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

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Presentation on theme: "Introduction To Dermatology Dr D J Barker St Lukes Hospital, Bradford."— Presentation transcript:

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

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

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

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

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

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9 Infections - Erysipelas n Fever & Rigor n Defined erythematous rash n Leg > face >elsewhere n Haemolytic streptococcus n Mild pre-existing skin disease n IV Benzyl penicillin n Lymphoedema and relapse

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

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

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

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

19 Anaphylaxis n Urticaria – angioedema n Bronchospasm, Laryngeal obstruction n Hypotension n Penicillin, peanuts, latex, insect stings n Adrenaline n Hydrocortisone & antihistamines n Oxygen & IV fluids

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

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

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

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

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29 Connective tissue diseases n Lupus erythematosus n Dermatomyositis n Systemic sclerosis n PAN – Wegeners granulomatosis

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

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

34 Erythema multiforme n Oral, Ano-genital & Cutaneous n Target lesions are acral n Often follows herpes simplex n Lasts days n May be recurrent

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

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

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

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

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48 Introduction To Dermatology Department of Dermatology (D2:F4) St Lukes Hospital, Bradford Derek Barker Andrew Wright Kate London Suzanne Hatfield


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