The skin is the body's largest organ and acts as a protective barrier. It has three layers - the epidermis, dermis and hypodermis. Lesions are areas of altered skin and can be macules, papules, nodules, pustules or vesicles. Common skin conditions include bites, pruritis, urticaria, scabies, acne, psoriasis, skin cancer and eczema. Eczema is characterized by erythema, rashes, itching, swelling and dryness. It is managed through emollients, topical steroids, antihistamines, immunosuppressants and light therapy to prevent infection and flare-ups.

2. INTRODUCTION
SKIN
The skin is often referred to as the largest body organ and
serves as the main protective barrier against damage to
internal tissues from trauma, ultraviolet light,
temperature, toxins and bacteria. The skin is also
responsible for sensory perception, temperature
regulation, production of vitamin D and excretion of
waste products. In addition to preventing harmful
substances from entering the body, it also controls the loss
of vital substances from the body. It is therefore important
that the skin remains intact to allow the body to perform
these essential functions.

3. LAYERS
EPIDERMIS
DERMIS
HYPODERMIS

4. LESIONS
Lesion A single area of altered
skin: it may be solitary or
multiple.
 Abscess Pus-filled lesion
(>1cm).
 Blister Fluid-filled lesion (any
size).
 Bulla Fluid-filled lesion,
circumscribed elevation (>1cm).
 Cyst A closed cavity or sac lined
with epithelium containing
fluid, pus or keratin.

5. Macule Flat circumscribed area of discolouration
(<1cm).
 Nodule Round elevated solid lesion (>1cm).
 Papule Any raised lesion or scaly, crusted,
keratinised or macerated surface (<1cm).
 Patch A large macula, change in color only, surface is
always normal (>1cm).
 Plaque Raised, flat-topped lesion (>1cm).
 Pustule Pus-filled lesion (<1cm). Vesicle Fluid-filled
lesion (<1cm).

6. COMMON SKIN CONDITION
BITES
PRURITIS:
Polycythemia, Uraemia
lymphoma,jaundice,bod
y lice,HIV AIDS,drying
out of skin.
Urticaria
Scabies

7. Skin conditions in adults
Acne
Dermatitis
Cellulitis
Psoriasis
Shingles(herpes zoster)
Skin cancer
Vasculitis
Malignant melanoma
Squamous cell
carcinoma

8. Skin conditions in childrens
Chicken pox(varicella)
Eczema (atopic)
Impetigo(staphy)
Miliaria(sweat rash)
Measles(rubella)
Napkin dermatitis

9. DERMATITIS
Eczema and dermatitis are synonymous. Around 20%
of the population develop eczema at some time in
their lives. There are a number of clinical variants in
adults.Childhood atopic eczema may persist into
adulthood, or may return following a prolonged
absence of symptoms. In some cases, childhood
eczema may resolve and present in a different form
(e.g. hand eczema in hairdressers). Adolescents with a
history of eczema need advice about careers involving
allergens and irritants

10. TYPES & pathogenesis
ATOPIC -childrens
SEBORRHIC
DISCOID - middle age men
CONTACT
Pathogenesis:
Environmental - heating, washing, pets, smoking,
housedust mite, tree and grass pollens, infections
(bacterial )
Genetic – gene (FILAGGEVIN)
HERPES SIMPLEX - eczema herpeticum
(ACYCLOVIR
PSYCOLOGICAL –stress,depression

11. DIAGNOSIS &
MANIFESTATIONS
Investigations: Height and weight monitoring in
children. Swabs for bacterial and viral culture as
appropriate.
SKIN biopsy
Patch test for contact dermatitis (ALLERGIC).
SYMPTOMS:
Erythema ,skin rash ,itching,swelling,scarring &
dryness of skin .

12. MANAGEMENT
Diet: dietary manipulation has little value in the
management of adult eczema, unless there is an obvious
dietary trigger (rare). Diets for children should be
supervised by a dietician and abandoned after 2 months if
unhelpful.
 Emollients: moisturisers should be applied liberally and
frequently; the minimum prescription should be for
500g/500mls.
 Topical steroids: a two-stage therapeutic approach is
recommended. Use a mild/moderate potency
corticosteroid for long-term maintenance, but a potent
topical corticosteroid for short-term use (5-7 days) in an
acute are. In infants and young children, use milder
preparations (e.g. l% hydrocortisone ointment and
Eumovate ointment respectively).

13. Facial eczema can be safely treated with regular l%
hydrocortisone ointment.
 Palms and soles may require superpotent
corticosteroid for maintenance treatment. Elocon and
Cutivate are newer generation steriods .
 Ointments are preferable to creams for non-weepy
dry skin. good evidence that l% hydrocortisone
cream can precipitate glaucoma.
 Antihistamines: Sedative antihistamines may be
helpful for patients whose sleep is disturbed by itch.
Chinese herbal remedies: Primrose oil (gamolenic
acid): ineffective
 Topical immunosuppressants: Tacrolimus (protopic)
Pimecrolimus (elidel)

14. management
Coal tar
Topical imidazoles (ketoconazole)
Light therapy –uv .
Prevention :
Avoid mites ,lices,insect bites.
Avoid cold climate exposure
Use antiseptics for cleaning wounds and cuts for
contamination of bacteria and virus.

15. PRESENTED BY NAGA VAMSIDHAR
PHARM D