AP401+Dermatology

= AP401 Dermatology =

Resources
Sample Questions: [|2008] [|2007] Sample Answers: 2008 2007
 * **Subject** || **Lecture Notes** || **mp3** || **Others** ||
 * Dermatology Intro || [|2008] [|2007] || [|2008] || [|Introduction to Dermatology.doc] ||
 * Psoriasis || [|2008] [|2007] || [|2008a] [|2008b] || [|Psoriasis.doc] ||
 * Eczema || [|2008] [|2007] || [|2008] || [|Eczema and Dermatitis.doc] ||
 * Contact Dermatitis || [|2008] [|2007] || [|2008] || [|Eczema and Dermatitis.doc] ||
 * Warts and Drug Eruptions || [|2008] [|2007] || [|2008] || [|Drug Eruptions & Warts.doc] ||
 * Acne || [|2008] [|2007] || [|2008] || [|Acne.doc] ||
 * Notes - Corticosteroids || [|2008] [|2007] ||  ||   ||
 * Notes - Lesions Summary || [|2008] [|2007] ||  ||   ||
 * Notes - Topical Therapy || [|2008] [|2007] ||  ||   ||

[|Conditions and Treatments]: dermatology edition

Outline
Date: Friday, September 21 Handouts: [|Dermatology 1a (Intro) - Handout] & [|Dermatology 1b (Psoriasis) - Handout] Slides: Dermatology 1a (Intro) - Slides & Dermatology 1b (Psoriasis) - Slides Audio: [|Dermatology 1a] & [|Dermatology 1b] Notes: Lecture slides are available for viewing in full colour to assist with diagrams and pictures, the lecture audio for this presentation is posted in mp3 format and provided for the purpose of revision support only [|contact dermatitis treatment] At the conclusion of this lecture students should be able to:
 * Dermatology 1: Naomi Burgess**

• **Describe the structure and function of skin** Comprised of two main layers: - Epidermis (5 sub-layers including the top layer stratum corneum which is continually shed) - Dermis (matrix supporting the epidermis – tensile strength, elastic properties, water retaining and contains blood vessels and nerves) - Hypodermis (sub-cutaneous or fatty layer, insulation, pliability and storage of nutrients) - Epidermal appendages (eccrine glands – sweat; sebaceous glands – lubricates and water repellent; apocrine glands – scent glands; hair follicles – protective, insulating; erectors pilorum – reaction to cold or fright; nails) Functions: [|contact dermatitis treatment]

- Barrier against damage to the internal organs - Regulation of temperature (vascular, sweat, pilo-erection) - Regulates fluid balance (sebum) - Sensory (heat and cold, pain) - Metabolic (vitamin D production)

Rash: - the totality of multiple lesions Types of lesions: - primary (macule, papule, nodule, vesicle – loculated serous fluid, bulla (blister > 5mm), pustule – neutrophil invasion of sub-corneal epidermis, wheal – oedematous papule, telangiectasia) - secondary (scales - hyperkeratosis, crust, erosion – loss of all or part of epidermis, ulcer – extends into or through the epidermis, excoriation, lichenification, atrophy, scar)
 * • Understand and use terminology associated with dermatology**
 * <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; font-weight: normal;">Lesion: **
 * <span style="font-family: 'Calibri','sans-serif'; font-size: 10pt; font-weight: normal;">- ****<span style="font-family: 'Arial','sans-serif'; font-size: 10pt; font-weight: normal;">a single area of skin pathology **
 * <span style="font-family: 'Calibri','sans-serif'; font-size: 10pt; font-weight: normal;">- ****<span style="font-family: 'Arial','sans-serif'; font-size: 10pt; font-weight: normal;">may be solitary or multiple, can coalescle to form larger confluent lesions **

- <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">large number of conditions often with similar appearance <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">- physical examination (palpation to detect tenderness, thickness etc., morphology of lesions, distribution and arrangement, all skin areas to be examined) <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">- history and family history: chronology, evolution of lesion, medications, recent and past illness, other – occupation, travel, family history <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">- laboratory investigations: biopsy, scraping, cultures, direct immunofluorescence, Wood’s light
 * • Understand the basis of the diagnosis of skin disease**

- <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">skin manifestation due to an internal cause (purpure and thrombocytopenia; pruritus and raised bilirubin; dry skin due to malabsorption and dehydration) - <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">skin causes disease of other organs: high output heart failure, burns) - <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">skin disease and systemic disease with common pathology: collagen vascular diseases; epilepsy due to glial proliferation with tuberous sclerosis  - <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">skin disease and systemic disease indirectly related: psoriasis and rheumatoid arthritis
 * • Understand the relationship between skin and systemic disease**

<span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">penetration of drug into skin: - <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">physicochemical properties of drug (polarity, solubility in lipid/base) - <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">nature of drug (concentration, composition/properties of base/vehicle) - <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">nature of skin (integrity of skin, age, site, flexural surfaces) - <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">method of application (frequency, strength, occlusion, hydration) - <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">external factors (temp, ambient water vapour pressure) <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">vehicles for topical therapy: - <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">site of application (moist, dry, hair bearing) - <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">effect required (localisation, occlusive, drying, cooling) <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">adverse effects: - <span style="font-family: 'Arial','sans-serif'; font-size: 10pt; line-height: 115%;">sensitisation, maceration, folliculitis, stinging with alcohol, allergy e.g. wool fat)
 * • Describe the principles of topical treatment**


 * • Describe basic lesion types**


 * • Describe the clinical signs of psoriasis**

Pharmacological Management - emollients - keratolytics - coal tar - phototherapy - photochemotherapy - systemic anti-mitotics - oral retinoids - dithranol - topical corticosteroids - topical vitamin D analogues Other oral agents cyclosporin, tacrolimus, alefacept, efalizumab, etanercept, infliximab
 * • Describe the common treatment modalities of psoriasis**

Date: Monday, September 24 Handouts: [|Dermatology 2a (Eczema) - Handout] & [|Dermatology 2b (Contact Dermatitis) - Handout] Slides: Dermatology 2a (Eczema) - Slides & Dermatology 2b (Contact Dermatitis) - Slides Audio: Dermatology 2a & Dermatology 2b Notes: Lecture slides are available for viewing in full colour to assist with diagrams and pictures, the lecture audio for this presentation is posted in mp3 format and provided for the purpose of revision support only At the conclusion of this lecture students should be able to:
 * Dermatology 2: Naomi Burgess**
 * • Describe the aetiology, classifications and onset of eczema**


 * • Describe the clinical signs of eczema and associated atopic presentations**


 * • Describe the common treatment modalities of acute and chronic eczema**


 * • Describe seborrhoeic dermatitis and its common treatment modalities**


 * • Describe direct contact dermatitis and its common treatment modalities**


 * • Describe allergic contact dermatitis and its common treatment modalities**

Date: Monday, September 24 Handouts: [|Dermatology 3a (Warts and Drug Eruptions) - Handout] & [|Dermatology 3b (Acne) - Handout] Slides: Dermatology 3a (Warts and Drug Eruptions) - Slides & Dermatology 3b (Acne) - Slides Audio: Dermatology 3a & Dermatology 3b Notes: Lecture slides are available for viewing in full colour to assist with diagrams and pictures, the lecture audio for this presentation is posted in mp3 format and provided for the purpose of revision support only At the conclusion of this lecture students should be able to:
 * Dermatology 3: Naomi Burgess**
 * • Describe the pathogenesis and common treatments for various warts**


 * • Describe urticaria and associated management options**


 * • Describe the basis of skin associated drug reactions**


 * • Describe the appearance and main types of drug associated skin reactions**


 * • Describe the aetiology, pathogenesis and common treatment options for the major forms of acne**

Other module resources: [|Dermatology Notes - Corticosteroids], [|Dermatology Notes - Lesions Summary] & [|Dermatology Notes - Topical Therapy]


 * Practice Questions:** [|Sample Questions (Dermatology)]