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Introduction To Dermatology

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Title: Introduction to Dermatology Author: Dr D J Barker Last modified by: Barker Created Date: 9/8/1997 4:26:52 PM Document presentation format: On-screen Show – PowerPoint PPT presentation

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Title: Introduction To Dermatology


1
Introduction To Dermatology
  • Dr D J Barker
  • St Lukes Hospital, Bradford

2
What Are the Functions of the Skin?
  • Temperature regulation
  • Water conservation
  • Protection (mechanical, UV, microbes)
  • Sensation
  • Synthesis storage
  • Psycho-sexual

3
Why Refer to a Dermatologist?
  • Diagnostic difficulty
  • Management advice
  • Failure of agreed treatment protocol
  • Patient counselling or education
  • Increasing use of potent topical steroids
  • Special treatment e.g. PUVA
  • Special investigation e.g. Patch Tests

4
In-patient Dermatology
  • Infections
  • Urticaria angioedema
  • Drug eruptions
  • Connective tissue diseases
  • Erythema nodosum multiforme
  • Cutaneous marker of systemic disease
  • Severe pre-existing skin disease

5
In-patient Dermatology
  • Infections
  • Urticaria angioedema
  • Drug eruptions
  • Connective tissue diseases
  • Erythema nodosum multiforme
  • Cutaneous marker of systemic disease
  • Severe pre-existing skin disease

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Infections - Erysipelas
  • Fever Rigor
  • Defined erythematous rash
  • Leg gt face gtelsewhere
  • Haemolytic streptococcus
  • Mild pre-existing skin disease
  • IV Benzyl penicillin
  • Lymphoedema and relapse

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Infections Herpes simplex
  • Severe primary infection
  • Kaposis varicelliform eruption
  • Atopic eczema
  • Cutaneous T-cell lymphoma
  • Dariers disease
  • IV Aciclovir
  • Anti-staphylococcal antibiotic

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Infections - Herpes Zoster
  • Varicella Zoster virus
  • Pain confined to a single dermatome
  • Vesicles confined to single dermatome
  • Patients are infectious
  • IV Aciclovir

14
In-Patient Dermatology
  • Infections
  • Urticaria angioedema
  • Drug eruptions
  • Connective tissue diseases
  • Erythema nodosum multiforme
  • Cutaneous marker of systemic disease
  • Severe pre-existing skin disease

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Urticaria
  • May be associated with angioedema
  • Vasoactive amine release from mast cells
  • Acute attacks frightening, not dangerous
  • Most attacks have no simple cause
  • Antihistamines

18
Anaphylaxis
  • Urticaria angioedema
  • Bronchospasm, Laryngeal obstruction
  • Hypotension
  • Penicillin, peanuts, latex, insect stings
  • Adrenaline
  • Hydrocortisone antihistamines
  • Oxygen IV fluids

19
In-Patient Dermatology
  • Infections
  • Urticaria angioedema
  • Drug eruptions
  • Connective tissue diseases
  • Erythema nodosum multiforme
  • Cutaneous marker of systemic disease
  • Severe pre-existing skin disease

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Drug eruptions - 1
  • Morbilliform
  • Toxic epidermal necrolysis
  • Fixed drug eruption
  • Stevens-Johnson syndrome
  • Lichenoid drug rash
  • Acneiform

23
Drug eruptions - 2
  • Any drug, any rash, any time
  • Likely sulphonamides, penicillins
  • Unlikely digoxin, insulin
  • Suspect recent agents
  • Stop inessential drugs
  • A dermatologist may not solve your problem

24
In-Patient Dermatology
  • Infections
  • Urticaria angioedema
  • Drug eruptions
  • Connective tissue diseases
  • Erythema nodosum multiforme
  • Cutaneous marker of systemic disease
  • Severe pre-existing skin disease

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Connective tissue diseases
  • Lupus erythematosus
  • Dermatomyositis
  • Systemic sclerosis
  • PAN Wegeners granulomatosis

29
In-Patient Dermatology
  • Infections
  • Urticaria angioedema
  • Drug eruptions
  • Connective tissue diseases
  • Erythema nodosum multiforme
  • Cutaneous marker of systemic disease
  • Severe pre-existing skin disease

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Erythema nodosum
  • Sarcoidosis
  • Post-streptococcal
  • TB
  • Inflammatory bowel disease
  • Leprosy
  • Histoplasmosis, coccidiomycosis

33
Erythema multiforme
  • Oral, Ano-genital Cutaneous
  • Target lesions are acral
  • Often follows herpes simplex
  • Lasts 10-14 days
  • May be recurrent

34
In-Patient Dermatology
  • Infections
  • Urticaria angioedema
  • Drug eruptions
  • Connective tissue diseases
  • Erythema nodosum multiforme
  • Cutaneous marker of systemic disease
  • Severe pre-existing skin disease

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Cutaneous markers
  • Neoplasia
  • Acanthosis nigricans, Dermatomyositis
  • Secondaries infiltrates
  • Non-neoplastic
  • Sarcoidosis and xanthomas,
  • Endocrine e.g. necrobiosis, PTM
  • Inherited conditions
  • Neurofibromatosis
  • Tuberous sclerosis

41
In-Patient Dermatology
  • Infections
  • Urticaria angioedema
  • Drug eruptions
  • Connective tissue diseases
  • Erythema nodosum multiforme
  • Cutaneous marker of systemic disease
  • Severe pre-existing skin disease

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Severe pre-existing skin disease
  • Erythroderma
  • Extensive eczema
  • Acute pustular psoriasis
  • Leg ulcers venous eczema
  • Photosensitivity

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Introduction To Dermatology
  • Department of Dermatology (D2F4)
  • St Lukes Hospital, Bradford
  • Derek Barker Andrew Wright
  • Kate London Suzanne Hatfield
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