Case Studies
A 6-month-old infant is brought in by their parent for a rash in the diaper area. The rash started 2 days ago and appears bright red with mild irritation. The parent reports frequent urination and that diapers are changed about 3–4 times daily. No fever, no broken skin, and no pus are present. The infant is otherwise healthy and not taking any medications.
Assessment: Diaper dermatitis
Plan: Self-care appropriate
Recommendation: Increase diaper changes + zinc oxide barrier
Counseling: Keep area dry, gentle cleaning
PanOxyl® is recommended for acne.
Generic: Benzoyl peroxide
MOA: Releases oxygen that kills bacteria (C. acnes)
Side effects: Dryness, irritation, bleaching fabrics
These tests detect protein antigens for COVID-19.
What are antigen tests?
This diaper rash ingredient is thick, protective, and difficult to remove.
What is zinc oxide?
First-line OTC treatment for dry eyes.
What are artificial tears?
A 21-year-old college student presents with itchy, watery, red eyes for the past week. Symptoms worsen when outdoors during spring. No pain, no vision changes, no discharge, and no contact lens use. The patient has not tried any medications.
Assessment: Allergic conjunctivitis
Plan: Self-care appropriate
Recommendation: Artificial tears + ketotifen drops
Counseling: Avoid allergens, limit decongestants
Differin® Gel is used for acne treatment.
Clue:
Lotrimin AF® is recommended for athlete’s foot.
Answer:
Clue:
Debrox® is used for ear care.
Answer:
Clue:
Zaditor® is used for itchy eyes.
Answer:
I can turn this into:
Generic: Adapalene
MOA: Normalizes keratinization + anti-inflammatory
Side effects: Dryness, redness, photosensitivity
This stool test uses antibodies to detect human hemoglobin.
What is FIT (fecal immunochemical test)?
This fungal infection of the foot is the most common and treatable with OTCs.
What is tinea pedis (athlete’s foot)?
This OTC agent is first-line for impacted cerumen.
What is carbamide peroxide 6.5%?
A 45-year-old male reports a scaly, itchy rash on his foot for 3 weeks. He has been using an OTC antifungal cream inconsistently for the past week with no improvement. The rash is now spreading between toes and causing discomfort. No fever is reported.
Assessment: Tinea pedis (treatment failure)
Plan: NOT self-care
Recommendation: Refer to provider
Lotrimin AF® is recommended for athlete’s foot.
Generic: Clotrimazole
MOA: Inhibits ergosterol synthesis (fungal membrane)
Side effects: Burning, irritation
This urine test detects leukocyte esterase and nitrites.
What is a UTI test?
This condition causes red, scaly plaques due to rapid skin cell turnover.
What is psoriasis?
These drugs (e.g., ketotifen) treat allergic conjunctivitis itching.
What are antihistamine eye drops?
A 60-year-old patient reports ear fullness and decreased hearing for several days. No pain, no fever, and no recent infections. The patient admits to frequent Q-tip use. No history of ear surgery or tympanic membrane rupture.
Assessment: Cerumen impaction
Plan: Self-care appropriate
Recommendation: Carbamide peroxide drops
Counseling: Avoid Q-tips
Debrox® is used for ear care.
Generic: Carbamide peroxide
MOA: Releases oxygen → softens and breaks up wax
Side effects: Mild irritation, bubbling sensation
This type of test detects HIV antibodies and may require a window period.
What is an HIV home test?
First-line OTC treatment for mild acne that is a topical retinoid.
What is adapalene?
These eye drops should not be used for more than 72 hours due to rebound redness.
What are decongestant eye drops?
A 30-year-old presents with severe eye pain, sensitivity to light, and blurred vision that began suddenly this morning. The patient wears contact lenses and reports possible overnight use. No medications have been tried.
Red flags: Pain, photophobia, vision changes, contact lens use
Assessment: Possible serious ocular condition
Plan: EXCLUSION! NO self-care
Recommendation: Immediate referral
Zaditor® is used for itchy eyes.
Generic: Ketotifen
MOA: H1 antagonist + mast cell stabilizer
Side effects: Dry eyes, headache, mild burning
Name one limitation of home testing kits.
What is false positives/negatives?
Name one referral criteria for dermatologic conditions.
What is no improvement after 7 days
Name one exclusion to self-care for eye conditions.
What is vision changes or severe pain