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Treament Goal
To relieve Prevent
itching , 05
03 prevent
secondary
skin infections
excessive
scratching
以下病人直接尋求治療
• 小於2歲的病人
• Eye, eyelids, mouth, genitals involvement
• Over 20% of skin surface
• Signs and symptoms of infection~ >37.8⁰C
• Tenderness(接觸會疼痛) on rash or pus膿
• Numerous large bullae 大水泡
• Rash has not improved within 1-2 weeks
Nonpharmacologic Therapy
• Preventive measures
• Learn the physical characteristics and usual
habitat of Toxicodendron plant
• Cover nose and mouth with a mask and wear
a protective clothing when eradicating the
plants near your residence
Pharmacological Therapy
Itching
• Topical creams, ointment containing
anesthetics, anti-histamine, antibiotics
should not be used
• Sensitizer
• Nightime sedation because of itching-first
generation of antihistamines can be used
• Itching is not alleviated- referred to PCP
Pharmacological Therapy
Weeping
• Astringent-vasoconstriction and reduce blood
flow in the inflamed tissue
• Aluminium acetate solution USP and
Burrow’s solution
( Burow’s solution-softening and removing crust
Mild antipruritic effect)
• Isotonic saline solution
Pharmacological Therapy
Inflammation
• Hydrocortisone (0.5%,1%)
• Mild to moderate ACD-no edema ,extensive
area of skin
i. Dandruff 頭皮屑
iii.Psoiasis 乾鮮
Dandruff
Treatment Goal
• Reduce epidermal turnover rate of scalp skin
by reducing the level of Malassezia species
• Minimize the cosmetic embarrassment of
visible scaling
• Minimize itching
General Treatment Approach
• Routine shampooing
• Shampoo containing sodium lauryl sulfate/
sodium lauryl sulfate should be avoided
• Cytostatic agent – pyrithione zinc, selenium
sulfide –recommended initially
• Nonprescription ketoconazole shampoo-anti
fungal shampoo
• Shampoo containing coal tar-second line therapy
• A kerolytic shampoo-containing salicylic acid
/sulfur
Scalp scrubber
Seborrheic dermatitis 脂漏性皮炎
Treatment Goal
• Reduce inflammation
• Reduce epidermal turnover rate of scalp skin
by reducing the level of Malassezia species
• Minimize /eliminate the visible erythema紅斑
and scaling
• Minimize itching
General Treatment Approach
• First line treatment: Antifungal agents
• Medicated shampoos such as pyrithione zinc and
selenium sulfide
• Hydrocortisone ointment- relieve the
inflammation
Infants:
• Use baby oil to massage gently on scalp, followed
by non-medicated shampoo,
• The patient should referred to pediatrician
Psoriasis 皮蘚
Treatment Goals
• To control /eliminate the signs and symptoms(
inflammation,scaling, itching)
• To minimize/ prevent flare-up
General Treatment Approach
• Mild psoriasis
• Self treated : topical agents-hydrocortisone
ointment 1% and emollient
• Bathe with lubricating bath products using
tepid water
• Daily lubrication of skin after a bath
General treatment Approach
• Bathe with lubricating bath products using tepid
water
• Daily lubrication of skin after a bath
立刻找醫生的情況:
• Area>5% involvement of face
• Joint point
• Nonresponding to emollient and nonprescription
hydrocortisone
• Children younger than 2 years
治療Scaly Dermatoses的非處方藥
• Cytostatic Agents
• Antifungal agents
• Keratolytic Agents
• Salicylic acid
• Sulfur
• Topical Hydrocortisone
Cytostatic Agents
Pyrithione Zinc Selenium Sulfide Coal Tar
效果 anti-Malassezia anti-Malassezia phototoxicity
activity activity
*處方藥物為主
DRY SKIN 皮膚乾燥
Product containing humectant to enhance
hydration
• Glycerin, urea, lactic acid
• Alpha hydroxyl acids and lipid moisturizers
such as phospholipids and ceramides
使用方法:先將頭髮弄濕,搓揉產
生泡沫,讓藥品停留在皮膚上3mins,
之後用清水清洗,反复沖洗確保清
洗乾淨。
一個星期裡使用兩次,長期使用必
須要資訊醫師。
注意事項:只限外用
允消優膚乳膏
• 成分:Urea 100mg
• 適應症:去角質
• 作用:皮膚保濕劑,角質軟化劑,能有效
的促進乾裂粗糙之皮膚柔嫩潤滑。
• 用法:1-2次/天,取出適量塗抹患部
• 副作用:部分患者偶有局部灼熱、疼痛感、
潮紅及瘙癢現象