An Introduction
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This document provides an overview of dermatology as a field of medicine focused on diagnosing and treating skin disorders. It discusses the anatomy of the skin, including the epidermis, dermis, and hypodermis. The four main cell types in the epidermis are described in detail: keratinocytes, melanocytes, Langerhans cells, and Merkel cells. The functions of the skin and common skin lesions are also outlined. The document concludes with an overview of the dermatologic examination process.
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General stool examination
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X-ray , CT-scan
PCR
There are some parasites which has the specific testes for diagnosis , in example
Cryptosporidium
Trichinella spiralis
Others , like Enterobius vermicularis
Cryptosporidium
Is a microscopic parasite that cause the diarrheal disease cryptosporidiosis , both the parasite and the disease are commonly known as Crypto .
This parasite protected out side the body for long time by outer shell .
There are different ways for spreading , but the most common is by water , drinking water and recreational water .
Life cycle
DIAGNOSIS
Cryptosporidiosis diagnosis is made by examination of stool sample .
The most often stool specimens are examined microscopically using acid fast staining
Trichinella spiralis
Is an ovoviviparous nematode parasite , occurring in rodent , pigs , horses , bears and human.
The name of disease is trichinosis .
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Life cycle
Diagnosis
During first week stool examination .
During second week peripheral blood sample of migrating larvae .
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Mesotherapy in Depth
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An Introduction
- 2. Dermatology…..what is it? • Dermatology is defined in the New Oxford Dictionary of English as ‘The branch of medicine concerned with the diagnosis and treatment of Skin disorders.’ • Internal medicine • Environmental Factors • Psychiatry Rook’s Textbook of Dermatology 8th edition
- 3. Anatomy & Histology • Epidermis • Epidermal Derivatives (Hairs, Nails, Sebaceous & Sweat Galnds) • Dermis • Panniculus Adiposus (Hypodermis)
- 5. Epidermis 4 types of cells: • Keratinocytes • Melanocytes • Langerhans Cells • Melanocytes
- 6. Epidermis
- 7. Keratinocytes • 80-95% of Epidermal Cells • Keratinization • 4 Main Layers: Basal Spinous Granular Stratum Corneum
- 10. Keratinocytes
- 11. Keratin • intermediate filaments • hallmark of all epithelial cells • 54 Keratin Genes : 34-epithelial keratins , 17- hair keratins • Fillagrin i.e: Keratohyaline
- 14. Melanocytes • neural crest-derived • pigment-synthesizing dendritic cells • m/k : 1/10 • I m 36 keratinocytes • reside primarily in the basal layer
- 15. Melanocytes
- 16. Melanocytes
- 17. Melanocytes
- 18. Langerhans Cells • 2-8% of total count of cells • dendritic antigen-processing and -presenting cells • Phagocytosis • Interactions with Lymphocytes • dSEARCH
- 19. Langerhans Cells
- 20. Langerhans Cells
- 21. Merkel Cells • 0.2 – 5% of total cells • induction or stimulation of perifollicular or dermal nerve plexuses via a direct complex • stimulation of keratinocyte proliferation and maintenance of their differentiation • histogenesis of the nail • release of various bioactive substances to the dermis.
- 22. Merkel Cells • cyclical changes in the number of dendritic- type Merkel cells in rat skin suggest a secretory function related to the hair cycle * Merkel cell-derived neoplasms are particularly aggressive and difficult to treat *.Nakafusa J, Narisawa Y, Shinogi T, et al. Changes in the number of Merkel cells with the hair cycle in hair discs on rat back skin. Br J Dermatol. Nov 2006;155(5):883-9. [Medline].
- 24. Dermal-Epidermal Junction • three supramolecular networks: hemidesmosome-anchoring filament complex basement membrane itself anchoring fibrils
- 27. Dermis • papillary layer • reticular layer • composed of three types of connective tissue: collagen, elastic tissue, and reticular fibers
- 28. Dermis
- 29. Dermis
- 31. Functions of The Skin • Protection • Sensation • Thermoregulation • Circulation • Metabolic • Movement • Secretion & absorption
- 33. Macule • Change in color • Well determined • No palpable change in structure
- 34. Patch • A macule that is larger than 0.5 cm
- 35. Papule • An elevated solid lesion up to 0.5 cm in diameter • Bigger Plaques
- 36. Nodule • A circumscribed, elevated, solid lesion more than 0.5 cm in diameter • Bigger Tumor/mass OR plaques
- 37. Vesicle • A circumscribed collection of free fluid up to 0.5 cm in diameter • Bigger Bulla
- 38. Wheal • A firm edematous plaque resulting from infiltration of the dermis with fluid; wheals are transient and may last only a few hours
- 39. Pustule • A circumscribed collection of leukocytes and free fluid that varies in size
- 40. Scales • Excess dead epidermal cells that are produced by abnormal keratinization and shedding
- 41. Erosion • A focal loss of epidermis • do not penetrate below the dej and therefore heal without scarring
- 42. Ulcer • A focal loss of epidermis & dermis • heal with scarring
- 43. Dermatologic Story & Examination
- 44. • Initial clinical impression: Does the patient appear ill?
- 45. • Physical examination: detailed examination of the skin, hair, nails, and mucous membranes
- 46. • Four cardinal features 1- Type of lesion
- 47. • Four cardinal features 2- Shape of individual lesions
- 48. • Four cardinal features • Arrangement of multiple lesions
- 49. • Four cardinal features Distribution • Extent of involvement • Pattern
- 50. • Characteristic locations • Three major characteristics • Color diascopy wood • Consistency and feel of lesion • Anatomic components of the skin primarily affected
- 51. • General physical examination as indicated by the clinical presentation • Review of systems as indicated by clinical situation • Review of systems for growths suspicious for, or associated with, malignancy • Medication history • Past medical history • Social history
- 52. Thanks!