BASIC DERMATOLOGYBASIC DERMATOLOGYHaseeb AhmedHaseeb Ahmed

2008-982008-98

Dermatology Dermatology Skin (Integument)Skin (Integument) Largest tissueLargest tissue Vital functionsVital functions Skin failureSkin failure Shock, collapse, deathShock, collapse, death Steven Johnson syndromeSteven Johnson syndrome Burns Burns

SKIN STRUCTURESKIN STRUCTURE

THREE LAYERS OF SKINTHREE LAYERS OF SKIN

EPIDERMISEPIDERMIS DERMISDERMIS SUBCUTANEOUS TISSUESUBCUTANEOUS TISSUE

EPIDERMISEPIDERMISFOUR LAYERSFOUR LAYERS

STRATUM CORNEUMSTRATUM CORNEUM STRATUM GRANULOSUMSTRATUM GRANULOSUM STRATUM SPINOSUMSTRATUM SPINOSUM STRATUM BASALESTRATUM BASALE

EPIDERMAL CELLSEPIDERMAL CELLS KERATINOCYTESKERATINOCYTES LANGERHAN’S CELLSLANGERHAN’S CELLS MELANOCYTESMELANOCYTES NEUROCEPTERSNEUROCEPTERS

Epidermal proteinsEpidermal proteins

KeratinKeratin FillagrinFillagrin ProfillagrinProfillagrin

DERMOEPIDERMAL DERMOEPIDERMAL JUNCTIONJUNCTION

THROWN INTO FOLDSTHROWN INTO FOLDS

DERMAL PAPPILLAEDERMAL PAPPILLAE

DERMISDERMIS

TWO PARTSTWO PARTS

PAPPILLARY DERMISPAPPILLARY DERMIS

RETICULAR DERMISRETICULAR DERMIS

DERMAL ELEMENTSDERMAL ELEMENTS

FIBRESFIBRES

COLLAGENCOLLAGEN ELASTINELASTIN RETICULINRETICULIN

DERMAL ELEMENTSDERMAL ELEMENTS

CELLSCELLS LYMPHOCYTESLYMPHOCYTES MACROPHAGESMACROPHAGES HISTIOCYTESHISTIOCYTES PLASMACELLSPLASMACELLS MAST CELLSMAST CELLS BASOPHILSBASOPHILS

APPENDAGESAPPENDAGES

HAIR FOLLICLESHAIR FOLLICLES SEBACEOUS GLANDSSEBACEOUS GLANDS SWEAT GLANDSSWEAT GLANDS NAILSNAILS

Pilosebaceous unitPilosebaceous unit

Hair follicles (slanting position)Hair follicles (slanting position) Sebaceous glands (sebum )Sebaceous glands (sebum )

Sweat glandsSweat glands

Apocrine (flexures)Apocrine (flexures) Eccerine Eccerine

Functions of skin Functions of skin

Protective barrierProtective barrier Environment Environment Temperature regulationTemperature regulation Immune functionsImmune functions First line of defence First line of defence Immune cellsImmune cells

Excretory functionsExcretory functions Waste materials, drugs, Waste materials, drugs, Electrolyte balanceElectrolyte balance Sweat Sweat Fluid balanceFluid balance Sweat Sweat

Metabolic functionsMetabolic functions Metabolic processesMetabolic processes Store house of caloriesStore house of calories Hormonal functionsHormonal functions Vitamin D3 (Cholecalciferol)Vitamin D3 (Cholecalciferol) Vitamin E (Tocopherol)Vitamin E (Tocopherol)

NeuroceptionNeuroception Receptors Dermoepidermal Receptors Dermoepidermal

junctionjunction Functions of modified structures Functions of modified structures

e.g.e.g. Hair, nailsHair, nails

MACULEMACULEAltered skin color less than Altered skin color less than 1 cm1 cm

PATCHPATCH Altered skin color more Altered skin color more than 1 cmthan 1 cm

PAPULEPAPULEPalpable lesion less than 1 Palpable lesion less than 1 cmcm

PLAQUEPLAQUE Palpable lesion more than 1 Palpable lesion more than 1 cmcm

VESICLEVESICLEWater filled lesion less than Water filled lesion less than 1 cm1 cm

BULLAEBULLAE Water filled lesion more Water filled lesion more than 1 cmthan 1 cm

PUSTULEPUSTULE Pus filled lesion Pus filled lesion

NODULENODULELesion 1 cm raised 1cm Lesion 1 cm raised 1cm broad broad

Excoriation/Scratch Excoriation/Scratch marks/Erosion marks/Erosion

Discontinuity of outer three layers Discontinuity of outer three layers of epidermis of epidermis

EXCORIATIONEXCORIATION

Erosion/Scratch markErosion/Scratch mark

Ulcer Ulcer

Discontinuity of outer three layers Discontinuity of outer three layers of epidermis with breakdown of of epidermis with breakdown of Dermoepidermal junctionDermoepidermal junction

ULCERULCER

ANNULAR LESIONANNULAR LESIONCircular lesion skin inside Circular lesion skin inside normal normal

LINEAR LESIONLINEAR LESIONLesions in one lineLesions in one line

HIVES (URTICARIAHIVES (URTICARIATransient erythematous Transient erythematous weals)weals)

ERYTHEMAERYTHEMALocalized rednessLocalized redness

ERYTHRODERMAERYTHRODERMARedness of 90% skin surface Redness of 90% skin surface areaarea

PURPURAPURPURABleeding into skin Bleeding into skin

HYPOPIGMENTATIONHYPOPIGMENTATIONSkin color less Skin color less

HYPERPIGMENTATIONHYPERPIGMENTATIONDarker colorDarker color

DEPIGMENTATIONDEPIGMENTATIONLoss of pigmentLoss of pigment

Lichenification Lichenification Thickening of skin with prominent Thickening of skin with prominent

skin creasesskin creases

Hstologicaly outer 3 layers Hstologicaly outer 3 layers thickened but basement thickened but basement membrane remains normalmembrane remains normal

TELENGIECTASIATELENGIECTASIADilated visible blood Dilated visible blood vesselsvessels

ATROPHYATROPHY

Scabies Scabies SARCOPTES SCABEIISARCOPTES SCABEII Burrow / vesicleBurrow / vesicle Genitals / fingure webs / toe websGenitals / fingure webs / toe webs Palms / solesPalms / soles

SCABIESSCABIES

SARCOPTES SARCOPTES SCABEIISCABEII

BURROWBURROW

Measles Measles

VIRAL INFECTIONVIRAL INFECTION Maculopapular eruptionMaculopapular eruption TrunkTrunk Febrile Febrile

MEASLESMEASLES

CHICKEN POXCHICKEN POXPolymorphic rashPolymorphic rashVARICELLA ZOSTERVARICELLA ZOSTER

SYSTEMIC LUPUS SYSTEMIC LUPUS ERYTHEMATOSUSERYTHEMATOSUSBUTTER FLY RASHBUTTER FLY RASH

Butterfly rashButterfly rash

Facial erythema Facial erythema

Raynaud’s Raynaud’s phenomenonphenomenon

Photosensitivity Photosensitivity

Photodermatitis Photodermatitis

Cheiltis Cheiltis

Oral ulcersOral ulcers

Lupus hairLupus hair

Livedoreticularis Livedoreticularis

Purpura Purpura

Acne Acne MULTIMORPHIC MULTIMORPHIC

LESIONSLESIONS