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dermatology
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Lecture notes of 13 pages for the course medicine at U of G (dermatology)
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o Tinea Crura (Pubic Area)- Diagnosis:
o Clinical Diagnosis
o Woods lamp ʹ only Microsporum canis fluoresces
o Microscopy of hairs/nail shavings/skin shavings
- Treatment:
o Topical Antifungals:
③ Clotrimazole
③ Miconazole
o Oral Antifungals:
③ Fluconazole
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- Yeasts (Eg. Candida):
o Cutaneous Candidiasis – (Candida Albicans):
③ (= Overgrowth of Normal Commensal of the mouth, vagina, or lower GIT.)
③ Only infects the outer layers of the epithelium of mucous membrane or skin.
③ Presentation:
ξ Red, macerated area
ξ Glistening Surface
ξ Scaling along the advancing border.
ξ The initial lesion is a papule that then becomes a pustule.
ξ Important clinical feature с presence of ‘satellite’ pustules beyond the border of
the main infection.
③ Treatment:
ξ Topical Therapy
o Oral Candidiasis – (Candida Albicans):
③ Presents as:
ξ White Patches easily scraped off to leave a red, raw base.
ξ Chronic red, raw gums, tongue and buccal mucosa.
ξ Treatment: Topical or Systemic Therapy
o Pityriasis versicolour – (Candida Albicans):
③ Caused by normal Commensals ʹ Eg. yeasts (Candida).
③ Common Superficial Fungal-Induced Rash
③ Presentation:
ξ ⮴flaky discoloured patches on chest & back.
ξ Small, well defined, slightly scaly patches
ξ Either Hyperpigmented or Hypopigmented
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DERMATOLOGY Pathology:
Skin Infections – Parasitic
Insects:
- Scabies:
o Organism:
③ Sarcoptes scabiei (Scabies Mite)
o Epidemiology:
③ Human infestations originating from pigs, horses and dogs are mild and self limiting.
③ Scabies infestations from other humans never cure without intervention.
o Ecology:
③ Mites live in stratum corneum (Don’t get any deeper Ϳ
③ Eat stratum corneal Keratinocytes
③ Make “tunnels” by eating
③ Mating occurs on the hosts skin
③ Fertilized Female Mites Burrow into the Stratum Corneum (1 mm deep)
③ Salivary Secretions contain Proteolytic Enzymes ⮴Digest Keratinocytes.
o Transmission:
③ High prevalence in children (50%) and adults (25%) in tropical remote communities
③ Spread by close physical contact
o Presentation:
③ Itch (Exacerbated at night and after hot showers).
③ Itchy, Excoriated Rash on Trunk, associated with Scaly Burrows on the fingers and wrists.
③ Often vesicles and pustules on the palms and soles and sometimes on the scalp.
o Diagnosis:
③ Clinical Diagnosis:
ξ Chronic itch with Symmetrical Rassh
ξ Burrows
③ Skin Scraping - Look for Scabies Mites:
ξ Intact larvae, nymphs or adults
ξ Unhatched or hatched eggs
ξ Moulted skins of mites
ξ Fragments of moulted skins
ξ Mite faeces
o Treatment:
③ Topical Permethrin
③ Or Oral Ivermectin (But not on PBS – Very Expensive)
③ Environmental Measures:
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