Year 4 DERM4: Dermatology
- Dr Jane McGregor
- j.mcgregor@qmul.ac.uk
Introduction
General practitioners report that up to 20% of their consultations involve some aspect of skin disease. In addition, signs present in the skin often provide clues to systemic disease that is otherwise hidden. Dermatology is a very visual subject and close observation and description is a clinical skill that you will develop during the course of the module. However, just like other areas of medicine, the diagnosis and management of skin disease requires a logical approach to history taking, examination and investigation.
Sessions
Dermatology Examination
- Be able to obtain an appropriate dermatological history from a patient presenting with a skin complaint.
- Be able to demonstrate an appropriate level of skill in skin examination, including nails, hair and mucosa.
- Can describe the clinical features of common skin disorders, using appropriate terminology, and to relate the signs to the underlying pathology eg eczema, urticaria, psoriasis, benign and malignant skin lumps
- Be able to construct an appropriate differential diagnosis and plan of investigation for a patient presenting with the index dermatological conditions
- Demonstrate the ability to communicate the nature of the condition and its management to the patient
- Be able to outline strategies available including education, drug therapy, physical treatments, psychosocial interventions) for the management of skin disorders
Interpretation of Results
Inflammatory Skin Disorders
- Demonstrate an ability to recognise common inflammatory skin disorders including: Psoriasis; Eczema and Lichen Planus
- Demonstrate an ability to understand the impact that chronic skin diseases have on a patient’s quality of life.
- Have a working knowledge of the treatments available for common inflammatory skin disorders including: Psoriasis; Eczema and Lichen Planus
- Describe important adverse effects or complications of common therapies employed in the treatment of Psoriasis; Eczema and Lichen planus
Blistering Skin Conditions
- Demonstrate an ability to recognise the signs and symptoms of a patient with a blistering dermatosis.
- Describe the relevance of the investigations employed in a patient with Blistering Dermatosis
- Have a working knowledge of the functional biology of the basement membrane in relation to blisters.
- Have a working knowledge of the treatments available and any complications for the following conditions: Bullous Pemphigoid; Pemphigus Vulgaris and Dermatitis Herpetiformis
Hair Loss and Gain
- Demonstrate an ability to discriminate between different patterns of hair loss eg distribution, pathology (scarring, non-scarring alopecia)
- Be able to list the common causes of hair loss
- Demonstrate an understanding of the impact of hair loss/gain on the patients quality of life
- Describe relevant investigations for a patient presenting with hair loss/gain including: Adrogenetic Alopecia; Hirsutism and Alopecia Areata
Benign Lumps and Bumps
- Demonstrate an ability to recognise and distinguish common benign skin lumps including: Moles; Freckles; Dermato-fibroma; Pyogenic Granuloma; Seborrheic Keratosis and Haemangioma
- Have a working knowledge of the treatment options available for the following: Moles; Freckles; Dermato-fibroma; Pyogenic Granuloma; Seborrheic Keratosis and Haemangioma
Melanoma
- Demonstrate an ability to recognise and distinguish malignant lesions including; Actinic Keratoses; Basal Cell Carcinoma; Squamous Cell Carcinoma and Melanoma
- Demonstrate competence in the recognition of moles, dysplastic moles and melanoma
- Understand the significance of the prognostic factors associated with melanoma.
- Have a working knowledge of the treatment options available
- Have a working knowledge of the public health strategies for increasing awareness of skin cancer and to understand the major risk factors for skin cancer.
Skin Infections
- Be able to demonstrate an ability to recognise presentation of common skin infections including: Cellulitis; Impetigo; Fungal infection; Herpes simplex; Herpes zoster; Human papillomavirus and Yeast infections
- Describe the relevant investigations required for the following skin infections: Cellulitis; Impetigo; Fungal infection; Herpes simplex; Herpes zoster; Human papillomavirus and Yeast infections
- Describe the basic management outline for following conditions: Cellulitis; Impetigo; Fungal infection; Herpes simplex; Herpes zoster; Human papillomavirus and Yeast infections
Systemic Disease in Dermatology
- Demonstrate an ability to recognise skin signs of common or important systemic diseases including: Granuloma Annulare; Dermatitis herpetiformis, Necrobiosis lipoidica; Acanthosis nigricans; Splinter haemorrhage; Dermatomyositis; Systemic lupus erythematos
- Describe the relevant investigations for confirmation of the following systemic diseases: Granuloma Annulare; Dermatitis herpetiformis, Necrobiosis lipoidica; Acanthosis nigricans; Splinter haemorrhage; vasculitis, Dermatomyositis; Systemic lupus erythema
- The above, but also for Erythema nodosum; Erythema multiforme and Pruritus
Dermatological Emergencies
- Demonstrate an ability to recognise a dermatologic emergency including the following conditions: Erythroderma; Toxic Epidermal Necrosis; Necrotising Fascitiis and Stevens Johnson Syndrome
- Describe the relevant investigations required for the following conditions: Erythroderma; Toxic Epidermal Necrosis; Necrotising Fascitiis and Stevens Johnson Syndrome
- Outline a basic management plan for first contact care of a patient with a life threatening skin disease including: Erythroderma; Toxic Epidermal Necrosis; Necrotising Fascitiis and Stevens Johnson Syndrome
Dermatology Treatments
- Demonstrate knowledge of the basic pharmacology and use of topical treatments, including emollients and steroids
- Can describe the common or important adverse effects, including important drug interactions, of the systemic treatments commonly used in the index dermatological conditions.
- Demonstrate knowledge of the basic pharmacology of common and important systemic therapeutic agents used in skin disease including methotrexate, roaccutane, prednisolone, azathioprine and the biologics.
Non-Melanoma Skin Cancer
- Demonstrate an ability to recognise and distinguish malignant lesions including; Actinic Keratoses; Basal Cell Carcinoma; Squamous Cell Carcinoma and Melanoma
- Have a working knowledge of the treatment options available.
- Have a working knowledge of the public health strategies for increasing awareness of skin cancer and to understand the major risk factors for skin cancer.
