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Introduction To Dermatology

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Presentation on theme: "Introduction To Dermatology"— Presentation transcript:

1 Introduction To Dermatology
Dr D J Barker St Luke’s 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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8 Infections - Erysipelas
Fever & Rigor Defined erythematous rash Leg > face >elsewhere Haemolytic streptococcus Mild pre-existing skin disease IV Benzyl penicillin Lymphoedema and relapse

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11 Infections – Herpes simplex
Severe primary infection Kaposi’s varicelliform eruption Atopic eczema Cutaneous T-cell lymphoma Darier’s disease IV Aciclovir Anti-staphylococcal antibiotic

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13 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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17 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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22 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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28 Connective tissue diseases
Lupus erythematosus Dermatomyositis Systemic sclerosis PAN – Wegener’s 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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32 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 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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40 Cutaneous markers Neoplasia Non-neoplastic Inherited conditions
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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44 Severe pre-existing skin disease
Erythroderma Extensive eczema Acute pustular psoriasis Leg ulcers – venous eczema Photosensitivity

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47 Introduction To Dermatology
Department of Dermatology (D2:F4) St Luke’s Hospital, Bradford Derek Barker Andrew Wright Kate London Suzanne Hatfield


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