DERMATOLOGY | BASIC DISCUSSION


Dermatology : Basic Discussion

Skin is the largest organ of the body ( 8% of total body mass).
SKIN is the heaviest organ of the body (16% of total body weight ).
SKIN is the first step to your beauty !
Integumentary system : Skin & its appendages (hairs , nails,sebaceous gland, sweat glands)
 

Layers of the skin : 
A. EPIDERMIS
1. Stratum corneum (Horny layer)
2. Stratum lucidum (present in palm & sole only )
3. Stratum granulosum
4. Stratum spinolosum (Thickest layer)
5. Stratum basalis / germinativum
 

B. DERMIS:
1. Papilary layer
2. Reticular layer
 

Notes:
Thick skin means thick stratum corneum.
Thickest epidermis in palm & sole.
Thickest dermis on the back .
Thinnest dermis is eyelids.


Major functions of SKIN : 
Organ of protection ( Trauma , Sunlight etc.)
Secretion & excretion of substances (sweat , sebum ,drugs, etc)
Regulation of body temperature
Synthesis of Vitamin –D,
Percutaneous absorption of substance drugs)
 

Skin health depends on :
1) Genetic factors
2) Age
3) Environmental (occupational, sunlight)
4) Plenty of water intake
5) Anxiety free states – proper sleep – (physical & mental rest )
6) Low fatty diet & more vegetables intake
7) Avoid alcohol, tea , coffee
8) Appropiate skin care : Protection from sunlight, water wash , cosmetic use


Most common Skin problems in Bangladesh 

1. Superficial fungal infection.
2. Bacterial infection
3. Viral infections
4. Scabies
5. Acne
6. Eczema/Chronic Dermatitis
7. Atopic Dermatitis
8. Urticaria
9. Insect bite hypersensitivity
10. Seborrhoeic Dermatitis

11. Psoriasis
12. Pigmentary disoders
13. Hairs & nail disorders
14. Nevus and skin tumours
 

Cutaneous symtoms : (Patients complaints )


  • Pruritus / Itching : may be defined as a sensation that produce desire to scratch.
  • Alteration of skin color : Hyper/hypo pigmentations , reddish , yellowish
  • Pain & burning
  • Dryness & scaling
  • Skin rashes
  • Blister
  • Disfiguration ( Skin , nail , mucosa )
  • Hairs : decrease / increase

Cutaneous signs ( Doctors findings ) Basic skin lesions

# Primary lesions :
 Macule (< .5 cm ) Alteration of color of skin without elevation or depression.
Patch ( > .5 cm ) Alteration of color of skin without elevation or depression.
Papules ( < ,5cm ) Solid epidermal elevation.
Plaque (> .5cm ) Solid epidermal elevation.
Nodules : Solid epidermal & dermal elevation
Blister : Fluid containing with in epidermis or sub epidermis
Vesicles ( < .5cm )
Bulla ( > . 5 cm)


# Secondary skin lesions:
 * Scales / Squama / Exfoliate / Pityriasis : dead keratinocytes.
* Crust : Dead keratinocytes + Serum + Inflammatory infiltrates.
* Fissure : Linear crake.
* Erosion : Loss of Epidermis
* Ulcer : Loss of epidermis and dermis or other part.
* Pustule : Pus containing cavity.
Excessive formation of connective tissue—– Collagen fibers are arranged in parallel Scar—– Collagen fibers are
arranged in claw-like — Keloid


# Special skin lesions :

  • Erythema : Redness of skin due to cutaneous vasodilatation ( Temporary )
  • Telangiectasia : Permanent vasodilatation.
  • Purpura : Extravasetion of blood ( Non- blanching )

Superficial Fungal Infection
  •  Dermatophytosis/ Tineasis / Ringworm infection
  •  Pityriasis versicolor / Tinea versicolor (Malassezia furfur)
  •  Candiasis. 
  •  A dermatophyte is a fungus that has developed the ability to live on the keratin (hairs, nail or skin)  TYPES OF TINEASIS :
    (Based on site of involvement)
    1) Scalp- Tinea capitis (a) Inflammatory type : Kerion, Favus (b) Non- inflammatory type: Grey patch, Black dots
    2) Beard- Tinea barbae 3) Face- Tinea faciei4) Trunk, extremities- Tinea corporis / Tinea circinata

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