dr. endang sutedja, dr. spkk(k)
DESCRIPTION
Science concerning theraphy of skin diseases DERMATOTHERAPY Science concerning theraphy of skin diseasesTRANSCRIPT
DERMATOTHERAPY
DR. Endang Sutedja, dr. SpKK(K)
DERMATOTHERAPY
Science concerning theraphy of skin diseases
TYPE OF THERAPY
1. Medicamentous : topical, systemic2. Skin surgery: scalpei surgery,electrosurgery, chemical surgery, cryosurgery3. Radiation: radiotherapy, UV light, laser4. Psycotherapy
MEDICATION
1. Nature2. Treat the patiet holystic3. Attention for physiology, pathology, biochemical,
anatomy4. Medical material5. Attention pharmacy & pharmacology of drugs
MEDIKAMENTOUS THERAPY
6. Causal therapy7. Simplest drug8. Individualization9. Economical
Principles of Topical Therapy
1. Choice of vehiculum depend on : a. Stage of the diseases b. Distribution & localisation c. Effect 2. More acute low concentration3. Explain usage & cleansing4. Avoid sensitizer5. Restrict unstable drugs
Topical therapy: type of Vehiculum
1. V.monophasic : a. powder b. solution c. ointment2. V. biphasic : powder + solution powder + ointment solution + ointment3. V. triphasic : powder + solution + paste
Solution Oint.
Powder
Lotion Paste
Cream
Cold paste
O/W W/O
POWDER
* Inert, used`of physical effectA. Effect : cover adhesion slipping power
absorption cooling powerB. Indication : dry lesion superficial lesion
acute vesicobulousC. contraindication : dermatoses wet & eksudativeD. usage : with sponge, sprinkle
SOLUTION
* If the soluble agent water : solution alcohol : tinctura
A. effect : 1. cleansing 2. drying 3. protective 4. cooling 5. warming 6. epitelialisation 7. anti prurytic
SOLUTION
B. Indication : wet and acute dermatoses,
acute dermatitisC. Contraindication : dry lesionD. Usage : bathing open dressing close dressing
OINTMENT• ≈ fat, fat like material with butter consistency, oil• Fat : natural fat : adeps lanae mineral fat : vaseline • A. Effect : 1. Covering 2. Protective 3. Slipping 4. Penetrative 5. Warming
OINTMENT
• B. Indication : dry or chronic dermatoses• C. Contraindication: wet lesion, hairy area, fold• D. Usage : spread with finger, spatula• E. Cleansing: 1 x / day with cotton moist with oil
LIQUID POWDER
• ≈ powder + solution (+ suspending agent)• More adhesive than powder• Usage < 40% body surface
• A. effect : 1. drying 2. Anti pruritic
LIQUID POWDER
• B. Indication : wide and generalisata dermatoses• C. Contraindication : - productive dermatoses - hairy area - dry dermatoses• D. Usage: shake and spread• E. Cleansing : 1 x / day, bathing,wash with water
CREAM
• ≈ fat + water (+ emulgator)• Cream O/W (oil/ointment in water)• Cream W/O (water in oil/ointment)
• A. Effect : 1. Protektive 2. Drying
CREAM
• B. Indication : subacute dermatoses wide dermatoses for hairy area : O/W dry lesion : W/O• C. Contraindication : productive and wet dermatoses• D. Usage : like ointment
W / O O / WWATER IN OIL OIL IN WATER
OIL >> WATER >>
LESION
MORE DRY MORE WET
CREAM
SUBACUTE
PASTE AND COLD PASTE
• Paste: mixed of ointment + powder• Cold paste: ointment + powder + solution
• 1. Effect : 1. Protective 2. drying• 2. Indication: subacute dermatoses non productive
PASTE AND COLD PASTE
• C. Contraindication: productive dermatoses, hairy area• D. Usage: spread with spatula, then close with gauze
(gauze changed 1 x 1-2 day)• E. Cleasing: bath or with cotton moist with oil
CHOICE OF DRUG ACCORDING : CLINICAL APPEARANCE / LESION / STAGE
ACUTE WET SUBACUTE
CHRONIC DRY
dressing Cream O/W Cream W/O Oint.
c
Tabel. VEHICULUM CHOICE ACCORDING DISTRIBUTION / LOCALISATION
Localisation Powder Water Alco- hol
Oint. Liquid powder
Paste Cream
Generalisata + -* - - + - +Scalp - + + - - - +
Face + + +# + + + +trunk,
extremity + + + + + + +Genitalia + + - - + - +Fold area + + + +@ + - +
EFFECTS OF DRUG
1. Protective : powder, paste, cold paste, cream2. Absorption : powder, liquid powder 3. Drying : solution, liquid powder 4. Good penetration : ointment, cream, tinctura5. Moisturizing (dry skin) : ointment, cream W/O 6. Cleansing : solution 7. Cooling : solution, liquid powder 8. Protection from UV : powder (Ti02) 9. Warming : close dressing