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- 1. Introduction To Dermatology Dr D J Barker Dr D J Barker St Lukes Hospital, Bradford St Lukes Hospital, Bradford
- 2. What Are the Functions of the Skin? Temperature regulation Temperature regulation Water conservation Water conservation Protection (mechanical, UV, microbes) Protection (mechanical, UV, microbes) Sensation Sensation Synthesis & storage Synthesis & storage Psycho-sexual Psycho-sexual
- 3. Why Refer to a Dermatologist? Diagnostic difficulty Diagnostic difficulty Management advice Management advice Failure of agreed treatment protocol Failure of agreed treatment protocol Patient counselling or education Patient counselling or education Increasing use of potent topical steroids Increasing use of potent topical steroids Special treatment e.g. PUVA Special treatment e.g. PUVA Special investigation e.g. Patch Tests Special investigation e.g. Patch Tests
- 4. In-patient Dermatology Infections Infections Urticaria & angioedema Urticaria & angioedema Drug eruptions Drug eruptions Connective tissue diseases Connective tissue diseases Erythema nodosum & multiforme Erythema nodosum & multiforme Cutaneous marker of systemic disease Cutaneous marker of systemic disease Severe pre-existing skin disease Severe pre-existing skin disease
- 5. In-patient Dermatology Infections Infections Urticaria & angioedema Urticaria & angioedema Drug eruptions Drug eruptions Connective tissue diseases Connective tissue diseases Erythema nodosum & multiforme Erythema nodosum & multiforme Cutaneous marker of systemic disease Cutaneous marker of systemic disease Severe pre-existing skin disease Severe pre-existing skin disease
- 8. Infections - Erysipelas Fever & Rigor Fever & Rigor Defined erythematous rash Defined erythematous rash Leg > face >elsewhere Leg > face >elsewhere Haemolytic streptococcus Haemolytic streptococcus Mild pre-existing skin disease Mild pre-existing skin disease IV Benzyl penicillin IV Benzyl penicillin Lymphoedema and relapse Lymphoedema and relapse
- 11. Infections Herpes simplex Severe primary infection Severe primary infection Kaposis varicelliform eruption Kaposis varicelliform eruption Atopic eczema Atopic eczema Cutaneous T-cell lymphoma Cutaneous T-cell lymphoma Dariers disease Dariers disease IV Aciclovir IV Aciclovir Anti-staphylococcal antibiotic Anti-staphylococcal antibiotic
- 13. Infections - Herpes Zoster Varicella Zoster virus Varicella Zoster virus Pain confined to a single dermatome Pain confined to a single dermatome Vesicles confined to single dermatome Vesicles confined to single dermatome Patients are infectious Patients are infectious IV Aciclovir IV Aciclovir
- 14. In-Patient Dermatology Infections Infections Urticaria & angioedema Urticaria & angioedema Drug eruptions Drug eruptions Connective tissue diseases Connective tissue diseases Erythema nodosum & multiforme Erythema nodosum & multiforme Cutaneous marker of systemic disease Cutaneous marker of systemic disease Severe pre-existing skin disease Severe pre-existing skin disease
- 17. Urticaria May be associated with angioedema May be associated with angioedema Vasoactive amine release from mast Vasoactive amine release from mast cells cells Acute attacks frightening, not Acute attacks frightening, not dangerous dangerous Most attacks have no simple cause Most attacks have no simple cause Antihistamines Antihistamines
- 18. Anaphylaxis Urticaria angioedema Urticaria angioedema Bronchospasm, Laryngeal obstruction Bronchospasm, Laryngeal obstruction Hypotension Hypotension Penicillin, peanuts, latex, insect stings Penicillin, peanuts, latex, insect stings Adrenaline Adrenaline Hydrocortisone & antihistamines Hydrocortisone & antihistamines Oxygen & IV fluids Oxygen & IV fluids
- 19. In-Patient Dermatology Infections Infections Urticaria & angioedema Urticaria & angioedema Drug eruptions Drug eruptions Connective tissue diseases Connective tissue diseases Erythema nodosum & multiforme Erythema nodosum & multiforme Cutaneous marker of systemic disease Cutaneous marker of systemic disease Severe pre-existing skin disease Severe pre-existing skin disease
- 22. Drug eruptions - 1 Morbilliform Morbilliform Toxic epidermal necrolysis Toxic epidermal necrolysis Fixed drug eruption Fixed drug eruption Stevens-Johnson syndrome Stevens-Johnson syndrome Lichenoid drug rash Lichenoid drug rash Acneiform Acneiform
- 23. Drug eruptions - 2 Any drug, any rash, any time Any drug, any rash, any time Likely: sulphonamides, penicillins Likely: sulphonamides, penicillins Unlikely: digoxin, insulin Unlikely: digoxin, insulin Suspect recent agents Suspect recent agents Stop inessential drugs Stop inessential drugs A dermatologist may not solve your A dermatologist may not solve your problem problem
- 24. In-Patient Dermatology Infections Infections Urticaria & angioedema Urticaria & angioedema Drug eruptions Drug eruptions Connective tissue diseases Connective tissue diseases Erythema nodosum & multiforme Erythema nodosum & multiforme Cutaneous marker of systemic disease Cutaneous marker of systemic disease Severe pre-existing skin disease Severe pre-existing skin disease
- 28. Connective tissue diseases Lupus erythematosus Lupus erythematosus Dermatomyositis Dermatomyositis Systemic sclerosis Systemic sclerosis PAN Wegeners granulomatosis PAN Wegeners granulomatosis
- 29. In-Patient Dermatology Infections Infections Urticaria & angioedema Urticaria & angioedema Drug eruptions Drug eruptions Connective tissue diseases Connective tissue diseases Erythema nodosum & multiforme Erythema nodosum & multiforme Cutaneous marker of systemic disease Cutaneous marker of systemic disease Severe pre-existing skin disease Severe pre-existing skin disease
- 32. Erythema nodosum Sarcoidosis Sarcoidosis Post-streptococcal Post-streptococcal TB TB Inflammatory bowel disease Inflammatory bowel disease Leprosy Leprosy Histoplasmosis, coccidiomycosis Histoplasmosis, coccidiomycosis
- 33. Erythema multiforme Oral, Ano-genital & Cutaneous Oral, Ano-genital & Cutaneous Target lesions are acral Target lesions are acral Often follows herpes simplex Often follows herpes simplex Lasts 10-14 days Lasts 10-14 days May be recurrent May be recurrent
- 34. In-Patient Dermatology Infections Infections Urticaria & angioedema Urticaria & angioedema Drug eruptions Drug eruptions Connective tissue diseases Connective tissue diseases Erythema nodosum & multiforme Erythema nodosum & multiforme Cutaneous marker of systemic disease Cutaneous marker of systemic disease Severe pre-existing skin disease Severe pre-existing skin disease
- 40. Cutaneous markers Neoplasia Neoplasia Acanthosis nigricans, Dermatomyositis Acanthosis nigricans, Dermatomyositis Secondaries & infiltrates Secondaries & infiltrates Non-neoplastic Non-neoplastic Sarcoidosis and xanthomas, Sarcoidosis and xanthomas, Endocrine: e.g. necrobiosis, PTM Endocrine: e.g. necrobiosis, PTM Inherited conditions Inherited conditions Neurofibromatosis Neurofibromatosis Tuberous sclerosis Tuberous sclerosis
- 41. In-Patient Dermatology Infections Infections Urticaria & angioedema Urticaria & angioedema Drug eruptions Drug eruptions Connective tissue diseases Connective tissue diseases Erythema nodosum & multiforme Erythema nodosum & multiforme Cutaneous marker of systemic disease Cutaneous marker of systemic disease Severe pre-existing skin disease Severe pre-existing skin disease
- 44. Severe pre-existing skin disease Erythroderma Erythroderma Extensive eczema Extensive eczema Acute pustular psoriasis Acute pustular psoriasis Leg ulcers venous eczema Leg ulcers venous eczema Photosensitivity Photosensitivity
- 47. Introduction To Dermatology Department of Dermatology (D2:F4) Department of Dermatology (D2:F4) St Lukes Hospital, Bradford St Lukes Hospital, Bradford Derek Barker Andrew Wright Derek Barker Andrew Wright Kate London Suzanne Hatfield Kate London Suzanne Hatfield