Sami N. Alsuwaidan, MD, FAAD ASSCOCIATE PROFESSOR AND CONSULTANT FOUNDER, CUTANEOUS LASER SURGERY DIVISION DIRECTOR, PSORIASIS RESEARCH CHAIR DEPARTMENT.

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Dermatology

Skin, hair, nails, and mucous membranes (mouth and genitila).

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Important functions of the skin

-Protection against external injury -Fluid balance

-Temperature buffering -Synthesis of Vit. D

-Immune system -Cosmetic function

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Why Dermatology?

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Epidermis

Dermis

Cornified layer

Spinous layer

Granular layer

Basal layer

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Dermis

Subcutaneous

Epidermis

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Skin Anatomy1 Epidermis2 Basement membrane (dermoepidermal junction)3 Dermis4 Subcutaneous fat

Epidermis: Four layers (from outside – inside)1. Cornified layer2. Granular layer3. Spinous layer4. Basal layer

Dermis contains:Collagen fibersElastic fibersGround substancesBlood vesselsNerves.

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Skin Appendages

Hair follicle Sebaceous gland Arrector pili muscle Eccrine sweat gland Apocrine sweat glands

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Hair follicle

Arrector Pilli muscle

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Apocrine gland

Sebaceous gland

Eccrine gland

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Nail Anatomy

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Examination

1. Morphology2. Configuration 3. Distribution

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Primary Lesions

Secondary lesions

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Primary Lesions

MaculePapule

PlaqueNodule

Wheal

VesicleBulla

Pustule

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Secondary lesions

Crust

Scale Ulceration

Excoriation

Scar

Fissure

Lichenification

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Distribution

Configuration

Color and Shape

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Some specific signs in Dermatology

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Dermatographism: When you stroke the normal skin edema and erythema (you can write on skin!) .Seen in physical urticaria

Kobener Phenomenon: Induction of new skin lesions on previously normal appearing skin by truma e.g. in psoriasis, wart, lichen planus

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Kobener Phenomenon

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Dermatographism

INVESTIGATIVE TOOLS

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Additional skin examination:~Wood’s Lamp: Produces long wave ultraviolet light(UVA). e.g. Vitiligo milky whiteTinea Versicolor goldenTinea Capitis (caused by microsporum) yellow greenErytherasma coral red

~Dermatoscopy: Helpful to differentiate benign from malignant pigmented lesions.

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Investigations:

*KOH and fungal culture•Scrap skin scales put over glass slide•Add KOH 10% -- warm gently•See under microscope•You may see hyphae and/ or spores

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Skin Prick Test

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Patch Test

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Investigations:

Skin biopsylocal anasthesia,different types: •Punch•Shave•Excisional•Incisional

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Treatment:

Topical

Systemic

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Topical Treatments

Various formulations:•Ointment•Cream•Gel•Solution•Lotion

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Topical steroids

7 Categories:

according to strength

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Phototherapy

Ultraviolet light A or Bwith or without psoralen

PUVA (Psoralen + UVA)New modalities:

Narrow band UVBUVA – 1

Excimer laser(308nm)

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Dermatology subspecialties

Pediatric dermatology Photomedicine Laser Hair Disorders and Transplantation Dermatologic surgery Allergy/Contact dermatitis Dermatopathology Immunodermatology Others

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