About ASFAD - Morse's Medications

Solutions

  • Burows Solution(Aluminum acetate) soaks or compresses
  • Domeboros (Aluminum sulfate)
  • Pedi-Soak
  • Drysol (20 % Aluminum chloride) 37.5 dab-o-matic
  • Hypercure 20% Aluminum Chloride

Topical Immunnosupressive Agents

  • Protopic .1% and .03% ointment
  • Elidel 1% cream

Antihistamines

  • Sedating
  • Atarax 10-25 mg PO q6 hrs prn or hs
  • Benadryl 25-50 mg POq6 hrs or hs
  • Non-Sedating
  • Claritin/Zyrtec 10 mg po qhs

Topical Anesthetics

  • Lidocaine patch
  • Flexor patch

Topical Anti Itch Preparations

  • Calamine lotion (not Caladryl or topical Benadryl)
  • Sarna, Sarnol (Camphor and Menthol)
  • Pramoxine
  • Doxepin (Zonalon)

Keratolytics

  • Gordons 40% urea
  • Lac Hydrin 12 %
  • Amlactin 12 %
  • Kersal
  • Uramaxin Lotion (40%) / Foam (20%

Hyperhydrosis

  • Drysol (20% aluminum chloride)
  • Forma-ray (20% formaldehyde)
  • Formadon (10 % formaldehyde)
  • Black Tea soaks x 20 min QD
  • Domeboro’s (aluminum acetate)
  • Castellani paint
  • Pedi-boro Soak Paks ( Aluminum sulfate)

Astringents
Drying agents that precipitate protein and shrink skin and can relieve itching. Can be used as wet dressings, compresses and soaks.

  • Aluminum acetate
    (Burow’s – an OTC product )
    Diluted 1:10 – 1:40
  • Aluminum sulfate plus calcium acetate
    (Domboro’s – an OTC product)
  • Witch hazel
    (from leaves and bark of witch hazel shrub – an OTC product)
  • Formaldehyde 10 %
    (lazerformalyde)
  • Aluminum Chloride Hexahydrate 20%
    (Drysol)
  • Aluminum Chloride (Onox)
  • Castellani paint
  • Right Guard Antiperspirant

Bromohydrosis
Excessive sweating with offensive odor.

  • Bromi-lotion
  • Bromi-talc
  • Lavilin
  • Black tea with epsom salt soak
  • Epsom salt ointment
  • Application of E-mycin or Cindamycin topical ( used in pitted keratolysis)
  • Acetic acid foot baths
  • For Shoes: Undecylenic acid (Tineacide spray), Chlorophyll, Formalin, Benzalkonium Chloride (Mycomist), Bleach on rag in plastic zip lock with shoe x 48 hours, Freezing shoes for 48 hours

Hyperpigmentation

  • Hydroquinone: In concentrations of 2 percent to 5 percent. It decreases pigmentation by inhibiting tyrosinase, which blocks the conversion of dopa to melanin.
  • Tretinoin (Retinoic Acid): Inhibits the transcription of tyrosinase, leading to decreased melanin. Concentrations of .05 - .10 %.
  • Azelaic Acid: Is thought to mediate decreased pigmentation by inhibition of tyrosinase. Concentrations of 15 percent to 20 percent.

Scarring

  • ScarCare Gel Pad – silicone sheeting (Blaine)
  • ScarSolution – silicone sheeting
  • Mederma – active ingredient is onion extract with petroleum.
  • Petroleum jelly
  • Injection – with Triamcinolone acetonide (Kenalog 40 mg/ml)

Antipruritics

  • Atarax
  • Benadryl

Antifungals

Oral Medications:

  • Terbenifine 250 mg qd x 3 months
  • Itraconazole 100mg. 200 mg bid x 1 week as a pulsed dose. Three weeks no medication. Repeat for 2 additional pulses
  • Fluconazole 200 mg. One pill q week (fungus friday) for 5 months

Tinea pedis

Oral Medications:

  • Ultramicrosize grisofulvin 125/250 mg bid x 4 weeks
  • Terbinefine 250 mg (peds – 125 mg) qd x 3 – 4 weeks
  • Fluconazole 150 mg q week x 4 – 6 weeks

Topical medications:

  • Azoles
  • Imidazoles
  • Miconazole (Fungoid Tincture 2%)  
  • Ketaconazole (Nizoral 2%)

Imidazoles:

  • Clotrimazole
  • Econazole 1% (Spectazole cream)
  • Oxiconazole (Oxistat cream 1%)
  • Allylamines: Terbinafine 1% (Lamisil cream), Naftifine  (Naftin Cream) 1% and 2% - for dry areas
  • Naftin Gel 1% - for moist areas ( web spaces)
  • Benzylamine: Butenafine 1% (Mentax cream)
  • Hydroxypyridone: Ciclopirox (Loprox .77% suspension)

Biopsy:

  1. 10 sec  alcohol scrub (= to a 5 min betadine scrub)
  2. Supplies: 1 cc TB syringe, 30 g needle, lido with epi 1:100,000 – ½ - 1cc, iris scissor, thumb forceps
  3. 30 – 45 degree angle to skin – bevel down. Inject subQ/dermis
  4. Raise a wheal so you see a small rise
  5. Punch: 2 mm, 3mm, 4mm
  6. Vertical pressure, rotate back and forth, full thickness to fatty layer, tilt it back so you see undersurface
  7. Push down on the skin around the biopsy site so the cylindrical skin is proud – and lift with a thumb forceps until you see the fat. Cut with a scissor. Apply gelfoam and dsd.
  8. I like 2 2mm punches instead of 1 4mm punch but 2, 3, 4 are all ok
  9. I use the larger punches 5mm, 6mm to excise a lesion (excisional bx)

Topical Steroids:

  • Plantar skin – Class 1 – Clobetasol propionate 0.05% (Temovate, Olux) or Halobetasol propionate 0.05% (Ultravate)
  • Dorsal skin – Class 2 – Fluocinonide 0.05%, Desoximetasone 0.05% (Lidex, Topicort)
  • Intertriginous skin - Class 3 – Fluticasone propionate .05% (Cutivate lotion)  Betamethasone valerate 0.12% (Luxiq foam) Desoximethasone (Topicort LP cream)

Oral Steroids:

  • Methylprednisone – Medrol dose pack – 4 mg tabs – for 1 week: 7 pills = 28 mg, 6 pills = 24 mg etc..,5,4,3,2,1
    Prednisone: 1 mg/kg/day
    20 days: 40 mg qd x 3 days, 20 mg qd x 3 days, 10 mg qd x 3 days, 5 mg qd x 3 days, 2.5 mg qd x 8 days (my favorite)
    15 days: 60 mg qd x 5 days, 40 mg qd x 5 days, 20 mg qd x 5 days (least expensive – 30 tabs of 20 mg)
    tablets come in 1 mg, 2.5mg, 5mg, 10mg, 20mg, 50mg, 100mg
    * prednisone oral solution: 5mg/ml : 30 ml
    * prednisone syrup: 5mg/5ml: 120 ml and 240 ml

Topical Antibiotics

  • Clindamycin - for pitted keratolysis
  • Erythomycin 2% - for pitted keratolysis
  • Mupirocin (Bactroban 2 %) - for staph and Strep infections
  • Gentamicin  - an aminoglycoside (Garamycin cream 1%) - for staph and strep and GM - bacteria
  • Bacitracin ointment – gm + bacteria
  • Neomycin  - an aminoglycoside(Neosporin ointment)– gm +, gm - bacteria
  • Silver sulfadiazine (Silvadene cream) 1% - gm+ and gm – and yeast.

Intralesional steroids (Triamcinolone 10 – 40 mg/cc.)

Topical Calcipitrione (Dovenex .005% 30/60 gm) – Inhibits keritinocyte proliferation

Tacoloex – combination Dovenex and betamethasone dipropinate (steroid)

Pseudomonas in Nails: Use diluted vinegar soaks 4:1 or diluted bleach 10:1.

Verruca:

  1. Pulsed Dye laser – at 15 joules/cm2 – may take multiple applications spaces 3 weeks apart. Used for more of the mosaic types, or overlying joints or on athletes
  2. Cantherdin plus – a solution of cantherone, salicyclic acid, and podophyllin. Apply on area and occlude. Leave on for 5 hours and wash off. See in three weeks. Debride and reapply as necessary
  3. Liquid Nitrogen / Nitrous oxide: Use 2 freeze/thaw cycles – 25 – 35 seconds for plantar skin and 10 – 15 seconds for dorsal skin. See in 3 weeks and debride and repeat as necessary.
  4. Candida albicans Antigen – 1000 pnu/ml. Inject 0.2 ml intradermally on at least 2 – 3 of the warts. This is a type of immunotherapy where the body will react to the antigen and cause an immune response to all of the warts – not just the ones injected
  5. Cimetidine – works best on pediatric patients at 25 – 40 mg/kg. An example is a 60 lb child (60 /2.2 = 27 x 30 mg/kg = 818 mg in divided doses. The medication is in 400 mg tablets. The dies would be 400 mg bid x 6 – 8 weeks (see paper by Mullen, Guiliana, Nesheiwat in JAPMA No.3, 2005)
  6. Bleomycin
  7. .5 Florouracil
  8. Salicyclic acid
  9. Imiquimod
  10. Monochloroacetic acid
  11. Squaric acid

CONTACT US

American Society of Foot and Ankle Dermatology
3301 New Mexico Avenue, NW.
Washington, DC 20016

Sarah Breymeier
Marketing/Administration
Phone: 309-642-9450
E-Mail: sarah@dermfootsociety.org

JOIN OUR E-MAIL LIST

Enter your e-mail address below to be added to our e-mail list.

  

SHARE US ON:

Home | About ASFAD | Member Directory | ASFAD Membership | Contact Us | Legal Notice | Privacy Statement | Site Map

Copyright © American Society of Foot and Ankle Dermatology
Web Site Development, Hosting & Maintenance By Catalyst Marketing Innovations, LLC/ Worry Free Websites