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Introduction To Dermatiology PowerPoint Presentation

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Introduction To Dermatology Dr D J Barker St Luke’s Hospital, Bradford
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What Are the Functions of the Skin? Temperature regulation Water conservation Protection (mechanical, UV, microbes) Sensation Synthesis & storage Psycho-sexual
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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
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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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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 > face >elsewhere Haemolytic streptococcus Mild pre-existing skin disease IV Benzyl penicillin Lymphoedema and relapse
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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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Infections - Herpes Zoster Varicella – Zoster virus Pain confined to a single dermatome Vesicles confined to single dermatome Patients are infectious IV Aciclovir
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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
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Anaphylaxis Urticaria – angioedema Bronchospasm, Laryngeal obstruction Hypotension Penicillin, peanuts, latex, insect stings Adrenaline Hydrocortisone & antihistamines Oxygen & IV fluids
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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
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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
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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 – Wegener’s granulomatosis
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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
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Erythema multiforme Oral, Ano-genital & Cutaneous ‘Target lesions’ are acral Often follows herpes simplex Lasts 10-14 days May be recurrent
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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
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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 (D2:F4) St Luke’s Hospital, Bradford Derek Barker Andrew Wright Kate London Suzanne Hatfield