الدفعة الـ 20
إختبار الجلدية عملي- المجموعة الثالثة(B) د.عادل النجار كان عبارة عن أسئلة oral يسأل كل طالب، وكذا spot diagnosis لـصور حالات في تلفونه يمرر على الطلاب. الأسئلة الـ oral: -What are Milia? -What is Acne Conglobata? -What is isotretinoin? -What are precautions…
Methods of transmission of "Gonorrhea" other than sex? ايش هن ياديلمي
🤔2
الدفعة الـ 20
Methods of transmission of "Gonorrhea" other than sex? ايش هن ياديلمي
1-A mother may transmit gonorrhea to her newborn during childbirth; when affecting the infant's eyes, it is referred to as ophthalmia neonatorum.
2-It may be able to spread through the objects contaminated with body fluid from an infected person. The bacteria typically does not survive long outside the body, typically dying within minutes to hours.
3-Also much less commonly, as a result of poor hygiene or the complementary/alternative “medical” use of urine.
2-It may be able to spread through the objects contaminated with body fluid from an infected person. The bacteria typically does not survive long outside the body, typically dying within minutes to hours.
3-Also much less commonly, as a result of poor hygiene or the complementary/alternative “medical” use of urine.
❤2🔥1👏1
A 55 yaers old male with history of preexisting dermatosis and presents with fatigue ,malaisa ,skin thickness
and lamellar scaling . what is the Dx ?
and lamellar scaling . what is the Dx ?
Anonymous Poll
15%
dermatitis herpetiforms
30%
Erytheroderma
49%
Psorasis
5%
Drug allergy
A 23 yaer- old male with intense pruritus and erythematous papules or plaques on elbow what is the cause ?
Anonymous Poll
64%
Autoimmue
19%
Acquired
6%
Genetic
11%
Unknwon
👍1
الدفعة الـ 20
A 55 yaers old male with history of preexisting dermatosis and presents with fatigue ,malaisa ,skin thickness
and lamellar scaling . what is the Dx ?
and lamellar scaling . what is the Dx ?
The best is "Erythroderma", of chronic type.
❤2👍2
الدفعة الـ 20
A 23 yaer- old male with intense pruritus and erythematous papules or plaques on elbow what is the cause ?
Dermatitis herpetiformis is considered an Autoimmune disease.
❤2👍2
A 70 year-old man presents with erythematous patches and papules é yellow scales on the nasolabial fold and retroauricular regions ,this patient has Hx of parakinson's disease .
Anonymous Poll
5%
Psoriasis
90%
Seborrheic dermatitis
3%
Lichen planus
2%
T.facialis
A 65 year-old farmer presents é a large irregular smooth nodule on the hand é yellowish color is focally , very hard upon palpation . The most likely diagnosis .
Anonymous Poll
19%
BCC
20%
SCC, undifferentiated
48%
SCC well-differentiated
13%
Keratoacanthoma
👇👇👇👇
د. عادل النجار :
أي مجموعة تدخل راوند الجلدية و تكون مجهّزة الواجبات المكلّفة (المعروفة)على الطلاب....
و من دون لف و دوران عليّ(يعني على الدكتور 🙊)...و من دون أخذ التكاليف من دفع سابقة
و كل واحد يتحمل مسئولية نفسه
د. عادل النجار :
أي مجموعة تدخل راوند الجلدية و تكون مجهّزة الواجبات المكلّفة (المعروفة)على الطلاب....
و من دون لف و دوران عليّ(يعني على الدكتور 🙊)...و من دون أخذ التكاليف من دفع سابقة
و كل واحد يتحمل مسئولية نفسه
Treatment of Psoriasis
According to age, site, pattern and exposure sites:
-Steroids are not used in face or intertriginous areas due to atrophy , but we use pimecrolimus
-Suppurative care and emollients are important.
LOCALIZED PSORIASIS
Topical agents are first line of treatment.
1-Trunk and Extremities
a) Topical fluorinated glucocorticoids, e.g.betamethasone valerate. Glucocorticoid-impregnated tape useful for small plaques.
b) For small plaques (≤4 cm), triamcinolone, there will be hypopigmentation.
c)Topical anthralin preparations, but very irritant.
d) Vitamin D analogues, e. g. calcipotriene.
e) Topical pimecrolimus is effective in inverse psoriasis and seborrheic dermatitis–like psoriasis of the face and ear canals.
2-Scalp
-Mild:
Ketoconazole shampoos followed by betamethasone valerate.
-Severe:
Removal of scales from plaques before active treatment by 10%salicylic acid in mineral oil.
Then use clobetasol propionate, lotion.
But it is better to use systemic treatment for recurrence or ineffective.
3-Palms and Soles,Nails
a) Topical glucocorticoids
b) PUVA
c) Retinoids (acitretin >isotretinoin) orally
d) Combination of a and b.
According to age, site, pattern and exposure sites:
-Steroids are not used in face or intertriginous areas due to atrophy , but we use pimecrolimus
-Suppurative care and emollients are important.
LOCALIZED PSORIASIS
Topical agents are first line of treatment.
1-Trunk and Extremities
a) Topical fluorinated glucocorticoids, e.g.betamethasone valerate. Glucocorticoid-impregnated tape useful for small plaques.
b) For small plaques (≤4 cm), triamcinolone, there will be hypopigmentation.
c)Topical anthralin preparations, but very irritant.
d) Vitamin D analogues, e. g. calcipotriene.
e) Topical pimecrolimus is effective in inverse psoriasis and seborrheic dermatitis–like psoriasis of the face and ear canals.
2-Scalp
-Mild:
Ketoconazole shampoos followed by betamethasone valerate.
-Severe:
Removal of scales from plaques before active treatment by 10%salicylic acid in mineral oil.
Then use clobetasol propionate, lotion.
But it is better to use systemic treatment for recurrence or ineffective.
3-Palms and Soles,Nails
a) Topical glucocorticoids
b) PUVA
c) Retinoids (acitretin >isotretinoin) orally
d) Combination of a and b.
👍2❤1🙏1
GENERALIZED PSORIASIS
1-Acute, Guttate Psoriasis
a) First treat streptococcus infection with antibiotics.
b) Narrow band UVB irradiation most effective.
c) PUVA.
2-Generalized Plaque-Type Psoriasis
a) Narrow-Band UVB Phototherapy:
Effective only in psoriasis with very thin plaques
b) Oral PUVA Photochemotherapy
oral (8-MOP or 5-MOP) then exposure to UV radiation.
-Side effects: keratosis, Squamous cell carcinoma.
c)In patients with recalcitrant plaque-type psoriasis, acitretin (in males) or isotretinoin (in females) may be combined with other antipsoriatic therapy.
4-Methotrexate أهم واحد
Is the drug of choice and the most convenient treatment for generalized plaque type psoriasis.
Warning: Before starting ttt, check CBC, LFT and RFT because it is contraindicated in anemia or liver and renal diseases also in pregnancy.
After treatment do liver biopsy.
5-Cyclosporine
6-Monoclonal Antibodies and Fusion Proteins:
a) Alefacept
b) Efalizumab
7-Tumor necrosis factor (TNF) α antagonists, e.g.Infliximab.
GENERALIZED PUSTULAR PSORIASIS
(von Zumbusch)
-Patients Should be treated in specialized unit like that of burn cases,do isolation, fluid replacement, and repeated blood cultures which are necessary.
DOC is (acitretin, 50 mg/d).
1-Acute, Guttate Psoriasis
a) First treat streptococcus infection with antibiotics.
b) Narrow band UVB irradiation most effective.
c) PUVA.
2-Generalized Plaque-Type Psoriasis
a) Narrow-Band UVB Phototherapy:
Effective only in psoriasis with very thin plaques
b) Oral PUVA Photochemotherapy
oral (8-MOP or 5-MOP) then exposure to UV radiation.
-Side effects: keratosis, Squamous cell carcinoma.
c)In patients with recalcitrant plaque-type psoriasis, acitretin (in males) or isotretinoin (in females) may be combined with other antipsoriatic therapy.
4-Methotrexate أهم واحد
Is the drug of choice and the most convenient treatment for generalized plaque type psoriasis.
Warning: Before starting ttt, check CBC, LFT and RFT because it is contraindicated in anemia or liver and renal diseases also in pregnancy.
After treatment do liver biopsy.
5-Cyclosporine
6-Monoclonal Antibodies and Fusion Proteins:
a) Alefacept
b) Efalizumab
7-Tumor necrosis factor (TNF) α antagonists, e.g.Infliximab.
GENERALIZED PUSTULAR PSORIASIS
(von Zumbusch)
-Patients Should be treated in specialized unit like that of burn cases,do isolation, fluid replacement, and repeated blood cultures which are necessary.
DOC is (acitretin, 50 mg/d).
👍2❤1🙏1
بإختصار:
Isolated localized chronic stable psoriasis 👉🏻T.glucocorticoids.
Generalized plaque type psoriasis 👉🏻Methotrexate.
Inverse psoriasis 👉🏻T.pimecrolimus.
GENERALIZED PUSTULAR PSORIASIS👉🏻Acitretin.
Isolated localized chronic stable psoriasis 👉🏻T.glucocorticoids.
Generalized plaque type psoriasis 👉🏻Methotrexate.
Inverse psoriasis 👉🏻T.pimecrolimus.
GENERALIZED PUSTULAR PSORIASIS👉🏻Acitretin.
👍2❤1🙏1
BCC👉🏻 Mohs surgery
SCC👉🏻 Surgery
M.melanoma👉🏻 Surgical excision
SCC👉🏻 Surgery
M.melanoma👉🏻 Surgical excision
❤2👍1🙏1
Quick notes:
Asboe Hansen's sign
Pressure over the surface of a bulla by the finger leads to peripheral bilster spreading.
Pemphigus vulgaris.
Fixed drug eruption:
Fixed to the drug and fixed to the same site.
-Characteristic early lesion is a sharply demarcated macule hours after
ingestion of the offending drug. Initially erythema, then dusky red to violaceous.
-Most common causative drug is Tetracyclines.
-Most common site involved is Genital skin.
-After healing leads to hyperpigmentation.
Treatment of Urticaria and Angioedema:
Chronic urticaria👉🏻Antihistamines
Acute urticaria with angioedema👉🏻Prednisone
Hereditary angioedema👉🏻Danazol
Severe angioedema 👉🏻Adrenaline life saving
Chronic idiopathic or autoimmune urticaria👉🏻 Cyclosporine "When systemic Glucocorticoids contraindicated or side effects.
Asboe Hansen's sign
Pressure over the surface of a bulla by the finger leads to peripheral bilster spreading.
Pemphigus vulgaris.
Fixed drug eruption:
Fixed to the drug and fixed to the same site.
-Characteristic early lesion is a sharply demarcated macule hours after
ingestion of the offending drug. Initially erythema, then dusky red to violaceous.
-Most common causative drug is Tetracyclines.
-Most common site involved is Genital skin.
-After healing leads to hyperpigmentation.
Treatment of Urticaria and Angioedema:
Chronic urticaria👉🏻Antihistamines
Acute urticaria with angioedema👉🏻Prednisone
Hereditary angioedema👉🏻Danazol
Severe angioedema 👉🏻Adrenaline life saving
Chronic idiopathic or autoimmune urticaria👉🏻 Cyclosporine "When systemic Glucocorticoids contraindicated or side effects.
❤2👍1🙏1
LEPROSY"Hansen disease"
Cause: M. leprae
Transmission: Uncertain; possibl transmission includes nasal droplet infection.
Types:
Tuberculoid: Well-defined, hypopigmented, slightly scaling, anesthetic macules and plaques on skin.
Borderline: Geographic shaped plaque on the skin with raised red indurated margins and central clearing. There is extension of the infection indicated by the erythematous papules beyond the margins.With anesthetic sensation.
Lepromatous: Macules, papules, nodules, plaques.Thickened on face leonine facies. Lesions not hypoaesthetic but glove and stocking anaesthesia, trophic ulcers of periphery, muscle paralysis. Nasal crusting and epistaxes. Saddle nose, Keratitis, Infertility.
MANAGEMENT:
DOC: Dapsone.
Cause: M. leprae
Transmission: Uncertain; possibl transmission includes nasal droplet infection.
Types:
Tuberculoid: Well-defined, hypopigmented, slightly scaling, anesthetic macules and plaques on skin.
Borderline: Geographic shaped plaque on the skin with raised red indurated margins and central clearing. There is extension of the infection indicated by the erythematous papules beyond the margins.With anesthetic sensation.
Lepromatous: Macules, papules, nodules, plaques.Thickened on face leonine facies. Lesions not hypoaesthetic but glove and stocking anaesthesia, trophic ulcers of periphery, muscle paralysis. Nasal crusting and epistaxes. Saddle nose, Keratitis, Infertility.
MANAGEMENT:
DOC: Dapsone.
❤1👍1🔥1🙏1