Anatomy and History taking in Dermatology.pptx
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The document describes the structure of the skin and its layers - the epidermis, dermis and hypodermis. It then provides details on the layers of the epidermis and components of the dermis. The document also discusses skin appendages and the process of history taking and physical examination for skin conditions, including important elements to evaluate such as distribution, characteristics, and symptoms of lesions.
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The skin has three main layers - the epidermis, dermis, and subcutaneous layer. The epidermis is made of epithelial tissue in 5 layers (stratum basale, stratum spinosum, stratum granulosum, stratum lucidum, stratum corneum) and contains four main cell types. The dermis is made of connective tissue and contains hair follicles, sebaceous glands, sweat glands, and nerves. The skin provides protection from external factors, regulates body temperature, and serves important sensory functions.
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Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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www.StokeNewingtonHistory.com
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- 1. History Taking, Physical Examination, Investigation, Psoriasis and Urticaria.
- 3. Layers of skin • Epidermis - Stratified squamous epithelium • Dermis - Tough supportive connective tissue matrix. - Has hair follicles and sweat gland • Hypodermis - Has adipose tissue
- 4. Epidermis layer a) Basal cell layer (Stratum basale) b) Prickle cell layer (stratum spinosum) c) Granular cell layer (stratum granulosum) d) Stratum lucidum (thick skin only) e) Horny layer (stratum corneum) Cells content type - Keratinocyte - Melanocyte - Merkel’s cell - Langerhans’ cell
- 5. Dermis • Tough supportive connective tissue matrix. • 0.6mm (eyelid) - 3mm (palm, back, sole) • Collagen fibre make up 70% : support & strength • Elastic fibres : elasticity to skin • Ground substance is GAG : allow some movements • Fibroblast : synthesize collagen, elastin • Others: dermal dendrocyte, mast cells, macrophage & lymphocytes • Highly vascularized & innervated • Function : Support skin nutritionally & structurally
- 6. Dermis
- 7. Papillary Dermis Reticular Dermis Thinner Thicker More superficial Deeper Areolar connective tissue Dense irregular connective tissue. • Contains: 1) More connective tissue cells. 2) Less collagen fibers. 3) Thin collagen fibers. 4) Thin elastic fibers. 5) More ground substance. 6) Meissner’s corpuscles (touch). • Contains: 1) Less connective tissue cells than the papillary layer. 2) More collagen fibers. 3) Thick collagen fibers. 4) Thick elastic fibers. 5) Pacinian corpuscles (pressure). 6) Ruffini’s corpuscle (stretching).
- 8. Hypodermis • Loose connective tissue & fats • Adipocytes: as storage for fats • Functions : – Provide thermal insulation – Crucial energy store – Shock absorber – Hormone factory (steroid hormone)
- 9. Appendages of the skin There are 5 skin appendages: 1) Hair follicles 2) Sebaceous glands 3) Arrector pili muscle 4) Sweat glands 5) Nails
- 10. History Taking
- 11. History Taking. •Patient Identification •Chief Complaint •History of Presenting Illness •Past Medical/ Surgical History •Family History •Social/ Occupational History •Drug and Diet history
- 12. The history should aim to elicit the following points: • Time course of the skin condition • Distribution of lesions • Symptoms (e.g. itch or pain) • Family history (especially of atopy and psoriasis) • Social and Occupational History. • Drug/allergy history • Past medical history(childhood eczema,DM) • Provoking factors (e.g. sunlight or diet) • Previous skin treatments. • Impairment of life quality?
- 13. PHYSICAL EXAMINATION. 1. Inspection. -Ask patient to undress. -Comment on: Distribution- isolated, localized, regional, generalize, symmetric, exposed area, site of pressure, dermatomes, random, Blaschko's lines. Character- redness (erythema), scaling, crusting, exudate,excoriations, blisters, erosions,pustules,papules,monomorphic, polymorphic. Shape of the lesions-small, large, annular (ring shaped), linear. Margin- Well defined? Ill defined?
- 16. 2. Palpation. – Temperature – Consistency – Tenderness – Depth (dermal or subcutaneous) – Mobility