Dermatology Skin hair nails and mucous membranes mouth
Dermatology Skin, hair, nails, and mucous membranes (mouth and genitila). 2
Important functions of the skin - Protection against external injury - Fluid balance - Temperature buffering - Synthesis of Vit. D - Immune system - Cosmetic function 3
Why Dermatology? 4
Cornified layer Epidermis Granular layer Spinous layer Dermis Basal layer 5
Epidermis Dermis Subcutaneous 6
Skin Anatomy 1 2 3 4 Epidermis Basement membrane (dermoepidermal junction) Dermis Subcutaneous fat v 1. 2. 3. 4. Epidermis: Four layers (from outside – inside) Cornified layer Granular layer Spinous layer Basal layer v Dermis contains: Collagen fibers Elastic fibers Ground substances Blood vessels Nerves. 7
Skin Appendages Ø Ø Ø Hair follicle Sebaceous gland Arrector pili muscle Eccrine sweat gland Apocrine sweat glands 8
Arrector Pilli muscle Hair follicle 9
Sebaceous gland Eccrine gland Apocrine gland 10
Nail Anatomy 11
Examination 1. Morphology 2. Configuration 3. Distribution 12
Primary Lesions Secondary lesions 13
Primary Lesions Macule Papule Plaque Nodule Wheal Vesicle Bulla Pustule 14
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Secondary lesions Crust Scale Ulceration Excoriation Scar Fissure Lichenification 26
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Color and Shape Distribution Configuration 41
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Some specific signs in Dermatology 49
v. Dermatographism: When you stroke the normal skin edema and erythema (you can write on skin!). Seen in physical urticaria v. Kobener Phenomenon: Induction of new skin lesions on previously normal appearing skin by truma e. g. in psoriasis, wart, lichen planus 50
Kobener Phenomenon 51
Dermatographism 52
INVESTIGATIVE TOOLS 53
Additional skin examination: ~Wood’s Lamp: Produces long wave ultraviolet light(UVA). e. g. Vitiligo milky white Tinea Versicolor golden Tinea Capitis (caused by microsporum) yellow green Erytherasma coral red ~Dermatoscopy: Helpful to differentiate benign from malignant pigmented lesions. 54
Investigations: *KOH and fungal culture • Scrap skin scales put over glass slide • Add KOH 10% -- warm gently • See under microscope • You may see hyphae and/ or spores 55
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Skin Prick Test 58
Patch Test 59
Investigations: Skin biopsy local anasthesia, different types: • Punch • Shave • Excisional • Incisional 60
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Treatment: Topical Systemic 66
Topical Treatments Various formulations: • Ointment • Cream • Gel • Solution • Lotion 67
Topical steroids 7 Categories: according to strength 68
Phototherapy Ultraviolet light A or B with or without psoralen PUVA (Psoralen + UVA) New modalities: Narrow band UVB UVA – 1 Excimer laser(308 nm) 69
Dermatology subspecialties q q q q q Pediatric dermatology Photomedicine Laser Hair Disorders and Transplantation Dermatologic surgery Allergy/Contact dermatitis Dermatopathology Immunodermatology Others 70
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