Burn cream

An unusual and treatment-resistant form of symptomatic hypocalcemia is seen in patients treated with large amounts of burn cream that contains polyethylene glycols. The glycols are absorbed and metabolized to dicarboxylic adds that bind calcium. Patients develop markedly increased total calcium and decreased free calcium, along with a metabolic acidosis and increased serum osmolality from the glycols. 

Antiseptic wipes Aspirin and non-aspirin for pain Burn cream Cold pack Dressing Eye wash First-aid cream First-aid manual Latex gloves Safety pins Scissors... 

Tea tree oil comes from an evergreen tree native to Australia. The herb has been used as a nonirritating, antimicrobial for cuts stings wounds burns and acne. It can be found in shampoos soaps and lotions. Tea tree oil should not be ingested orally but is effective when used topically for minor cuts and stings. Tea tree oil is used as an antifungal to relieve and control the symptoms of tinea pedis Topical application is most effective when used in a cream with at least 10% tea tree oil. Several commercially prepared ointments are available. The cream is applied to affected areas twice daily for several weeks... 

In case of burning and stinging, the patient should stop the application of bleaching creams for few days and then start again. 

Trivial burns are sometimes produced by the accidental handling of hot glass. These may be smeared with vaseline or skin cream and covered with clean or preferably sterile linen. Blisters should not be broken. Tannic acid jelly is not recommended. 

Elder leaves are primarily used for topical applications as an emollient and vulnerary. They were traditionally mixed with tallow and made into an ointment for hemorrhoids, burns, bruises, sprains, chilblains, wounds, hives, eczema, tumors and gout. Elder leaf salve is reported to be as effective as cortisone creams. Elder is most beneficial in moving the stagnation associated with black-and-blue marks. Soaking cuts in a tea of elder leaves before applying the salve is another common first aid application. 

To be effective, capsaicin must be used regularly, and it may take up to 2 weeks to work. It is well tolerated, but some patients experience temporary burning or stinging at the site of application. Patients should be warned not to get the cream in their eyes or mouth and to wash their hands after application. 

Calcipotriene (Dovonex) is a synthetic vitamin D analog used for mild to moderate plaque psoriasis. Improvement is usually seen within 2 weeks of treatment, and approximately 70% of patients demonstrate marked improvement after 8 weeks. Adverse effects occur in about 10% of patients and include lesional and perilesional burning and stinging. Calcipotriene 0.005% cream, ointment, or solution is applied one or two times a day (no more than 100 g/wk). 

Tazarotene (Tazorac) is a synthetic retinoid that is hydrolyzed to its active metabolite, tazarotenic acid, which modulates keratinocyte proliferation and differentiation. It is available as a 0.05% or 0.1% gel and cream and is applied once daily (usually in the evening) for mild to moderate plaque psoriasis. Adverse effects are dose- and frequency related and include mild to moderate pruritus, burning, stinging, and erythema. Application of the gel to eczematous skin or to more than 20% of body surface area is not recommended because this may lead to extensive systemic absorption. Tazarotene is often used with topical corticosteroids to decrease local adverse effects and increase efficacy. 

The topical immunomodulators tacrolimus (Protopic) and pimecrolimus (Elidel) inhibit calcineurin, which normally initiatives T-cell activation. These agents can be used on all parts of the body for prolonged periods without producing corticosteroid-induced adverse effects. Tacrolimus ointment 0.03% and 0.1% is applied twice daily the lower strength is preferred in children with moderate to severe atopic dermatitis. The most common adverse effect is transient itching and burning at the site of application. Pimecrolimus cream 1% is applied twice daily for mild to moderate atopic dermatitis in adults and children older than age 2. 

Fig. 21.16. 513C values for the Ci6 o and Ci8 0 fatty acids extracted from the Roman cream, compared with confidence ellipses (la) corresponding to those from modern cow, sheep, and pig adipose fat and sheep and cow butter fat (reference 513C values are adjusted for post-industrial Revolution effects of fossil-fuel burning analytical precision + 0.3%). (Reprinted/redrawn from Nature, 432, 35-36, Copyright 2004, Nature Publishing Group, with permission.)... 

Silver and its compounds have long been used as antimicrobial agents in medicine. The mechanisms of silver toxicity as they relate to human exposure to pharmaceuticals have been reviewed (328). Silver is active at low concentrations and has a low toxicity. The practice of instilling the eyes of infants with 1% of AgN03 solution immediately after birth is still common in some countries, for prevention of opthalmia neonatorum (329). Silver sulfadiazine 77 is clinically used as a topical antimicrobial and antifungal agent and applied as a cream to prevent bacterial infections in cases of severe burns. It is an insoluble polymeric compound and releases Ag(I) ions slowly. 

Elidel cream consists of pimecrolimus, which is a calcineurin inhibitor that is used for eczema or psoriasis. Patients should be advised to avoid alcoholic drink during the treatment period as consumption of alcohol may lead to facial flushing and skin irritation. Side-effects associated with the topical administration of pimecrolimus include a burning sensation, pruritus, erythema and skin infections, including folliculitis and, less commonly, impetigo. 

Imiquimod cream is used for the treatment of external anogenital warts, where it may be used for both keratinised and non-keratinised lesions. It is also used in superficial basal cell carcinoma and actinic keratosis. Side-effects include local reactions such as itching, burning sensation, erythema, erosion, oedema, excoriation and stabbing and, less commonly, local ulceration. Patients should be advised to rub it in and to allow it to stay on the treated area for 6-10 hours for warts. The cream should then be washed off with mild soap and water. 

---