sami n. alsuwaidan, md, faad asscociate professor and consultant founder, cutaneous laser surgery...
TRANSCRIPT
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Dermatology
Skin, hair, nails, and mucous membranes (mouth and genitila).
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Important functions of the skin
-Protection against external injury -Fluid balance
-Temperature buffering -Synthesis of Vit. D
-Immune system -Cosmetic function
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Why Dermatology?
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Epidermis
Dermis
Cornified layer
Spinous layer
Granular layer
Basal layer
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Dermis
Subcutaneous
Epidermis
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Skin Anatomy1 Epidermis2 Basement membrane (dermoepidermal junction)3 Dermis4 Subcutaneous fat
Epidermis: Four layers (from outside – inside)1. Cornified layer2. Granular layer3. Spinous layer4. Basal layer
Dermis contains:Collagen fibersElastic fibersGround substancesBlood vesselsNerves.
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Skin Appendages
Hair follicle Sebaceous gland Arrector pili muscle Eccrine sweat gland Apocrine sweat glands
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Hair follicle
Arrector Pilli muscle
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Apocrine gland
Sebaceous gland
Eccrine gland
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Nail Anatomy
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Examination
1. Morphology2. Configuration 3. Distribution
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Primary Lesions
Secondary lesions
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Primary Lesions
MaculePapule
PlaqueNodule
Wheal
VesicleBulla
Pustule
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Secondary lesions
Crust
Scale Ulceration
Excoriation
Scar
Fissure
Lichenification
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Distribution
Configuration
Color and Shape
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Some specific signs in Dermatology
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Dermatographism: When you stroke the normal skin edema and erythema (you can write on skin!) .Seen in physical urticaria
Kobener Phenomenon: Induction of new skin lesions on previously normal appearing skin by truma e.g. in psoriasis, wart, lichen planus
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Kobener Phenomenon
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Dermatographism
INVESTIGATIVE TOOLS
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Additional skin examination:~Wood’s Lamp: Produces long wave ultraviolet light(UVA). e.g. Vitiligo milky whiteTinea Versicolor goldenTinea Capitis (caused by microsporum) yellow greenErytherasma coral red
~Dermatoscopy: Helpful to differentiate benign from malignant pigmented lesions.
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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
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Skin Prick Test
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Patch Test
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Investigations:
Skin biopsylocal anasthesia,different types: •Punch•Shave•Excisional•Incisional
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Treatment:
Topical
Systemic
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Topical Treatments
Various formulations:•Ointment•Cream•Gel•Solution•Lotion
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Topical steroids
7 Categories:
according to strength
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Phototherapy
Ultraviolet light A or Bwith or without psoralen
PUVA (Psoralen + UVA)New modalities:
Narrow band UVBUVA – 1
Excimer laser(308nm)
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Dermatology subspecialties
Pediatric dermatology Photomedicine Laser Hair Disorders and Transplantation Dermatologic surgery Allergy/Contact dermatitis Dermatopathology Immunodermatology Others
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