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BASIC TERMINOLOGY

PROF DR ZARNAZ WAHID

CLASSIFICATION

1 VISIBLE BUT IMPALPABLE ALTERATION 2 PALPABLE AND USUALLY VISIBLE ALTERATION 3 FLUID CONTAINING LESIONS 4 LESIONS CONCERNING STRATUM CORNEUM 5 LESIONS SECONDARY TO SKIN DAMAGE 6 LESIONS CONCERNED WITH BLOOD VESSELS 7 CERTAIN SPECIFIC LESIONS

1 VISIBLE BUT IMPALPABLE ALTERATION

MACULE
A CIRCUMSCRIBED ALTERATION IN THE COLOUR AND TEXTURE OF THE SKIN LESS THAN 1 CM IN DIAMETER

PATCH
A LARGER LESION WITH ALTERATION IN COLOUR AND TEXTURE

2 PALPABLE AND USUALLY VISIBLE ALTERATION

PAPULE
A CIRCUMSCRIBED PALPABLE ELEVATION,LESS THAN 1 CM IN DIAMETER

PLAQUE
A FLAT ELEVATED AREA OF SKIN 1CM OR MORE IN DIAMETER, HAVING LENGTH BREADTH AND HEIGHT

2 PALPABLE AND USUALLY VISIBLE ALTERATION

NODULE
A SOLID MASS MORE THAN 1CM

PAPILLOMA
A NIPPLE LIKE MASS FROM THE SURFACE OF THE SKIN

2 PALPABLE AND USUALLY VISIBLE ALTERATION

WEAL
A TRANSIENT AREA OF DERMAL AND HYPODERMAL EDEMA,WHITE COMPRESSIBLE AND EVANESCENT

3 FLUID CONTAINING LESIONS

VESICLE
FLUID CONTAINING LESIONS LESS THAN 0.5CM IN DIAMETER

BULLAE
FLUID CONTAINING LESIONS MORE THAN 0.5CM IN DIAMETER.

3 FLUID CONTAINING LESIONS

PUSTULE
A VISIBLE ACCUMULATION OF FREE PUS.IT MAY OCCUR WITHIN A PILOSEBACEOUS FOLLICLE OR SWEAT DUCT OR LESS OFTEN ON GLABEROUS SKIN

CRUST
CRUST CONSISTS OF DRIED SERUM OR OTHER EXUDATES.

4 LESIONS CONCERNING STRATUM CORNEUM

SCALE
A FLAT PLATE OR FLAKE OF STRATUM CORNEUM.

EXFOLIATION
THE SPLITING OF THE EPIDERMAL KERATIN IN SCALE OR SHEET.

4 LESIONS CONCERNING STRATUM CORNEUM

HYPERKERATOSIS A HORNY THICKENING OF THE EPIDERMIS

5 LESIONS SECONDARY TO SKIN DAMAGE

EROSION
A LOSS OF EPIDERMIS WHICH HEALS WITHOUT SCARRING.

EXCORIATION
LOSS OF SKIN SUBSTANCES PRODUCED BY SCRATCHING IT MAY BE LINEAR SUPERFICIAL OR DEEP.

5 LESIONS SECONDARY TO SKIN DAMAGE

FISSURE
A LINEAR GAP OR SLIT IN THE SKIN.

ULCER
A LOSS OF DERMIS AND EPIDERMIS OFTEN WITH LOSS OF UNDERLYING TISSUE. IT IS PRODUCED BY SLOUGHING OF OVERLYING NECROTIC TISSUES.

5 LESIONS SECONDARY TO SKIN DAMAGE

SCAR
REPLACEMENT BY FIBROUS TISSUE OF ANOTHER TISSUE THAT HAS BEEN DESTROYED BY INJURY OR DAMAGE.

LICHENIFICATION
THE THICKENING OF THE EPIDERMIS (AND TO SOME EXTENT ALSO OF THE DERMIS) IN RESPONSE TO PROLONG RUBBING.

6 LESIONS CONCERNED WITH BLOOD VESSELS

ERYTHEMA
REDNESS OF THE SKIN PRODUCED BY VASCULAR CONGESTION AND INCREASED
PERFUSION.

ECCHYMOSIS
A MACULAR AREA OF HAEMORRHAGIC SPOT MORE THAN 2 MM IN DIAMETER

6 LESIONS CONCERNED WITH BLOOD VESSELS

PETECHIAE
A PUNCTATE HEMORRAGHIC SPOT, APPROXIMATELY 1-2 MM IN DIAMETER.

TELENGIECTASIS
PATTERN PRODUCED BY PERMANENTLY DILATED BLOOD VESSELS.

6 LESIONS CONCERNED WITH BLOOD VESSELS

GANGRENE
DEATH OF TISSUES DUE TO LOSS OF BLOOD SUPPLY.

7 CERTAIN SPECIFIC LESIONS

BURROW
A GREYISH LINEAR C OR S SHAPED TUNNEL,FORMED BY THE FEMALE SARCOPTES SCABEI IN THE STRATUM CORNEUM

COMEDONE
A PLUG OF KERATIN OR SEBUM IN A DILATED PILOSEBACEOUS CANAL.

7 CERTAIN SPECIFIC LESIONS

TARGET LESIONS
THESE ARE LESS THAN 3MM IN DIAMETER AND HAVE THREE ZONES. CENTRAL AREA OF DUSKY ERYTHEMA OR PURPURA MIDDLE PALE ZONE OF ERYTHERMA OUTER RING OF ERYTHEMA WITH WELL DEFINED EDGE.

7 CERTAIN SPECIFIC LESIONS

KOEBNERS PHENOMENON
THE LESIONS OCCUR ON THE NORMAL SKIN SECONDARY TO SOME TRAUMA OR SCRATCHING.

SCABIES

Scabies is a contagious disease caused by a mite sarcoptes scabeii var.homini often occurring in epidemics. SARCOPTES SCABEII

SHAPE FLATTENED DORSOVENTRALLY COLOUR CREAMY WHITE MARKED BY CORRUGATION FEMALE 0.4mm long by 0.3mm broad. MALE 0.2mm long by 0.15mm broad. 40-50 eggs are laid by each female.

SCABIES
CLIINICAL FEATURES (PRIMARY LESIONS ) PAPULES/NODULES/BURROW (SECONDARY LESIONS) IMPETIGO/FOLLICULITIS/ECZEMATISATION
pustule

BURROW /FINGER WEB


PAPULES NODULES

EXCORIATION

INTRACTACTABLE ITCHING

SECONDARY INFECECTION

PAPULE

NORWEGIAN SCABIES IMMUNOSUPPRESSED PATIENTS WARTY CRUSTS AND PLAQUES ERTHRODERMA / GEN LYMPHADENOPATHY

SCABIES
DIAGNOSIS
CLINICAL FEATURES / FAMILY HISTORY / KOH PREPERATION / EXAMINATION OF BURROW
CLINICAL FEATURE FAMILY HISTORY KOH PREPERATION

EXAM BURROW

SCABIES

TRANSMISSION.
TREATMENT.

General instruction. Topical scabicidal agent.


25% Benzyl benzoate. 25% Monosulfiram. 0.5% Malathion. 5% Permethrin. 1% Lindane(GBHC) Crotamiton.

SCABIES
SYSTEMIC TREATMENT
Antibiotics. Antihistamine. Ivermectin.