Summary
Samenvatting dermatologie
- Course
- Institution
KU Leuven, 2e master - zintuigen 1 Dit is een samenvatting van het deel 'dermatologie'. Het bevat alle leerstof van de powerpoints van prof De Haes, prof Van Laethem en prof Bosisio.
[Show more]
Seller
Follow
zGNK
Reviews received
Content preview
INHOUDHoofdstuk 1: onderzoek van de huid .....................................................................................................1
Algemene principes ..........................................................................................................................1
Efflorescenties .................................................................................................................................1
Primair .........................................................................................................................................1
Secundair .....................................................................................................................................2
Distributie en lokalisatie (predilectieplaatsen) ...................................................................................2
Afmeting, rangschikking en vorm .......................................................................................................2
Hoofdstuk 2: bulleuze dermatosen .......................................................................................................3
Inleiding huid ...................................................................................................................................3
Congenitaal: Epidermolysis Bullosa ..................................................................................................3
Epidermolysis Bullosa Simplex ......................................................................................................3
Junctionele Epidermolysis Bullosa .................................................................................................3
Dystrofische Epidermolyis Bullosa .................................................................................................4
Verworven: auto-immuun .................................................................................................................4
Pemphigus groep ..........................................................................................................................4
Pemphigus vulgaris .................................................................................................................4
Pemphigus foliaceus ...............................................................................................................5
Pemphigoid groep .........................................................................................................................5
Bulleus pemphigoid .................................................................................................................5
Lineaire IgA dermatose ............................................................................................................6
Dermatitis herpetiformis ...............................................................................................................6
Hoofdstuk 3: contactdermatitis of contacteczeem ................................................................................8
Dermatitis (eczeem) .........................................................................................................................8
Contactdermatitis (contacteczeem) ..................................................................................................8
Irritatiedermatitis ..........................................................................................................................8
Allergische contactdermatitis ........................................................................................................9
Hoofdstuk 4: atopisch en seborrheïsch eczeem................................................................................... 12
Dermatitis (eczeem) ....................................................................................................................... 12
Atopische dermatitis (atopisch eczeem) .......................................................................................... 12
Intrinsieke of genetische factoren ................................................................................................ 12
Omgevingsfactoren ..................................................................................................................... 12
Kliniek ........................................................................................................................................ 13
Diagnose .................................................................................................................................... 14
Complicaties .............................................................................................................................. 14
Behandeling eczeem ................................................................................................................... 14
Inhoud
, Algemene maatregelen .......................................................................................................... 14
Lokale behandeling ............................................................................................................... 14
Corticosteroïden ............................................................................................................... 14
Calcineurine inhibitoren .................................................................................................... 15
Lichtbehandeling .................................................................................................................. 15
Systemische behandeling ...................................................................................................... 15
Ciclosporine ..................................................................................................................... 15
Biologicals ........................................................................................................................ 15
Small molecule inhibitoren ................................................................................................ 16
Behandeling surinfecties ............................................................................................................. 16
Behandeling jeuk ........................................................................................................................ 16
Seborrheïsche dermatitis (seborrheïsch eczeem) ............................................................................. 16
Kliniek ........................................................................................................................................ 16
Behandeling ............................................................................................................................... 18
Hoofdstuk 5: psoriasis ....................................................................................................................... 19
Kliniek............................................................................................................................................ 19
Psoriasis vulgaris: plaque ............................................................................................................ 19
Psoriasis vulgaris: guttata ............................................................................................................ 19
Psoriasis vulgaris: inversa ........................................................................................................... 20
Psoriasis vulgaris: nagels ............................................................................................................ 20
Psoriasis non-vulgaris: pustulosa ................................................................................................ 20
Psoriasis non-vulgaris: erythrodermie .......................................................................................... 20
Ontstaansmechanisme .................................................................................................................. 21
Genetische aanleg ...................................................................................................................... 21
Uitlokkende factoren................................................................................................................... 21
Behandeling ................................................................................................................................... 21
Lokale behandeling ..................................................................................................................... 21
Corticosteroïden ................................................................................................................... 21
Vitamine D analogen ............................................................................................................. 22
Teerzalf ................................................................................................................................. 22
Lichtbehandeling ........................................................................................................................ 22
Systemische behandeling ........................................................................................................... 23
Acitretine .............................................................................................................................. 23
Methotrexaat ......................................................................................................................... 23
Ciclosporine ......................................................................................................................... 24
Biologicals ............................................................................................................................ 24
Small molecule inhibitoren .................................................................................................... 24
Inhoud
,Hoofdstuk 6: bacteriële infecties van de huid ...................................................................................... 26
Door overgroei van commensale flora.............................................................................................. 26
Erythrasma ................................................................................................................................. 26
Trichomycosis palmellina............................................................................................................ 26
Pitted keratolysis ........................................................................................................................ 26
Behandeling ............................................................................................................................... 26
Door pathogene kiemen .................................................................................................................. 27
Niet-bulleuze impetigo ................................................................................................................ 27
Bulleuze impetigo ....................................................................................................................... 27
Ecthyma ..................................................................................................................................... 28
Folliculitis .................................................................................................................................. 28
Furunkel ..................................................................................................................................... 29
Karbunkel ................................................................................................................................... 30
Erysipelas................................................................................................................................... 30
Cellulitis..................................................................................................................................... 31
Hoofdstuk 7: acne vulgaris ................................................................................................................. 32
Inleiding ......................................................................................................................................... 32
Klinische varianten ......................................................................................................................... 32
Behandeling ................................................................................................................................... 33
Isotretinoïne ............................................................................................................................... 34
Topisch retinoïd .......................................................................................................................... 34
Benzoylperoxide ......................................................................................................................... 35
Topische antibiotica .................................................................................................................... 35
Orale antibiotica ......................................................................................................................... 35
Orale contraceptiva .................................................................................................................... 36
Hoofdstuk 8: acne inversa – hidradenitis suppurativa ........................................................................... 37
Inleiding ......................................................................................................................................... 37
Kliniek............................................................................................................................................ 37
Behandeling ................................................................................................................................... 37
Hoofdstuk 9: rosacea ......................................................................................................................... 39
Kliniek............................................................................................................................................ 39
Behandeling ................................................................................................................................... 40
Lokale behandeling ..................................................................................................................... 40
Systeembehandeling .................................................................................................................. 40
Andere opties ............................................................................................................................. 40
Hoofdstuk 10: oppervlakkige mycosen van huid en slijmvliezen ............................................................ 41
Dermatofyten ................................................................................................................................. 41
Inhoud
, Soorten ...................................................................................................................................... 41
Diagnose .................................................................................................................................... 43
Behandeling ............................................................................................................................... 43
Gisten ............................................................................................................................................ 43
Candidose .................................................................................................................................. 44
Diagnose .................................................................................................................................... 45
Behandeling ............................................................................................................................... 45
Hoofdstuk 11: parasitaire aandoeningen ............................................................................................. 46
Inleiding ......................................................................................................................................... 46
Scabies.......................................................................................................................................... 46
Complicaties .............................................................................................................................. 47
Luizen ............................................................................................................................................ 48
Pediculosis capitis (hoofdluis) ..................................................................................................... 48
Pediculosis pubis (schaamluis) ................................................................................................... 49
Vlooien .......................................................................................................................................... 49
Teken............................................................................................................................................. 50
Fase 1: vroeg gelokaliseerd stadium (primair) ............................................................................... 50
Fase 2: vroegtijdige disseminatie (secundair) ................................................................................ 51
Fase 3: laattijdig chronische infectie (tertiair) ............................................................................... 51
Behandeling ............................................................................................................................... 51
Hoofdstuk 12: virale infecties ............................................................................................................. 53
Humane herpesvirus ...................................................................................................................... 53
Herpes Simplex type 1 ................................................................................................................. 53
Herpes Simplex type 2 ................................................................................................................. 54
Bijzondere vormen HSV ............................................................................................................... 54
Varicella Zoster Virus (VZV) .......................................................................................................... 55
Bijzondere vormen VZV ............................................................................................................... 56
Diagnose (HSV, VZV) ................................................................................................................... 57
Humaan papillomavirus.................................................................................................................. 57
Cutaan verrucae ......................................................................................................................... 57
Mucosaal verrucae ..................................................................................................................... 58
Pokkenvirus ................................................................................................................................... 60
Molluscum contagiosum virus ..................................................................................................... 60
Parapokken virus (Orf = ecthyma contagiosum) ............................................................................ 60
Seksueel overdraagbare aandoeningen (SOA) .................................................................................. 60
Syfilis ......................................................................................................................................... 60
Hoofdstuk 13: tumoren van de huid .................................................................................................... 62
Inhoud
, Goedaardige pigmentletsels ........................................................................................................... 62
Maligne melanoom ......................................................................................................................... 63
Superficieel spreidend maligne melanoom (SSMM) ...................................................................... 64
Lentigo maligne melanoom (LMM) ............................................................................................... 64
Acrolentigineus maligne melanoom (ALMM) ................................................................................. 64
Nodulair maligne melanoom (NMM) ............................................................................................. 64
Klinisch beoordelen .................................................................................................................... 65
Behandeling ............................................................................................................................... 66
Epidermale tumoren van de huid ..................................................................................................... 66
Goedaardige epidermale tumoren ............................................................................................... 66
Premaligne huidafwijkingen ......................................................................................................... 66
Maligne epidermale tumoren (non-melanoma) ............................................................................. 68
Hoofdstuk 14: huidaantasting bij systeemziekten ................................................................................ 71
Inleiding ......................................................................................................................................... 71
Lupus erythematosus (LE)............................................................................................................... 71
Acute cutane Lupus Erythematosus ............................................................................................. 72
Subacute cutane Lupus Erythematosus ....................................................................................... 72
Chronische cutane Lupus Erythematosus (= discoïde LE) .............................................................. 72
Diagnose .................................................................................................................................... 73
Behandeling ............................................................................................................................... 73
Dermatomyositis ............................................................................................................................ 74
Diagnose .................................................................................................................................... 75
Behandeling ............................................................................................................................... 75
Systeemsclerose (sclerodermie) ..................................................................................................... 76
Diagnose .................................................................................................................................... 77
Behandeling ............................................................................................................................... 77
Morphea..................................................................................................................................... 77
Vasculitis ....................................................................................................................................... 78
Small vessle vasculitis ................................................................................................................ 79
Medium vessle vasculitis ............................................................................................................. 80
Hoofdstuk 15: acuut cutane aandoeningen ......................................................................................... 82
Inleiding ......................................................................................................................................... 82
Toxisch medicamenteuze reacties .................................................................................................. 82
Maculopapuleus exantheem ....................................................................................................... 82
Acute gegeneraliseerde exanthemateuze pustulose (AGEP) .......................................................... 83
Drug reactie met eosinofilie en systemische symptomen (DRESS) ................................................. 83
Stevens-Johnson syndroom (SJS) ................................................................................................. 83
Inhoud
, Toxische epidermale necrolyse (TEN) ........................................................................................... 84
Urticaria en angioedeem ............................................................................................................. 84
Toxisch infectieuze reacties ............................................................................................................ 87
Erythema nodosum ........................................................................................................................ 89
Acuut cutaan vasculaire aandoeningen ........................................................................................... 89
Hoofdstuk 1: histologie van huid en basisbegrippen in huidpathologie ....................................................1
Anatomie van de huid .......................................................................................................................1
Epidermis .....................................................................................................................................1
Keratinocyten - stratum corneum .............................................................................................2
Keratinocyten - stratum granulosum .........................................................................................2
Keratinocyten - stratum spinosum ............................................................................................2
Keratinocyten - stratum basale .................................................................................................2
Melanocyten ...........................................................................................................................2
Langerhans cellen ...................................................................................................................3
Merkel cellen ..........................................................................................................................3
Dermis .........................................................................................................................................3
Hypodermis ..................................................................................................................................5
Basisletsels .....................................................................................................................................5
Epidermis .....................................................................................................................................5
Hyperplasie en hypoplasie .......................................................................................................5
Orthokeratose en parakeratose ................................................................................................6
Acantholyse ............................................................................................................................6
Inflammatie van de huid ..........................................................................................................6
Civatte-lichaampjes en dyskeratose .........................................................................................7
Dermis .........................................................................................................................................8
Elastose..................................................................................................................................8
Homogenisatie ........................................................................................................................8
Oedeem .................................................................................................................................8
Ontsteking ..............................................................................................................................8
Subcutis .......................................................................................................................................9
Steatonecrose .........................................................................................................................9
Panniculitis .............................................................................................................................9
Vasculitis .............................................................................................................................. 10
Patronen ........................................................................................................................................ 10
Inflammatoire huidpathologie ..................................................................................................... 10
Hoofdstuk 2: bulleuze dermatosen ..................................................................................................... 11
Intra-epidermaal ............................................................................................................................ 11
Inhoud
, Subacuut eczeem ....................................................................................................................... 11
Herpes virus infectie ................................................................................................................... 11
Pemphigus vulgaris ..................................................................................................................... 11
Intra-epidermaal ............................................................................................................................ 12
Brandwonden (2e graad) of insectenbeten .................................................................................... 12
Bulleuze lichen planus ................................................................................................................ 12
Bulleus pemphigoid .................................................................................................................... 13
Dermatitis herpetiformis ............................................................................................................. 13
Lineaire IgA-dermatose ............................................................................................................... 14
Epidermolysis bullosa acquisita .................................................................................................. 14
Hoofdstuk 3: huidtumoren ................................................................................................................. 15
Epidermis ...................................................................................................................................... 15
Melanocyten – pigmentceltumoren .............................................................................................. 15
Pathway 1: lage UV-blootstelling............................................................................................. 18
Pathway 2: hoge UV-blootstelling............................................................................................ 20
Pathway 3: hoge UV-blootstelling............................................................................................ 20
Pathway 4: variabele UV-blootstelling ..................................................................................... 21
Pathway 5: variabele UV-blootstelling ..................................................................................... 21
Pathway 6: variabele UV-blootstelling ..................................................................................... 22
Pathway 7: variabele UV-blootstelling ..................................................................................... 22
Pathway 8: variabele UV-blootstelling ..................................................................................... 22
Pathway 9: variabele UV-blootstelling ..................................................................................... 23
Keratinocyten – epidermale tumoren ........................................................................................... 24
Merkel cellen – merkelcel carcinoom ........................................................................................... 25
Adnexen – dermale tumoren (adnexieel) ....................................................................................... 26
Fibroblasten – fibrohistiocytaire tumoren ..................................................................................... 26
Langerhans cellen en immuun cellen ........................................................................................... 27
Inhoud
,DERMATOLOGIE
HOOFDSTUK 1: ONDERZOEK VAN DE HUID
Dit deel is niet te kennen
ALGEMENE PRINCIPES
- Warm lokaal, goede belichting
- Inspecteren van volledige huidoppervlak, haren, nagels en mucosa
- Palperen van huid om textuur na te gaan
- Observeren van morfologie, configuratie en distributie van individuele letsels
- Anamnese voor, tijdens en na onderzoek
- Technische hulpmiddelen en onderzoeken
EFFLORESCENTIES
Efflorescenties = huidveranderingen die typerend kunnen zijn voor een bepaalde huidziekte
PRIMAIR
Primaire efflorescenties = door huidziekte zelf
- Niet verheven
o Macula (vlek)
▪ Bv epheliden (sproetjes), vitiligo, fixed drug eruptie (erythemateus)
- Verheven
o Compacte opbouw
▪ Papel: < 5 mm - (epi)dermis
• Bv xanthomen, mollusca contagiosa, verruca vulgaris, lichen planus
▪ Nodulus: > 5 mm - subcutis
• Bv erythema nodosum, nodulair basocellulair epithelioom
▪ Plaque: vlak verheven haard
• Bv psoriasis
▪ Urticaria: vluchtige verheving (< 24u) door dermaal oedeem
o Niet compacte opbouw (holten)
▪ Vesikel: < 5 mm, helder vocht
• Bv herpes simplex vesikels, dermatitis herpetiformis
▪ Bulla (blaar): > 5 mm, helder vocht
• Subepidermaal: klieving tussen dermis en epidermis: strakke blaren
o Bv bulleus pemphigoid
• Intra-epidermaal: klieving in epiderm: fragiele blaren, snel kapot
o Bv pemphigus vulgaris
▪ Pustula: > 5 mm, seropurulent vocht
• Bv folliculitis, psoriasis pustulosa, acne vulgaris
Hoofdstuk 1: onderzoek van de huid 1
,SECUNDAIR
Secundaire efflorescenties = door verdere evolutie van primaire of reactie op primaire letsels
- Excoriaties (krabletsels)
- Squamae (schilfering, ophoping hoornlaag): pityriasiform, psoriasiform, lamellair
- Crusta (korst, opgedroogd wondvocht)
- Erosie (oppervlakkige epidermis) ulceratie (diepe epidermis en dermis)
- Fissuur (kloven, onderbreking continuïteit huid)
- Litteken = genezing van defect reikend tot in dermis
- Atrofie = versmalling epidermis of dermis
- Sclerose = verharding van huid
- Hypertrofie of pachydermie
- Dyschromie = kleurverandering
- Lichenificatie = chronische verdikking van huid, met vergroving van huidlijnen
DISTRIBUTIE EN LOKALISATIE (PREDILECTIEPLAATSEN)
Distributie = verspreiding
- Solitair
- Gegroepeerd
- Discreet gedissemineerd
- Diffuus gedissemineerd
- Gegeneraliseerd
Anatomische lokalisaties en predilectieplaatsen voor diagnose
- Acne vulgaris: gelaat en bovenste deel romp
- Atopisch eczeem: plooizijde (elleboog, knie)
- Psoriasis: strekzijde (knie)
AFMETING, RANGSCHIKKING EN VORM
- Oppervlakte meten of vergelijken met bekende grootte bv muntstuk, erwt, boon…
- Vormen: rond, ovaal, annulair, lineair, gegroepeerd
Hoofdstuk 1: onderzoek van de huid 2
, HOOFDSTUK 2: BULLEUZE DERMATOSEN
INLEIDING HUID
- Huidoppervlak van 1,8 m2 en 16% van lichaamsgewicht
- 3 lagen
o Epidermis: opperhuid, < verschillende lagen cellen
o Dermis: < steunweefsel en cellen
o Subcutis: < vetweefsel
- Adnexen
o Haren
o Zweet- en talgklieren
o Nagels
Dermo-epidermale junctie = overgangszone tussen epidermis en dermis (basale membraan zone)
- Opgebouwd uit verschillende structuren zodat epidermis vasthangt aan dermis
o Lamina lucida
o Lamina densa
o Sublamina densa
o < cytoskelet, hemidesmosomale plaque, plasmamembraan van basale keratinocyten
- Blaren = fouten in deze plakstructuur, waardoor lagen loskomen van elkaar
CONGENITAAL: EPIDERMOLYSIS BULLOSA
Ontstaan door genetische fouten in de code van verschillende structuren en/of adhesie-eiwitten in huid
→ genetica belangrijk voor diagnose
- Epidermolysis Bullosa Simplex
- Junctionele Epidermolysis Bullosa
- Dystrofische Epidermolysis Bullosa
Vooral aantasting van handpalmen en voetzolen
EPIDERMOLYSIS BULLOSA SIMPLEX
Splijting doorheen basale keratinocyten (opperhuid)
- Mechanische fragiliteit
- Blaren, erosies
- Geen verlittekening (kan nog zonder genezen)
Milde vorm
JUNCTIONELE EPIDERMOLYSIS BULLOSA
Splijting doorheen lamina lucida (helemaal los van dermis)
- Mechanische fragiliteit
- Blaren, erosies
- Verlittekening
Vaak lethaal
Hoofdstuk 2: bulleuze dermatosen 3
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller zGNK. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $16.53. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75282 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 15 years now