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Introduction to Dermatology
Dr.duaa salem alrehaili
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What Is Dermatology? Dermatology is the branch of medicine dealing with the skin and its diseases. It is a unique specialty with both medical and surgical aspects. A dermatologist takes care of a variety of diseases, in the widest sense, variety of patients.
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Relation to General Medicine
A good dermatologist should be a good physician.
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We are sharing a Dentist
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Sharing Gynechologist,
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Industry and dermatology
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Onchology,
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Peadiatric Dermatology
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Dermatopathology
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Hair and Nail Diseases
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Surgical Dermatology
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Laser And Dermatology
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Sexual Transmitted Diseases
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Cosmetic Dermatology,
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Adrology, Andrology is not a part of Dermatology.
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Dermatology Approach
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The Dermatological diagnosis
Taking history of a skin disorder is usually less prolonged affair than in general medicine. In practice many dermatologist will take a history after assess the problem or even after examination
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History General Questions: Duration? Behavior? (Relapse and remit)
How did it start? Is it anywhere else? Travelling? Details Symptoms: Itching? Painful?
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Associated Symptoms Past History of skin and Related disorders Family History Drug history Occupation Social history
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Examination The Primary Lesions:
Primary lesions are physical changes in the skin considered to be caused directly by the disease process. Types of primary lesions are rarely specific to a single disease entity. The Secondary Lesions: Secondary lesions may evolve from primary lesions, or may be caused by external forces such as scratching, trauma, infection, or the healing process.
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Primary Skin Lesions Macule
A macule is flat area of skin discoloration which is less than 0.5 cm in diameter
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Papule Palpable elevation of the skin less than 0.5 cm
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Nodule A circumscribe palpable mass, lump larger than 1 cm
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Patch A flat lesion greater than 0.5 cm in diameter
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Plaque A slightly raised lesion greater than 0.5 cm in diameter
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Vesicle It is a raised lesion less than 0.5 cm in diameter containing clear fluid
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Bulla (blister) It is a vesicle that is greater than 0.5 cm in diameter
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Pustule It is a raised lesion less than 0.5 diameter containing yellow fluid
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Wheal It is a transient, itchy, pink swelling of the skin
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Secondary Skin Lesions
Crust It is a dried exudate, which may have been serous, purulent or hemorrhagic.
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Excoriation A secondary, superficial ulceration due to scratching
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Lichenification A flat topped thickening of the skin due to chronic scratching
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Scar It is a white, smooth, firm, shiny lesion.
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Scaling A scale is a flat plate or flake due to aggregation of shed epidermal cells.
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Atrophy Thinning and transparency of the skin is caused by diminution of the epidermis.
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Erosion A partial break in the epidermis
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Ulcer It is a full thickness loss of the epidermis that heals with scaring.
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Questions?
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Clinical Manifestation
Classical plaque psoriasis
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Scalp Psoriasis
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Nail Psoriais
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Psoriatic Arthritis Arthritis occurs in 10-25% of patients.
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Psoriasis of palms and soles
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Erythrodermic Psoriasis
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Oral Lichen Planus
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Seborrheic Dermatitis
A very common dermatosis charactrized by redness, scaling in sebaceous gland area. Role of Malassezia yeasts.
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Clinical Features The hallmark of impetigo is superficial lesion covered with a heavy honey colored crust. It may be associated with acute glomerulonephritis.
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Erysipelas A cutaneous streptococcal infection characterized by sharply demarcated lesions, commonly in face. The organism gains entry through minor abrasion.
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Cellulitis Usually due to Streptococci, but with deeper involvement.
The organism enter through abrasion or pre-existing dermatological condition such as leg ulcer.
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Clinical features of Type 1
The characteristic picture of primary herpes is a fine vesicles that rupture to form erosions in lips, face, with fever.
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The cornea could be involved
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Type 2 Usually due to sexual transmission
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Herpes simplex and erythema multiforme
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Clinicherpes zoster
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Ophthalmic division of trigeminal nerve
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In adult (Candidal intertrigo)
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Oral Candidosis
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Systemic candidosis
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Clinical features
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Tinea Corporis It infects mostly the trunk, itchy,
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Tinea Cruris
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Tinea pedis Mostly in young adult, showers, swimming pools
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Kerion Inflammatory reaction to the fungi, boggy appearance
Associated with fever, pain, scarring alopecia
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Tinea Unguium (onychomycosis)
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Acne 1- describe Coexisting open and closed comedones,
Papules, pustules, and nodular lesions Lesion are located primarily on face, neck, and upper trunk Diagnosis: acne
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Acanthosis negricans The flexsor surfaces of the neck, axillae, and groin are the main affected sites Nearly 75% of obese \ patients develop this lesion. There is a strong association with insulin resistance. Weight loss is the primary interventions required. This lesion is associated with malignancy
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Thank u
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