1. THE LANGUAGE OF DERMATOLOGY Prepared by : SIG, Dermatology Nursing, IADVL

2. Why learn the language of dermatology ?  Nurses play a very important part in patient care  The dialogue between doctor and patient has to be clear and well understood  In order to report any observations, the nurse must speak the language used in dermatology which is also used by the dermatologists

3. CATEGORIES of TERMINOLOGY General terms Terms used to describe distribution Terms used to describe patterns

4. GENERAL TERMS Cutaneous : related to the skin

5. Pruritus : used to describe the sensation of itching or an irritating sensation that causes the person to scratch  Most common dermatological complaint  Usually represents inflammation  Can be a manifestation of something simple like dry skin or more serious systemic diseases like carcinomas  Time relationship can be a clue to disease ( nocturnal in scabies; transient in urticaria; constant in systemic diseases )  Excoriation marks and shiny nails might be a clue to its severity

6. Lesion : An area of altered skin texture, colour or elevation which is surrounded by normal skin May be a papule, macule, nodule, plaque, patch etc. May be one or many May change over time Type of lesion is a very good indicator of possible diagnosis

7. Lesion around the mouth

8. Lesion on the foot

9. Lesion on the neck

10. Rash : A collection of many lesions May involve any body part May be long standing or last a short while May be itchy or non itchy May be bilateral or unilateral If bilateral, symmetrical vs asymmetrical May change over time

11. Rash on the neck

12. Rash on the ‘V’ of the neck

13. Rash on the back

14. Dermatome : Area of skin supplied by a cutaneous nerve on one side of the body Important in some conditions like Herpes Zoster and some birth marks

15. Herpes Zoster along a dermatome

16. Naevus along a dermatome

17. Erythema : Redness of the skin caused by dilatation of blood vessels Purpura : Red or purple colour due to bleeding into the skin. It does not become pale on pressure Pin point purpura = petechiae Large bruise like patches = ecchymosis

18. Petechiae

19. Ecchymosis

20. Erythroderma : Generalized redness of the skin associated with scaling May be acute or chronic May be the result of worsening of psoriasis or eczemas May cause loss of proteins due to extensive shedding of scales

21. Thick scales in Erythroderma

22. Fine scales in Erythroderma

23. Exfoliation : Separation of the outermost dead layer of the skin from the underlying layers This may be in the form of scales or sheets

25. Fissure : A linear gap or slit in the skin surface Due to thickened, rigid outer layer of the skin splitting due to excessive dryness If unusually large and deep, may be due to anesthetic limb in leprosy

26. Fissured feet

27. TERMS USED TO DESCRIBE DISTRIBUTION ( The pattern of spread of lesions) Generalized : all over the body Widespread : involving large areas or extensive Localized : Restricted to one/ some area or the body Flexural : Body folds like groin, neck, behind ears, popliteal and antecubital fossa

28. Generalized

29. Localized (to palms)

30. Flexural

31. COMMONLY USED TERMS Extensor : knees, elbows, shins Pressure areas : Sacrum, buttocks, ankles, heels Symmetrical : similar distribution on both sides of the midline Asymmetrical : dissimilar distribution on both sides of the midline Photosensitive : over areas exposed to the sun Acral : pertaining to peripheral parts

32. Extensor

33. Symmetrical

34. Asymmetrical

35. Photosensitive

36. Acral

37. TERMS USED TO DESCRIBE CONFIGURATION ( Pattern or shape of grouped lesions) Discrete : individual lesions separated from each other Confluent : Lesions merging together Linear : In a line Annular : Like a circle or a ring Target : Group of rings inside each other ( concentric) Discoid/ Nummular : Like a coin

38. Discrete

39. Confluent

40. Linear

41. Annular

42. Target lesions

43. TERMS USED TO DESCRIBE CHANGES IN SKIN COLOUR Hypopigmentation : areas of paler skin Depigmentation : white skin due to absence of melanin Hyperpigmentation : Darker skin which may be due to various causes Erythema/ Purpura : As previously described

44. Hypopigmentation

45. Depigmentation

46. Hyperpigmentation

47. THANK YOU