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SA

 

SA

SA

sinoatrial.

SA

1 abbreviation for sinoatrial.
2 abbreviation for surface area.
3 abbreviation for surgeon's assistant.

SA

Abbreviation for sacroanterior position.

SA

sinoatrial

salicylic acid

; SA topical agent that is caustic/keratolytic in high strengths (i.e. 40-70%, applied topically as ointment/paste; used to treat verrucae and heloma dura - see Table 1), and antifungal (see Table 2), antiseptic and astringent (Table 3) in lower strengths (i.e. 3-5% applied topically as an ointment/lotion/cream/powder); it is incompatible with iodine, iron salts and oxidizing agents
Table 1: Treatment of dyshidrosis
PathologyTreatment options
HyperhidrosisTopical astringents, e.g. 3% salicylic acid solution; aluminium salts (e.g. Anhydrol forte solution; ZeaSORB dusting powder), foot baths: 1: 10 000 potassium permanganate solution; contrast foot baths
Non-occlusive foot wear (e.g. leather shoes/sandals; cotton socks)
Drug therapy: iontorphoresis of 0.05% glycopyrronium bromide solution; local injection of botulinum A toxin-haemagglutinin complex
AnhidrosisTopical emollients: aqueous cream; emulsifying ointment; hydrous ointment; lanolin; liquid and white soft paraffin ointment; white soft paraffin; proprietary products, e.g. Diprobase, E45
BromidrosisAs hyperhidrosis ± deodorant sprays
Table 2: Caustic agents used in podiatric practice to achieve local tissue destruction
AgentActionSpecial precautionsContraindications
Monochloroacetic acid (crystals or saturated solution) e.g. single VPKeratolytic; hydrolysing agent
Non-self-limiting
Deep penetration
Painful
Do not use mask if applying solution
Use a mask if applying crystals
Review in 5-7 days
Neutralize with foot bath ± NaHCO3 or NaCl
Soft-tissue atrophy
Peripheral vascular disease
Sensory neuropathy
Salicylic acid paste (40-70%) e.g. single VP; plantar hard cornKeratolytic; hydrolysing agentMacerates tissues
Review in 7-14 days
May be used in conjunction with monochloroacetic acid crystals
Neutralize with foot bath ± NaHCO3 or NaCl
Soft-tissue atrophy
Peripheral vascular disease
Sensory neuropathy
Pyrogallic acid e.g. single VPKeratolytic; oxidizing agentDeep penetration
Review in 3-5 days
Prolonged caustic action
Do not apply more than 3 times sequentially
Stains skin black/brown
Use with great care: may cause deep tissue breakdown
Soft-tissue atrophy
Peripheral vascular disease
Sensory neuropathy
Trichloroacetic acid (saturated solution; 10% solution) e.g. mosaic VPMild keratolytic
Protein precipitant
Shallow penetration
Neutralize with foot bath ± NaHCO3 or NaCl
Review in 3 weeks
Peripheral vascular disease
Sensory neuropathy
Silver nitrate (70% solution; 75-95% stick) e.g. mosaic VP; as a protective skin application below a maskProtein precipitant
Self-limiting
Stains skin black/brown
Maximum effect occurs within 24 hours
Some patients show hypersensitivity to silver nitrate (or experience acute pain)
Neutralize with NaCl foot bath
May be applied in alternate layers with trichloroacetic acid
Peripheral vascular disease
Known sensitivity
Potassium hydroxide (KOH; 85% pellets)Strong keratolyticPotentially deep penetration
Action of KOH stopped by application of 5% acetic acid after macerated coagulum has been removed
Single treatment
Soft-tissue atrophy
Peripheral vascular disease
Sensory neuropathy
Phenol (80% solution or 100% crystal)Protein precipitateAction retarded by flooding with industrial methylated spirit
Skin overspill flooded with glycerine
Review as per postoperative protocol
Peripheral vascular disease (phenol suppresses inflammatory response)

VP, verruca pedis.

Table 3: Treatment of fungal infections of skin and nails
Infection siteAgent
Antimycotic agent (for the treatment of dermatophytosis)
SkinTopical allylamine (e.g. 1% terbinafine cream for 7 days)
Topical imidazoles (e.g. 2% miconazole or 1% clotrimazole for 28 days)
Topical 0.25% amorolfine
Topical 1% econazole
Topical griseofulvin spray (400 μg puff daily for 14 days)
Topical 1% sulconazole
Topical tea tree (manuka) oil
Topical undecenoate (20% zinc undecenoate + 5% undecenoic acid)
Topical Whitfield's ointment (6% benzoic acid + 3% salicylic acid)
Other topicals include: weak iodine solution 2.5%; potassium permanganate paint 1%; salicylate acid cream or alcoholic solution 3-5%; benzoic acid (Whitfield's) ointment; sodium polymetaphosphate dusting powder
Systemic terbinafine (250 mg daily for 2 weeks)
Systemic itraconazole (100 mg daily for 15 days)
Systemic griseofulvin (500 mg daily )
NailTopical amorolfine 0.25% lacquer as an adjunct to systemic treatment
Topical borotannic acid complex acid; Phytex paint (1.46% salicylic acid + 4.89% tannic acid + 3.12% boric acid)
Topical 28% tioconazole lacquer
Topical undecenoate lacquer; Monphytol paint (5% methyl undecenoate + 0.7% propyl undecenoate + 3% salicylic acid + 25% methyl salicylate + 5% propyl salicylate + 3% chlorambucil)
Other topicals: strong iodine 10% solution
Systemic terbinafine (250 mg daily for 12-16 weeks)
Systemic itraconazole (400 mg for 1 week in a month, repeated overall 3 or 4 times)
Anticandidal agent (for the treatment of candidiasis)
SkinTopical antimycotic creams (1% clotrimazole; 1% econazole; 2% miconazole)
Topical nystatin (100 000 units ± 1% tolnaftate)
Antipityriasis versicolor agent (for the treatment of pityriasis versicolor)
SkinTopical 2% ketoconazole
Topical 2.5% selenium sulphide
Topical antimycotic agents (1% clotrimazole; 1% econazole; 2% miconazole; 1% sulconazole; 1% terbinafine)
Systemic fluconazole/itraconazole/ketoconazole/miconazole/voriconazole

S-A, SA

sinoatrial.
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