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Introduction to Dermatology PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "INTRODUCTION TO DERMATOLOGY".

This medical PowerPoint presentation talks about dermatology, the branch of medicine that deals with the study, diagnosis, and treatment of conditions related to the skin, hair, nails, and mucous membranes. The skin is the largest organ of the body and plays a crucial role in protecting the body from external factors such as infections, injuries, and UV radiation.

Dermatologists are medical specialists who diagnose and treat a wide range of skin-related conditions, including skin cancers, acne, eczema, psoriasis, warts, and various other skin infections. They also deal with issues related to hair loss, nail disorders, and sexually transmitted infections (STIs) that may affect the skin.

Dermatology involves a comprehensive approach to patient care, which may include a physical examination, laboratory tests, and imaging studies. Treatment options may vary depending on the condition and severity, and may include medications, surgery, or other therapeutic procedures.

In addition to treating skin conditions, dermatologists also provide preventive care, education, and counseling to help patients maintain healthy skin and reduce the risk of developing skin-related diseases. They also play an important role in educating the public about the dangers of excessive sun exposure and the importance of early detection of skin cancers.

Tags : dermatology, Dermatologists, skin cancers, acne, eczema, psoriasis, warts, skin infections, Dermatology, Dermatology PowerPoint presentation

Published on : Mar 31, 2023 | Views : 3012 | Downloads : 6

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Slide 1-

INTRODUCTION TO DERMATOLOGY
Slide 2-

Objectives of the course To know the normal skin structure. To be able to take proper history. To be able to describe lesions by using proper dermatological terminology. To be able to formulate a differential diagnosis. To be able to diagnose and treat common skin disorders. To be familiar with dermatologic emergencies .
Slide 3-

Lecture outlines Function , Structure of the skin. Approach to dermatology patient. Descriptive Terms and morphology of skin lesions. Important signs and Investigations. Topical therapy.
Slide 4-

Introduction to dermatology The skin is a complex, dynamic organ. It is the largest organ of the body.
Slide 5-

Function Barrier to harmful exogenous substance & pathogens. Prevents loss of water & proteins. Sensory organ protects against physical injury. Regulates body temperature. Important component of immune system. Vit .D production by absorbing UVB. Has psychological and cosmetic importance such as hair, nails.
Slide 6-

Skin Structure The skin consists of: Epidermis Basement membrane Dermis Subcutaneous tissue Skin appendages
Slide 7-

Epidermis "epi" coming from the Greek meaning "over" or "upon” Is the outermost layer of the skin. The main type of cells are: Keratinocytes Melanocytes Merkel cells Langerhans cells which make up the epidermis
Slide 8-

Skin Structure Epidermis: Consist of several zones Basal layer (stratum basale) :columnar dividing cells. Spinous layer (stratum spinosum): polyhedral cells attached by desmosomes. Granular layer (stratum granulosum): flat cells containing keratohyaline granules. Cornified layer (stratum corneum ):dead cell with no organells. 7
Slide 9-

Skin Structure Basal cell layer (stratum basale): Rest on the basement membrane. Divides continuously and move upwards. Melanocytes are dendritic cells lying between basal cells in a ratio of 1:10 . They synthesize melanin stored in melanosomes. 10 Keratinocytes 1 melanocyte
Slide 10-

Skin Structure Spinous cell layer (stratum spinosum): Adhere to each other by Desmosomes (complex modification of the cell membrane). Desmosomes appear like spines hence the designation Stratum Spinosum. Langerhan cells are antigen presenting present in abundance .
Slide 11-

Skin Structure Granular cell layer (stratum granulosum): Diamond shaped cells. Cytoplasm is filled with Keratohyaline granules. Thickness of this layer is proportional to the thickness of the stratum cornium layer . In thin skin it is 1 -3- cell layers and 10 cell layers in thick skin.
Slide 12-

Skin Structure Cornified layer (stratum corneum): The cells in this layer have no nucleus . It is 25 cell layer . Cells have thick envelope that resist chemicals.
Slide 13-

Basement membrane It is a pink undulated homogenous area between the epidermis and dermis It consist of number of proteins. It is the site of attack injury in blistering diseases.
Slide 14-

Basement membrane Formed by: Plasma membrane of basal cells and hemidesmosomes. Thin clear amorphous space (lamina lucida). An electron dense area (lamina densa ). Anchoring fibrils that anchors the epidermis to dermis .
Slide 15-

Skin structure Dermis: is divided into Papillary dermis. Reticular dermis. Consists of : 1)Collagen fibers: Provides strength Thin fibers in papillary dermis but thick and coarse in the reticular dermis .
Slide 16-

Skin Structure 2) Elastic Fibers: Provides elasticity Protection against shearing forces.
Slide 17-

Skin structure 3) Ground substance: Binds water and maintains the skin turgor. 4) Blood vessels: To nourish the overlying epidermis also. 5) Fibroblasts: Produce the above elements.
Slide 18-

Skin Structure Function of dermis: It provides nourishment to the epidermis and interact with it during wound repair. It gives the skin its strength, elasticity, and softness.
Slide 19-

Skin structure Subcutaneous Fat: lies below the dermis. Attach the skin to underlying bone and muscle as well as supplying it with blood vessels and nerves. The main cell types are fibroblasts, macrophages and adipocytes .
Slide 20-

Skin Structure Skin Appendages: include Eccrine/ apocrine sweat glands. Sebaceous glands. Hair Follicles. Nails
Slide 21-

Skin appendages Eccrine sweat glands: Tubular structures open freely on the skin ;not attached to hair follicles. Under the influence of cholinergic stimuli. Present everywhere except the vermilion border ; nail beds ; labia minora and glans. Abundant in palms and soles.
Slide 22-

Skin appendages Apocrine sweat glands: Secrete viscous material that give musky odor when acted upon by bacteria. Present in the axillae ; anogenital area ; modified glands in the external ear canal ; the eye lids ( moll’s glands ) ; and areolae. Under adrenergic stimuli.
Slide 23-

Skin appendages Sebaceous glands: Attached to hair follicles or open freely. Present in the scalp, forehead, face,upper chest except palms and soles. Secrete sebum to moisturize the skin. Sebaceous glands are under the control of androgens.
Slide 24-

Skin Appendages Hair follicles: Hair follicle has the hair shaft, hair bulb and the bulge. Pilosebaceous unit include: hair follicle+sebaceous gland+ arrector pili muscle.
Slide 25-

Skin appendages Nails: The nail plate is formed of hard keratin. Proximal nail fold morphology can be altered in connective tissue disease . The lunula is the visible part of the matrix. The matrix covers the midportion of the distal Phalanx.
Slide 26-

Skin appendages Fingernails grow 3mm/month. Toenails grow 1mm/month. Nails can be affected in systemic and skin diseases
Slide 27-

Lecture Outlines Function , Structure of the skin. Approach to dermatology patient. Descriptive Terms and morphology of skin lesions. Important signs and Investigations. Topical therapy.
Slide 28-

Approach to Dermatology Patient Step 1: Start with basics Age Race Sex Occupation
Slide 29-

Approach to Dermatology Patient Step 2 : History of skin lesion When? Onset. Where? site of onset. Extension of lesions. Evolution. Associated symptoms. Aggravating factors. Treatment.
Slide 30-

Approach to dermatology patient Past medical history. Family history. Drug history. Occupational, travel and social history.
Slide 31-

Examination Use good light when examining a patient. Examine hair, nails & mucous membrane.
Slide 32-

Examination Describe.. General appearance of patient. Distribution of lesions. Arrangement. Type. Shape. Color. Size.
Slide 33-

Examination Palpation: Look for consistency, mobility, depth and tenderness.
Slide 34-

Distribution Generalized :can be Symmetrical: 1.Universal (head to toe). 2.Bilateral. Asymmetrical: 1.Diffuse. 2.Unilateral.
Slide 35-

Distribution Localized: Acral. Malar. Sun exposed. Trauma sites. Flexures. Specific part.
Slide 36-

Lecture outlines Function , Structure of the skin. Approach to dermatology patient. Descriptive Terms and morphology of skin lesions. Important signs and Investigations. Topical therapy.
Slide 37-

Descriptive Terms (Arrangement)
Slide 38-

Descriptive Terms Photodistribution: Lesions occurring over sun exposed skin. Protected areas remain free of lesions.
Slide 39-

Descriptive Terms Linear: Forms a line .
Slide 40-

Descriptive Terms Dermatomal: Occurring within the distribution of nerve.
Slide 41-

Descriptive Terms Annular: Ring like .
Slide 42-

Descriptive Terms Herpitiform/Grouped: Lesions grouped in a manner similar to herpes simplex lesions
Slide 43-

Descriptive Terms Reticular: Net like .
Slide 44-

Descriptive Terms Verrucous, warty, papillomatous: Surface consisting of finger like projections.
Slide 45-

Descriptive Terms Nummular/discoid: coin like lesions.
Slide 46-

Descriptive Terms Guttate: Drop like, “en gouttes”.
Slide 47-

Descriptive Terms Targetoid: Round lesions with concentric border and a dark center. Iris like.
Slide 48-

Descriptive Terms Umbilication: Round depression in the center.
Slide 49-

Morphology Skin lesions are divided into: Primary =Basic lesion. Secondary= Develop during evolution of skin disease or created by scratching or infection
Slide 50-

Morphology Primary lesions Macule/patch Papule/plaque Nodule Cyst Wheal Secondary lesions
Slide 51-

Morphology Primary lesions Vesicle/bulla Pustule Purpura Secondary lesions Excoriation Erosion Scale Fissure Ulcer
Slide 52-

Primary Skin Lesions Macule : A flat circumscribed area of altered skin color less than 1 cm in size. Lacks surface elevation or depression.
Slide 53-

Primary lesions Patch: Flat circumscribed skin discoloration; More than 1cm.
Slide 54-

Primary Skin Lesions Papule : Elevated, Solid lesion < 0.5cm in diameter.
Slide 55-

Primary Skin Lesion Plaque: Elevated, solid confluence or expansion of papules . > 0.5cm in diametern(lacks a deep component ).
Slide 56-

Primary Skin Lesions Nodule: Elevated, Solid lesion. > 0.5 cm in diameter; with deep component.
Slide 57-

Primary Skin Lesions Cyst: Closed sac-like lesion that contain liquid or semi-solid substance. Usually soft and has depth.
Slide 58-

Primary Skin Lesions Vesicle: Elevation that contains clear fluid < 0.5cm in diameter. Bulla: Localized fluid collection. >0.5cm in diameter (large vesicle).
Slide 59-

Primary Skin Lesions Purpura: Extra-vasation of red blood cells giving non- blanchable erythema.
Slide 60-

Primary Skin Lesion Wheal: A transient, edematous slightly raised lesion, characteristically with a pale center and a pink margin.
Slide 61-

Primary Skin Lesions Pustule: Elevation that contains purulent material.
Slide 62-

Secondary Skin Lesions Scale: Thick stratum cornium
Slide 63-

Secondary Skin Lesion Crust: A collection of cellular debris, dried serum and blood . Antecedent primary lesion usually a vesicle, bulla, or pustule.
Slide 64-

Secondary Skin Lesions Erosion: A partial focal loss of epidermis that heals without scarring.
Slide 65-

Secondary Skin Lesions Excoriation: Linear erosion induced by scratching.
Slide 66-

Secondary Skin Lesions Fissure : Vertical loss of epidermis and dermis with sharply defined walls, (crack in skin).
Slide 67-

Secondary Skin Lesion Ulcer: A full thickness focal loss of epidermis and dermis; heals with scarring
Slide 68-

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Slide 69-

Secondary Skin Lesions Scar: A collection of new connective tissue. May be Hypertrophic or Atrophic. Implies dermoepidermal damage.
Slide 70-

Secondary Skin Lesions Lichenification: Increased skin markings secondary to scratching.
Slide 71-

Lecture Outlines Function , Structure of the skin. Approach to dermatology patient. Descriptive Terms and morphology of skin lesions. Important signs and Investigations. Topical therapy.
Slide 72-

Important Sign in Dermatology NIKOLSKY SIGN: Rubbing of apparently normal skin induce blistering. Seen in pemphigus vulgaris and toxic epidermal necrolysis (TEN)
Slide 73-

Important Signs in Dermatology AUSPITZ SIGN: Removal of scale on top of a red papule produces bleeding points. Seen in psoriasis.
Slide 74-

Important Sign in Dermatology Koebner’s phenomenon: Trauma to the skin re- produce certain diseases like: Psoriasis Vitiligo Lichen planus. Warts.
Slide 75-

Important Signs in Dermatology DERMATOGRAPHISM: Firm stroking of the skin produce erythema and wheal. Seen in physical urticaria. In patient with atopy, stroking produces white dermatographism ratherthan red.
Slide 76-

Investigations Wood’s lamp: Produces long wave UVL (360 nm) Useful in: Tinea Versicolor-yellowish green flourescence. Tinea Capitis -yellow green flourescence in M.canis, M. andouini. Vitiligo - Milky white. Erythrasma –coral red flourescence. Melasma becomes more intensefied.
Slide 77-

Investigation KOH preparation for fungus: Cleanse skin with alcohol Swab. Scrape skin with edge of microscope slide onto a second microscope slide. Put on a drop of 10% KOH. Apply a cover slip and warm gently. Examine with microscope.
Slide 78-

Investigation Tzank smear : Important in diagnosing: Herpes simplex or VZV (multinucleated giant cells). Pemphigus Vulgaris (acantholytic cells).
Slide 79-

Tzank smear Select a fresh vesicle. De-roof and scrape base of the vesicle. Smear onto a slide. Fix with 95% alcohol. Stain with Giemsa stain. Examine under microscope.
Slide 80-

Investigation Prick test : Primary method for the diagnosis of IgE mediated allergies in most allergic diseases. Useful in the diagnosis of hay fever allergy, food allergy, latex allergy, drug allergy and bee and wasp venom allergy.
Slide 81-

Prick test Put a drop of allergen containing solution. A non bleeding prick is made through the drop. After 15-20 min the antigen is washed , the reaction is recorded. Positive test shows urticarial reaction at site of prick. Emergency therapeutic measures should be available in case of anaphylaxis.
Slide 82-

Investigations PATCH SKIN TEST: Useful diagnostic test for patients with allergic contact dermatitis. Select the most probable substance causing dermatitis. Apply the test material over the back.
Slide 83-

PATCH SKIN TEST Read after 48 & 72 hr. Positive patch test showing erythema and edema. In severe positive reaction vesicles may be seen.
Slide 84-

Investigation SKIN PUNCH BIOPSY: Clean skin with alcohol. Infiltrate with 1-2% xylocaine with adrenaline. Rotate 2-6 mm diameter punch into the lesions.
Slide 85-

SKIN PUNCH BIOPSY: Lift specimen and cut at base of lesion. Fix in 10% formalin For Immunoflourescence put in normal saline. Suture if 4 or 5 mm is used.
Slide 86-

Investigations Direct immunoflouresence DIF: Used to diagnose autoimmune diseases e.g. Pemphigus Vulgaris, Bullous pemphigoid Detects immunoglobulin and complement deposits in skin. The deposits will give a green fluorescence
Slide 87-

Investigations Indirect ImmunoFluorescence : IDIF Detect auto antibodies in the serum. It is used: To confirm a diagnosis. To differentiate between bullous diseases. To monitor disease activity.
Slide 88-

Lecture Outlines Function , Structure of the skin. Approach to dermatology patient. Descriptive Terms and morphology of skin lesions. Important signs and Investigations. Topical therapy.
Slide 89-

Topical Therapy A wide variety of topical agents are available. Delivers the drug to target site. Golden rule: IF the lesion is dry -wet it iF wet -dry it.
Slide 90-

Topical Therapy Topical drugs consist of: Active substance: like steroids, antimicrobial agents. Vehicle: Is the base in which the active ingredient is dispersed.
Slide 91-

Topical therapy Topical steroids side effects: Atrophy and striae. Telangiectasia and purpura. Masking the initial lesion. Perioral dermatitis and rosacea or acne. Systemic absorption. Tachyphylaxis (sudden loss of response).
Slide 92-

Topical therapy Guidelines regarding steroid use: Avoid high potency steroid on flexures and face. Avoid high potency steroid in children. Avoid use for extended periods of time.
Slide 93-

Topical Therapy Cream is 50 % oil and 50 % water. creams are useful in wet lesions. They are white in color.
Slide 94-

Topical Therapy Ointment is 80 % oil and 20 % water. Ointments are useful in dry lesions. They are translucent.
Slide 95-

Topical Therapy Gels are mixtures of propylene glycol and water. Sometimes they contain alcohol. They are translucent. used in wet lesions and hairy regions.
Slide 96-

How much to use? Finger tip unit: The amount of cream/ointment expressed from 5mm nozzle. It weighs 0.5g. It covers 2 hand units.
Slide 97-

Finger Tip Unit
Slide 98-

Phototherapy machine/NBUVB Other therapeutic modalities
Slide 99-

Hand and feet narrow band UVB
Slide 100-

Vitiligo treated by NBUVB Other indications include psoriasis lichen planus and atopic dermatitis.
Slide 101-

Liquid nitrogen gun (Cryotherapy). Used to treat warts.
Slide 102-

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