Jul 22, 2015
• Dissolve intercellular substance in horny layer of skin
• Epidermal cells swell, soften & desquamate
SALICYLIC ACID
10-20% sol in alcohol or propylene glycol for dissolving corns.
Polypylene glycol?
RESORCINOL
Antiseptic,antifungal,keratolytic
3-10% for eczema,seborrheicdermatitis, ringworm
UREA
5-20% in cream & ointment base
Ichthyosis,lichen planus
Concurrently with topical steroid?
SALICYLIC ACID 10-20%
RESORCINOL 3-10%
UREA 5-20%
Seborrheic dermatitis-face ,trunk, scalp(dandruff)
Pityrosporum ovale
Emotional ,genetic,local factors
SELENIUM SULFIDE
ZINC PYRITHIONE
CORTICOSTEROIDS
IMIDAZOLE ANTIFUNGALSSULFUR, COAL TAR,AMMONIATED MERCURY
RESORCINOL
SALICYLIC ACID
SELENIUM SULFIDE2.5% lotion or shampoo
Antiproliferative,antikeratolytic,fungicidal
More than 50% -relapse on discontinuation.
ZINC PYRITHIONE
Weekly shampoo-1%
‘Reduce’ epidermal turnover, dandruff
With ketoconazole
CORTICOSTEROIDS
Lotion-massage in scalp
Relapse rates high
Atopy ,poor healing, purpura...
IMIDAZOLE ANTIFUNGALS
KETACONAZOLE(KTZ)-200mg/day for 4 weeks
2% shampoo/cream/scalp gel
Good – excellant results without much S/E
SELENIUM SULFIDE 2.5%
ZINC PYRITHIONE 1%
CORTICOSTEROIDS
IMIDAZOLE ANTIFUNGALSSULFUR, COAL TAR,AMMONIATED MERCURY
RESORCINOL
SALICYLIC ACID
Increase sensitivity to solar radiation
Repigmentation of vitiliginous areas
Stimulate melanocytes & induce proliferation
Ammi majus
Furocoumarins – photoactivation stimulate melanocytes & induce proliferation
METHOXSALEN & TRIOXSALENSynthetic psoralens
Sensitize skin
Topical & oral
Short plasma t1/2 ; max skin sensitization 1-2 hrs ;lasts for 8 hrs.
TOPICAL ORAL
TOPICAL
Solution or ointment
On well defined vitiliginous lesion
1 min exposure to sunlight
Occluded by bandage or sunscreen ointment
Under supervision of physician.
ORAL THERAPY
“In alternate days after 2 hrs of 0.3-0.6mg/kg
15 min exposure to sunlight gradually
increasing to 30 min.”
Normally pigmented areas should be protected
Keratolyticssalicylic acid,resorcinol, urea
Anti-seborrheicsselenium sulfide,
zinc pyrithione, corticosteroids
imidazole antifungals.
Melanizing agents-
Psoralen,
methoxsalen ,trioxalen