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

2. Science concerning theraphy of skin diseases
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. Solution Oint. Powder Lotion Paste Cream Cold paste
W/O

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. WATER IN OIL OIL IN WATER OIL >> WATER >>
W / O O / W
WATER IN OIL OIL IN WATER
OIL >> WATER >>
LESION
MORE DRY MORE WET
CREAM
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
ACUTE WET
CHRONIC
DRY
SUBACUTE
dressing
Cream O/W
Cream W/O
Oint. c

22. Tabel. VEHICULUM CHOICE ACCORDING DISTRIBUTION / LOCALISATION
Powder
Water
Alco- hol
Oint.
Liquid powder
Paste
Cream
Generalisata + -* -
Scalp
Face +#
trunk, extremity
Genitalia
Fold area

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