE

BASICS OF DERMATOLOGY (8)

COMMON TREATMENTS IN DERMATOLOGY

11. COMMON TREATMENTS IN DERMATOLOGY

√	Topical steroids: Topical preparation that functions as anti-inflammatory and antipruritic agent by inhibiting mitosis and DNA synthesis. Side effects include skin atrophy, striae and hypopigmentation. Preparations vary by potency: Low potency: Hydrocortisone and desonide. Intermediate potency: Triamcinolone and fluocinolone. High potency: Betamethasone and fluocinonide. Ultra high potency: Clobetasol and halobetasol.
√	Bleaching agents: Used to lighten skin in different hyperpigmentation disorders. Side effects include hyper- or hypopigmentation. The main agents used for this purpose are: Hydroquinone Topical Retinoids (vitamin A derivatives) Topical Steroids
√	Phototherapy: Therapeutic exposure of affected skin to specific wavelengths of UV-A or UV-B light. Phototherapy works by decelerating keratinocyte proliferation and suppressing immune response. A common type of phototherapy is PUVA, which is the combination of a skin sensitizer (Psoralen) plus UV-A light (UVA) The patient ingests the skin sensitizer followed by exposure of affected area to UV-A lamps. Major side effects of phototherapy include: burning, itching, hyperpigmentation, eye damage, skin aging and cancer. Common uses for phototherapy are: Atopic Dermatitis Cutaneous lymphoma Psoriasis Vitiligo
√	Mohs micrographic microsurgery (MMM): Specialized surgical technique used for the removal of skin cancers (eg, melanomas, SCCs and BCCs). Thin layers of cancer-containing skin are progressively removed and examined under the microscope until only cancer-free tissue remains. Used for aggressive and recurrent cancers and when maximum cosmetic results are needed (eg, facial skin cancers).
√	Cryotherapy: Destruction of skin lesions using liquid nitrogen. This is an office based procedure that is quick, convenient and safe. Common side effects include: pain, hypopigmentation and scar formation. This treatment modality is mainly used for: Actinic Keratoses Seborrheic keratosis Warts
√	Miscellaneous: Certain antimicrobials are used over prolonged periods of time in low doses to take advantage of the immunomodulatory and anti-inflammatory properties. The most common agents used for this purpose are: Dapsone (used for pyoderma gangrenosum and dermatitis herpetiformis) hydroxychloroquine (used for rheumatoid arthritis and cutaneous lupus erythematosus) Minocycline and doxycycline (used for bullous pemphigoid)