Operational Medicine Medical Education and Training

Operational Dermatology

Objectives

Discuss common skin conditions

Basic management

You as a primary care provider

Highlight patient education

Pitfalls & Mismanagement

Recognize skin cancers

When to refer to dermatology

Recommended References

Clinical Dermatology, 4th ed

Thomas P. Habif

ISBN: 3323013198

Color Atlas & Synopsis of Clinical Dermatology

Thomas B. Fitzpatrick, et al.

ISBN: 0071360387

Operational Dermatology

4.9 MB pdf File

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Inflammatory Acne

Acne

Disease of the pilosebaceous units

Hormonally influenced

Disfiguring

Acne Classification

Comedonal

Non-inflammatory

Whiteheads

Blackheads

Inflammatory

Red papules

Pustules

Nodulocystic

Comedonal acne

Inflammatory acne – Mild

Inflammatory acne – Moderate

Nodulocystic acne

Other involved areas

Treatment

Good MILD skin care

mild soaps

gentle washing

No facial scrubs BAD, BAD, BAD

Acne comes from within

Not from dirt

Not from foods

Comedonal Acne

Start with low dose retinoid

Retin-A 0.05% cream

Switch to Retin-A micro 0.04%

after several weeks

or when adjusted

Benzoyl peroxide 5% gel/wash

+/- topical antibiotics

Cleocin T lotion or gel

Retinoids

Reduces keratinocyte cohesion

Opens plugged pores

Prevents plugging

Problems

Irritating

Photosensitizing

Retinoids

To avoid irritation:

Go easy in the beginning

Use lower strength to start (creams, low %)

Use 2 nights per week

Increase as tolerated to nightly use

Apply on very dry face

Wash face, then wait 15-20 minutes

Avoid moist areas

nasal folds, periorbit, oral commissures

Retinoids

Apply only at night

Photosensitivity

Use mild non-comedogenic moisturizer in the morning with SPF 15-30

Patient education

Acne will get worse before it gets better

Should continue even though face clears

Retinoids

Retin A

Cream 0.025%, 0.05%, 0.1%

Gel 0.01%, 0.025%

Micro 0.04%, 0.1%

Differin gel

Tazorac

This is KEY to long term acne tx!

Benzoyl Peroxide

Antibacterial

Minimizes bacterial resistance

Mild peeling effect

Bleaches colored cloth

5% wash or gel

Inflammatory acne – Mild

Dry face with topical antibiotics first

Cleocin T gel/lotion x 2-3 weeks

Introduce retinoids

Retin-A 0.05% cream

Switch to Retin-A micro 0.04%

after several weeks

or when adjusted

Continue topical antibiotics

Benzoyl peroxide 5% wash

Continue to PowerPoint® Lecture...

 

Lecture by LCDR Will Lumbang
2006 Surface Warfare Medical Officer Indoctrination Course
Naval Operational Medicine Institute
340 Huise Road
Pensacola FL 32508-1092

Contact Dermatitis

Operational Dermatology

4.9 MB pdf File

Free Download Now

 

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