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Ok. Hi guys. Um Can you hear me? Cause I just typed something in the chat? Ok, perfect. Um Sorry about the delay. Um Let's get started. So I'm I'm a third year medical student um and I'm on my final clinical attachment for the year. So that's GP for me. Um that's my email there. So feel free to drop me any questions. Um and I think my phone number is also on the year two chat so you can message me um about anything pretty much it doesn't have to be done but yeah. Ok. Um let's get started. So um yeah, dermatology, I'm gonna start with um like a little background. Ok, hopefully like the technology works. So I'm not too good at this stuff but yeah, these are the two TYS um the first one is just your basic BRS Tylo and the second one is specifically for skin disorders. Um We start with some like general derm and then the other each of your lectures. Yeah. OK. Um Just a brief note on etymology that's the study of origin of words. Um It's quite helpful and dumb because a lot of the terms are derived from like Latin and Greek roots. So being familiar with these roots just makes it easier to understand. Um For example, dermatitis comes from derma, meaning skin and itis, meaning inflammation. So I put that in. Um OK, how to describe the lesion? So when we um fic like images or care about like a dumb condition, you wanna ask yourself fly is the lesion flat. So if it's a flat, uh efficient, sorry. Um Meaning it doesn't have any change in things, thickness or texture. It's either gonna be a macule or a pa, it's greater than one second lesson. After that, we certainly ask ourselves, is there any fluid? Um If there is, there's gonna be a vesicle or blood, if there's no fluid, but the skin is elevated. Um And when I'm elevated, I mean, like bump like spotlight, it's going to be a papule or a nodule. Um If you have sort of like a flat, um slightly elevated, so it's not like properly bumpy, but it's a little raised. That's what we call a plaque. And then our third question to ask is, is there any pus? So if it's like big and bumpy and it's filled with pus, that's your, if it's painful and it's sort of like a pain collection of pus, we call that an abscess. Um And when the skin, so when that pus is in the skin, it's so like a boil. I was like, what's the difference between pustule and oil oils are sort of like, deeper, bigger, more painful while pustules are kinda like, like the baby version. Um, they're more like a bump or a blister. Um, and then you have a wheel as well, which is like a sudden inflamed raise of skin. Um, imagine, like you've been bitten by a mosquito. So, when you have like, an allergic reaction you get sort of a w, um, yeah. Ok. I've got some examples. Um, for the sake of time I might just like come through them because the doctors are quite long and a week we have everything. Um, yeah, the first one is hopefully this one. Yeah, a that, um, you can kind of see. It's, uh, um, the second one is the, um, and it's, you know, the difference between bone and vesicle. This one looks quite big, so it's bigger than a centimeter. Whereas the next one looks smaller. So it's, um, a vesicle. Um, I think one day before this is a mapping. Yeah. Um, and then the next one you can kinda see it's like a pussy and spot, like going to pustule. Um, then we have a plaque. Um, the next one is sort of like a papule cause it's smaller and then you've got a nodule and then the last one is what you have an allergic reaction. That's good. But I'll send all of these slides so you guys can have a look at it, um, in your own time as well. OK. Describing rashes. So a rash is just a widespread eruption of lesions. Um maculopapular rash. So maculopapular rash is made up of both flat and raised skin lesions. Um It look like the name is a blend between the words macule, which are the flat discolored skin and papule which were the small face. Yeah. OK. Peper. So, Peper are red or purple spots on the skin and you usually get them because of bleeding that happens underneath. So they don't blanch and blanch means fade by the way when you press on them. Um purpura can be a sign of like blood or vessel problem, like disorders, vasculitis, infections, that sort of stuff. And then we divide pura into two major categories. So, nonpalpable purpura, which are called macular and then PPAR which are called papula. Um And then there are two main types of nonpalpable P So you have P and ecchymosis PTA are just like t um they're more than three millimeters and ecchymosis are larger bruises. Um So that'll be greater than three centimeters. Um And I think it has Yeah. So this is just an example of papula pura, I think it's oh yeah, potassium and um that's seen in thrombocytopenia. Um This is a hum as you can see, it's like a lot bigger. It's like um you see the like blood vessel fragility and this is an example of necrotic Amos um which you can find in the disseminated intravascular coagulation where the thrombi in dermal vessels lead to infarction and how much OK. Kind of w through that, it's really quickly. So if you have any questions, you get on something, feel free to touch in the chat. Uh and then yeah, I'll try and answer them as we go along. So, skin and systemic disease. Ok. So there are four ways in which the skin links to systemic disease. It can be targeted by multisystem disorders. It can be um suggestive of something else going on. Um or like a disease, having skin symptoms and that being another disease secondary to s I think the main takeaway is why is this important? Um So I think what I was trying to get out is that just more than skin deep. So they're basically just signs that there's something else bigger going on. And that's why doing a comprehensive assessment. Um you try and diagnose skills in d is really important because it prevents or reduces internal damage by early detection. And it also allows you to detect internal malignancies. So if there's cancer things like that happening, so you'll take it's very, oh I don't know why. Yeah, there we go. Ok. It's a quick um punch biopsy. So punch biopsy is a diagnostic skin procedure. Um Basically you have a circular blade, um put it in the and remove a small full thickness sample. Um It's usually, I think like epidermis, dermis, sometimes it's subcutaneous as well. Um um used for kind of like diagnosis or diagnosing rashes, lesions and cancers or when deeper layers of the skin need to be examined. Um But yeah, you basically just like put in some local anesthetic because it can be a bit painful. Um put the punch tool and like rotate it and then remove the sample with forcep cut base and then they usually, I think give one or two sutures um and leave it to heal. It's quite good in them because it's quite quick and simple and invasive and it preserves the skin architecture for histology, which is really important because a lot of um conditions look really similar and often when you want to be really sure about diagnosis, everyone's like, let's just do punch up. Yeah. Yeah. So these are the longest conditions um in skin and systemic diseases can go through them. I'd say they are quite important, especially cause a few of them are sort of dumb emergencies and there are a lot of DM emergencies. So there's quite a bit of information on the ones that are. Um but I do want us to go through it in a way that's easy to understand. So, Lupus.