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DERMATOTHERAPY

DERMATOTHERAPY. DR. Endang Sutedja, dr. SpKK(K). DERMATOTHERAPY. Science concerning theraphy of skin diseases. TYPE OF THERAPY. Medicamentous : topical, systemic Skin surgery: scalpei surgery,electrosurgery, chemical surgery, cryosurgery

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DERMATOTHERAPY

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  1. DERMATOTHERAPY DR. Endang Sutedja, dr. SpKK(K)

  2. DERMATOTHERAPY Science concerning theraphy of skin diseases

  3. TYPE OF THERAPY Medicamentous : topical, systemic Skin surgery: scalpei surgery,electrosurgery, chemical surgery, cryosurgery 3. Radiation: radiotherapy, UV light, laser 4. Psycotherapy

  4. MEDICATION Nature Treat the patiet holystic Attention for physiology, pathology, biochemical, anatomy Medical material Attention pharmacy & pharmacology of drugs

  5. MEDIKAMENTOUS THERAPY 6.Causal therapy 7. Simplest drug 8. Individualization 9. Economical

  6. Principles of Topical Therapy 1. Choice of vehiculum depend on : a. Stage of the diseases b. Distribution & localisation c. Effect 2. More acute  low concentration 3. Explain  usage & cleansing 4. Avoid sensitizer 5. Restrict unstable drugs

  7. Topical therapy: type of Vehiculum 1. V.monophasic : a. powder b. solution c. ointment 2. V. biphasic : powder + solution powder + ointment solution + ointment 3. V. triphasic : powder + solution + paste

  8. Powder Lotion Paste Cold paste Solution Oint. Cream W/O O/W

  9. POWDER * Inert, used`of physical effect A. Effect : cover adhesion slipping power absorption cooling power B. Indication : dry lesion superficial lesion acute vesicobulous C. contraindication : dermatoses  wet & eksudative D. usage : with sponge, sprinkle

  10. 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

  11. SOLUTION B. Indication : wet and acute dermatoses, acute dermatitis C. Contraindication : dry lesion D. Usage : bathing open dressing close dressing

  12. 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

  13. 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

  14. LIQUID POWDER • ≈ powder + solution (+ suspending agent) • More adhesive than powder • Usage < 40% body surface • A. effect : 1. drying 2. Anti pruritic

  15. 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

  16. CREAM • ≈ fat + water (+ emulgator) • Cream O/W (oil/ointment in water) • Cream W/O (water in oil/ointment) • A. Effect : 1. Protektive 2. Drying

  17. 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

  18. CREAM W / O O / W WATER IN OIL OIL IN WATER OIL >> WATER >> LESION MORE DRY MORE WET SUBACUTE

  19. 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

  20. 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

  21. CHOICE OF DRUG ACCORDING : CLINICAL APPEARANCE / LESION / STAGE CHRONIC DRY ACUTE WET SUBACUTE dressing Oint. Cream O/W Cream W/O c

  22. Tabel. VEHICULUM CHOICE ACCORDING DISTRIBUTION / LOCALISATION

  23. EFFECTS OF DRUG 1. Protective : powder, paste, cold paste, cream 2. Absorption : powder, liquid powder 3. Drying : solution, liquid powder 4. Good penetration : ointment, cream, tinctura 5. 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

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