203. Dermatology Simplified

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203. Dermatology Simplified

203. Dermatology Simplified

 

 

CATEGORY: Medical & Medicine – 500 Courses

COURSE NUMBER: 203

FEES: 555/- INR only

CERTIFICATE VALIDITY: Lifetime

CERTIFICATES DELIVERY: In 48 hours

BOOKS/ MANUALS: Pages

Syllabus

Part I Introduction
1 The Starter Kit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.1 General Advice on Studying . . . . . . . . . . . . . . . 4
1.1.1 How to Study . . . . . . . . . . . . . . . . . . . . . . 4
1.1.2 Logic of This Book. . . . . . . . . . . . . . . . . . 4
1.2 Describing Skin Conditions . . . . . . . . . . . . . . . . 6
1.2.1 Primary Lesions (Defining
Lay Terms) . . . . . . . . . . . . . . . . . . . . . . . . 10
1.2.2 Secondary Lesions . . . . . . . . . . . . . . . . . . 13
1.2.3 Other Non-specific Terms (Try to Limit
Use, but Impossible to Avoid) . . . . . . . . 14
1.3 Describing Dermatopathology Findings . . . . . 14
1.3.1 Dermpathology Terminology . . . . . . . . . 14
1.3.2 A Few Quick Tips . . . . . . . . . . . . . . . . . . 16
1.3.3 Approaching Histopathologic
Description . . . . . . . . . . . . . . . . . . . . . . . . 16
1.3.4 Immunofluorescence Findings . . . . . . . . 17
1.4 Morphologic Reaction Patterns . . . . . . . . . . . . 18
Part II Medical Dermatology Outlines
2 Papulosquamous Diseases . . . . . . . . . . . . . . . . . . . . . 23
2.1 Psoriasiform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
2.1.1 Psoriasis. . . . . . . . . . . . . . . . . . . . . . . . . . . 24
2.1.2 Seborrheic Dermatitis . . . . . . . . . . . . . . . 27
2.1.3 Parapsoriasis . . . . . . . . . . . . . . . . . . . . . . . 28
2.1.4 Mycosis fungoides (MF) . . . . . . . . . . . . . 29
2.1.5 Reactive arthritis (Formerly Reiter’s
syndrome) . . . . . . . . . . . . . . . . . . . . . . . . . 29

2.1.6 Pityriasis rubra pilaris (PRP) . . . . . . . . . 29
2.1.7 Palmoplantar keratoderma (PPK). . . . . 30
2.2 Pityriasiform . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
2.2.1 Pityriasis Rosea (PR) . . . . . . . . . . . . . . . 30
2.2.2 Secondary Syphilis . . . . . . . . . . . . . . . . . . 30
2.2.3 Tinea/Dermatophytoses . . . . . . . . . . . . . 30
2.2.4 Pityriasis (Tinea) Versicolor . . . . . . . . . . 31
2.2.5 Pityriasis Rotunda . . . . . . . . . . . . . . . . . . 31
2.3 Lichenoid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
2.3.1 Lichen Planus (LP) . . . . . . . . . . . . . . . . . 31
2.3.2 Lichenoid Drug Reaction . . . . . . . . . . . . 32
2.3.3 Lichen Nitidus . . . . . . . . . . . . . . . . . . . . . 32
2.3.4 Lichen Striatus . . . . . . . . . . . . . . . . . . . . . 32
2.3.5 Graft vs. Host Disease (GVHD) . . . . . . 33
2.3.6 Keratosis Lichenoides Chronica . . . . . . 33
2.4 Erythroderma/Exfoliative Dermatitis . . . . . . . 33
2.5 Other (Not Traditionally Thought
of as Papulosquamous, but may
be Pink, Raised, and Scaly) . . . . . . . . . . . . . . . . 34
3 Eczematous Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . 37
3.1 The Three Stages of Eczema . . . . . . . . . . . . . . . 38
3.1.1 Acute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
3.1.2 Subacute . . . . . . . . . . . . . . . . . . . . . . . . . . 38
3.1.3 Chronic . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
3.2 Types of Eczema . . . . . . . . . . . . . . . . . . . . . . . . . 39
3.2.1 Contact Dermatitis . . . . . . . . . . . . . . . . . 39
3.2.2 Atopic Dermatitis . . . . . . . . . . . . . . . . . . 48
3.2.3 Nummular Dermatitis . . . . . . . . . . . . . . . 49
3.2.4 Dyshidrotic Eczema/Pompholyx . . . . . . 49
3.2.5 Id Reaction (Autosensitization or
Autoeczematization Dermatitis) . . . . . . 50
3.2.6 Infectious Eczematoid. . . . . . . . . . . . . . . 50
3.2.7 Drug Dermatitis . . . . . . . . . . . . . . . . . . . . 50
3.2.8 Stasis Dermatitis . . . . . . . . . . . . . . . . . . . 50
3.2.9 Cutaneous T-Cell Lymphoma (CTCL)/
Mycosis Fungoides (MF) . . . . . . . . . . . . 50
3.2.10 Asteatotic Dermatitis
(Eczema Craquele) . . . . . . . . . . . . . . . . . 51

3.2.11 Lichen Simplex Chronicus
(LSC)/Prurigo Nodularis. . . . . . . . . . . . . 51
3.2.12 Exfoliative Dermatitis
(Erythroderma) . . . . . . . . . . . . . . . . . . . . 51
3.2.13 Seborrheic Dermatitis . . . . . . . . . . . . . . 51
3.2.14 Other Eczemas . . . . . . . . . . . . . . . . . . . . 51
4 Vesiculobullous Diseases . . . . . . . . . . . . . . . . . . . . . . 53
4.1 Subcorneal Blisters/Superficial . . . . . . . . . . . . . 54
4.2 Intraepidermal Blisters. . . . . . . . . . . . . . . . . . . . 58
4.3 Suprabasilar Blisters . . . . . . . . . . . . . . . . . . . . . . 59
4.4 Subepidermal Blisters. . . . . . . . . . . . . . . . . . . . . 61
4.4.1 Neutrophilic . . . . . . . . . . . . . . . . . . . . . . . 61
4.4.2 Lymphocytic . . . . . . . . . . . . . . . . . . . . . . . 63
4.4.3 Eosinophilic and Mixed . . . . . . . . . . . . . 63
4.4.4 Non-inflammatory/Cell-Poor . . . . . . . . . 66
4.5 Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
5 Vascular Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
5.1 Toxic Erythema . . . . . . . . . . . . . . . . . . . . . . . . . . 72
5.1.1 Viral Exanthems
(Children > > Adults). . . . . . . . . . . . . . . . 72
5.1.2 Drug Eruptions
(Adults > > Children). . . . . . . . . . . . . . . . 73
5.1.3 Scarlatiniform Eruptions. . . . . . . . . . . . . 77
5.1.4 Other Reactive Toxic Erythema . . . . . . 78
5.2 Figurate Erythemas
(Annular or Gyrate Erythemas) . . . . . . . . . . . . 79
5.3 Urticaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
5.4 Erythema Multiforme (EM) . . . . . . . . . . . . . . . 83
5.5 Purpura. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
5.5.1 Palpable Purpura/Vasculitis . . . . . . . . . . 85
5.5.2 Macular Purpura . . . . . . . . . . . . . . . . . . . 92
5.5.3 Vasculopathy. . . . . . . . . . . . . . . . . . . . . . . 93
5.6 Regional Erythema. . . . . . . . . . . . . . . . . . . . . . . 97
5.7 Vascular Tumors . . . . . . . . . . . . . . . . . . . . . . . . . 103
5.8 Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104

6 Dermal Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
6.1 Inflammatory . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
6.1.1 Lymphocytic . . . . . . . . . . . . . . . . . . . . . . . 108
6.1.2 Granulomatous/Histiocytic. . . . . . . . . . . 110
6.1.3 Neutrophilic . . . . . . . . . . . . . . . . . . . . . . . 119
6.1.4 Eosinophilic . . . . . . . . . . . . . . . . . . . . . . . 122
6.1.5 Mastocytic . . . . . . . . . . . . . . . . . . . . . . . . . 123
6.1.6 Plasmacytic . . . . . . . . . . . . . . . . . . . . . . . . 125
6.1.7 Mixed Cell Infiltrate . . . . . . . . . . . . . . . . 126
6.2 Neoplastic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
6.3 Depositional. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
6.3.1 Amyloid. . . . . . . . . . . . . . . . . . . . . . . . . . . 127
6.3.2 Calcium . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
6.3.3 Urate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
6.3.4 Mucin. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
6.3.5 Lipid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
6.3.6 Pigment Deposition . . . . . . . . . . . . . . . . . 137
6.3.7 Hyaline-Like Material
Deposition. . . . . . . . . . . . . . . . . . . . . . . . . 139
6.3.8 Implantable Depositions. . . . . . . . . . . . . 140
6.3.9 Porphyrias . . . . . . . . . . . . . . . . . . . . . . . . . 140
6.3.10 Storage Disorders . . . . . . . . . . . . . . . . . . 143
6.4 Subcutaneous/Panniculitis . . . . . . . . . . . . . . . . . 144
6.4.1 Mostly Septal Panniculitis. . . . . . . . . . . . 144
6.4.2 Mostly Lobular Panniculitis . . . . . . . . . . 146
6.4.3 Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
7 Neoplastic Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . 151
7.1 Keratinocyte Neoplasms . . . . . . . . . . . . . . . . . . 152
7.2 Melanocytic Neoplasms . . . . . . . . . . . . . . . . . . . 159
7.3 Adnexal Tumors . . . . . . . . . . . . . . . . . . . . . . . . . 171
7.4 Other Epidermal
Neoplasms/Hyperplasias . . . . . . . . . . . . . . . . . . 180
7.5 Vascular Tumors . . . . . . . . . . . . . . . . . . . . . . . . . 180
7.6 Spindle Cell Tumors . . . . . . . . . . . . . . . . . . . . . . 187
7.7 Fatty Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
7.8 Cysts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198

7.9 Lymphatic Malformations . . . . . . . . . . . . . . . . . 201
7.10 Lymphomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
7.11 Other Malignant (Including Metastatic) . . . . . 210
7.12 Other Benign . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212
7.13 Syndromes with Multiple Tumors
or Multiple Types of Tumors . . . . . . . . . . . . . . . 213
7.14 Paraneoplastic Syndromes . . . . . . . . . . . . . . . . . 220
7.15 Skin Diseases Associated with Monoclonal
Gammopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222
8 Acneiform Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . 227
8.1 Acne . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
8.2 Rosacea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
8.3 Folliculitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
8.3.1 Superficial Folliculitis . . . . . . . . . . . . . . . 233
8.3.2 Deep Folliculitis . . . . . . . . . . . . . . . . . . . . 234
8.3.3 Pseudofolliculitis . . . . . . . . . . . . . . . . . . . 234
8.4 Follicular Cysts . . . . . . . . . . . . . . . . . . . . . . . . . . 235
9 Alopecia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
9.1 Scarring Alopecia . . . . . . . . . . . . . . . . . . . . . . . . 238
9.1.1 Inflammatory Scarring Alopecia . . . . . . 238
9.1.2 Non-Inflammatory Scarring
Alopecia . . . . . . . . . . . . . . . . . . . . . . . . . . 240
9.2 Non-Scarring Alopecia . . . . . . . . . . . . . . . . . . . . 240
9.2.1 Non-Inflammatory Non-Scarring
Alopecia . . . . . . . . . . . . . . . . . . . . . . . . . . 240
9.2.2 Inflammatory Non-Scarring
Alopecia . . . . . . . . . . . . . . . . . . . . . . . . . . 242

9.3 Genodermatoses Associated
with Alopecia. . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
9.4 Hair Shaft Abnormalities. . . . . . . . . . . . . . . . . . 244
9.4.1 Structural Abnormalities
with Increased Hair Fragility . . . . . . . . . 244
9.4.2 Structural Abnormalities
Without Hair Fragility. . . . . . . . . . . . . . . 246
9.5 Excess Hair Growth . . . . . . . . . . . . . . . . . . . . . . 247

10 Connective Tissue Diseases . . . . . . . . . . . . . . . . . . . . 249
10.1 Lupus Erythematosus (LE). . . . . . . . . . . . . . 250
10.2 Dermatomyositis. . . . . . . . . . . . . . . . . . . . . . . 253
10.3 Sclerotic Disease. . . . . . . . . . . . . . . . . . . . . . . 256
10.3.1 Scleroderma/Systemic
Sclerosis . . . . . . . . . . . . . . . . . . . . . . . 256
10.3.2 Lichen Sclerosus
(et atrophicus). . . . . . . . . . . . . . . . . . 257
10.3.3 Other Sclerodermoid
Conditions . . . . . . . . . . . . . . . . . . . . . 258
10.4 Rheumatoid Arthritis. . . . . . . . . . . . . . . . . . . 259
10.5 Sjögren’s Syndrome . . . . . . . . . . . . . . . . . . . . 260
10.6 Other Autoimmune Connective
Tissue Diseases . . . . . . . . . . . . . . . . . . . . . . . . 260
10.7 Non-Autoimmune Connective
Tissue Diseases . . . . . . . . . . . . . . . . . . . . . . . . 261
10.7.1 Inherited Non-Autoimmune
Connective Tissue Diseases. . . . . . . 261
10.7.2 Acquired Non-Autoimmune
Connective Tissue Diseases. . . . . . . 263
11 Infectious Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
11.1 Bacterial. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266
11.1.1 Gram Positive Bacteria . . . . . . . . . . 266
11.1.2 Gram Negative Bacteria. . . . . . . . . . 272
11.2 Treponemes and Spirochetes. . . . . . . . . . . . . 277
11.3 Fungal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
11.3.1 Superficial Fungal . . . . . . . . . . . . . . . 283
11.3.2 Subcutaneous Fungal . . . . . . . . . . . . 289
11.3.3 Deep/Systemic Fungal Infection . . . 291
11.4 Mycobacteria. . . . . . . . . . . . . . . . . . . . . . . . . . 294
11.4.1 Typical Mycobacteria . . . . . . . . . . . . 294
11.4.2 Atypical Mycobacteria . . . . . . . . . . . 298
11.5 Viral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
11.5.1 DNA Viruses . . . . . . . . . . . . . . . . . . . 299
11.5.2 RNA Viruses . . . . . . . . . . . . . . . . . . . 307
11.6 Sexually Transmitted
Infections (STIs) . . . . . . . . . . . . . . . . . . . . . . . 310
11.7 Congenital Infections: TORCHeS . . . . . . . . 311

11.8 Parasites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312
11.8.1 Protozoa . . . . . . . . . . . . . . . . . . . . . . . 312
11.8.2 Helminths (Worms) . . . . . . . . . . . . . 314
11.9 Infestations . . . . . . . . . . . . . . . . . . . . . . . . . . . 317
11.9.1 Arthropods (Insects) . . . . . . . . . . . . 317
11.9.2 Arachnids . . . . . . . . . . . . . . . . . . . . . . 320
11.10 Other Bites and Stings . . . . . . . . . . . . . . . . . . 323
12 Pigmentary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . 325
12.1 Hyperpigmented Conditions. . . . . . . . . . . . . 325
12.1.1 Localized Hyperpigmentation. . . . . 325
12.1.2 Generalized
Hyperpigmentation . . . . . . . . . . . . . 326
12.2 Hypopigmented Conditions . . . . . . . . . . . . . 328
12.2.1 Localized Hypopigmentation . . . . . 328
12.2.2 Segmental/Nevoid
Hypopigmentation . . . . . . . . . . . . . . 329
12.2.3 Generalized Hypopigmentation . . . 329
12.2.4 Leukodermas
(Depigmentation). . . . . . . . . . . . . . . 330
12.3 Reticulated Pigmentation . . . . . . . . . . . . . . . 334
12.4 Mixed Hyper and Hypopigmentation . . . . . 335
13 Keratotic Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337
13.1 Ichthyoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . 338
13.1.1 Retention of Keratin (Retention
Hyperkeratosis) . . . . . . . . . . . . . . . . 338
13.1.2 Hyperproliferation
of Keratin (Proliferative
Hyperkeratosis) . . . . . . . . . . . . . . . . 339
13.1.3 Genodermatoses
With Ichthyosis
or Erythrokeratodermia . . . . . . . . . 341
13.2 Palmoplantar Keratoderma (PPK). . . . . . . . 343
13.2.1 Inherited Palmoplantar
Keratodermas . . . . . . . . . . . . . . . . . . 343
13.2.2 Acquired Palmoplantar
Keratoderma . . . . . . . . . . . . . . . . . . . 346
13.3 Papillomatous Epidermal Eruptions . . . . . . 347

13.4 Hyperkeratotic/Verrucous
Lesions and Eruptions . . . . . . . . . . . . . . . . . . 348
13.5 Prurigo and Lichen Simplex . . . . . . . . . . . . . 351
13.6 Perforating Disease . . . . . . . . . . . . . . . . . . . . 353
13.7 Porokeratosis. . . . . . . . . . . . . . . . . . . . . . . . . . 354
14 Nutritional Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . 357
14.1 General Nutrition Deficiency/
Protein- Energy Malnutrition. . . . . . . . . . . . . 357
14.2 Vitamin Deficiencies . . . . . . . . . . . . . . . . . . . 358
14.3 Hypervitaminosis/Vitamin Excess . . . . . . . . 361
14.4 Mineral Deficiencies. . . . . . . . . . . . . . . . . . . . 361
14.5 Mineral Excess . . . . . . . . . . . . . . . . . . . . . . . . 363
14.6 Other Deficiencies/Excesses . . . . . . . . . . . . . 364
14.7 Other Diseases Associated
with Malnutrition . . . . . . . . . . . . . . . . . . . . . . 365
Part III Lists and Mnemonics
15 Lists, Common Differential Diagnoses,
and Mnemonics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369
15.1 Differentials. . . . . . . . . . . . . . . . . . . . . . . . . . . 370
15.1.1 Triads and Near Triads . . . . . . . . . . . 370
15.1.2 Important Clinical Differentials . . . 373
15.1.3 Differentials by Distribution/
Anatomic Location . . . . . . . . . . . . . . 377
15.1.4 Differentials by Morphology and
Configuration. . . . . . . . . . . . . . . . . . . 382
15.1.5 Other Clinical Differentials . . . . . . . 384
15.1.6 Other Disease Category
Differentials . . . . . . . . . . . . . . . . . . . . 385
15.2 Associations and Work-Ups . . . . . . . . . . . . . 389
15.2.1 Disease-Specific Associations . . . . . 389
15.2.2 Work-Ups. . . . . . . . . . . . . . . . . . . . . . 391
15.3 Acronyms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394
15.3.1 List of Acronyms. . . . . . . . . . . . . . . . 394
15.3.2 Diseases Known Primarily
by Acronyms . . . . . . . . . . . . . . . . . . . 397

15.4 Dermatopathology . . . . . . . . . . . . . . . . . . . . . 399
15.4.1 Differentials, Lists,
and Mnemonics . . . . . . . . . . . . . . . . . 399
15.4.2 Lists and Notes . . . . . . . . . . . . . . . . . 403
15.4.3 Other Factoids . . . . . . . . . . . . . . . . . . 404
15.4.4 Stains and
Immunohistochemistry. . . . . . . . . . . 407
15.5 Lists. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409
15.5.1 Quick Quiz Lists . . . . . . . . . . . . . . . . 409
15.5.2 Often Asked Facts. . . . . . . . . . . . . . . 414
15.5.3 Interesting Factoids. . . . . . . . . . . . . . 416
15.5.4 Nevi, Erythemas, and Other
Common Terms . . . . . . . . . . . . . . . . . 418
15.5.5 Clinical Signs (with Nicknames
or Eponymous Names). . . . . . . . . . . 421
15.5.6 Nail and Teeth Findings . . . . . . . . . . 422
15.6 Commonly Confused Diseases . . . . . . . . . . . 424
15.6.1 Sound-Alikes and Look-Alikes. . . . 424
15.6.2 Other Similar Sounding
Diseases . . . . . . . . . . . . . . . . . . . . . . . 433
15.6.3 Misnomers . . . . . . . . . . . . . . . . . . . . . 434
15.7 Other Lists. . . . . . . . . . . . . . . . . . . . . . . . . . . . 436
15.7.1 Types of Certain Dermatologic
Diseases . . . . . . . . . . . . . . . . . . . . . . . 436
15.7.2 Drug Eruption Mnemomics. . . . . . . 439
15.7.3 Other Lists . . . . . . . . . . . . . . . . . . . . . 443
Part IV High Yield Topics
16 Medications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451
16.1 Systemic Immunosuppressants
and Anti-inflammatory Agents . . . . . . . . . . . 452
16.2 Cytotoxic Medications
and Chemotherapy Agents . . . . . . . . . . . . . . 456
16.2.1 Metastatic Melanoma
Systemic Therapies. . . . . . . . . . . . . . 459
16.2.2 BCC Systemic Therapy. . . . . . . . . . . 460
16.2.3 Anti-Cutaneous T-Cell
Lymphoma Systemic Therapies. . . . 460

16.3 Biologics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460
16.4 Retinoids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 463
16.5 Antibiotics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
16.5.1 Antifungals. . . . . . . . . . . . . . . . . . . . . 465
16.5.2 Bacteriostatic/Bactericidal
Antibiotics (Divided by
Site of Action). . . . . . . . . . . . . . . . . . 466
16.5.3 Anti-viral Medications . . . . . . . . . . . 468
16.5.4 Other Antibiotic Agents. . . . . . . . . . 469
16.6 Other Systemic Medications . . . . . . . . . . . . . 470
16.7 Other Topical Medications . . . . . . . . . . . . . . 473
16.7.1 Combination Products for Acne . . . 477
16.8 Drug Metabolism and Interactions . . . . . . . 477
17 Procedures, Cosmetics, and Surgery . . . . . . . . . . . . . 479
17.1 Procedures and Cosmetics. . . . . . . . . . . . . . . 480
17.1.1 Neurotoxins . . . . . . . . . . . . . . . . . . . . 480
17.1.2 Fillers . . . . . . . . . . . . . . . . . . . . . . . . . 481
17.1.3 Peels . . . . . . . . . . . . . . . . . . . . . . . . . . 482
17.1.4 Lasers . . . . . . . . . . . . . . . . . . . . . . . . . 482
17.1.5 Phototherapy . . . . . . . . . . . . . . . . . . . 486
17.1.6 Photodynamic Therapy. . . . . . . . . . . 487
17.1.7 Sclerotherapy. . . . . . . . . . . . . . . . . . . 488
17.1.8 Dermabrasion . . . . . . . . . . . . . . . . . . 489
17.1.9 Hair Transplantation
(Follicular Unit Transplantation) . . 489
17.1.10 Liposuction . . . . . . . . . . . . . . . . . . . . 489
17.2 Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489
17.2.1 Anatomy. . . . . . . . . . . . . . . . . . . . . . . 489
17.2.2 Antiseptics . . . . . . . . . . . . . . . . . . . . . 498
17.2.3 Sterilization . . . . . . . . . . . . . . . . . . . . 498
17.2.4 Pre-surgery Medication . . . . . . . . . . 499
17.2.5 Wound Healing . . . . . . . . . . . . . . . . . 500
17.2.6 Wound Dressings. . . . . . . . . . . . . . . . 501
17.2.7 Mohs Surgery. . . . . . . . . . . . . . . . . . . 502
17.2.8 Indications for Mohs Surgery . . . . . 502
17.2.9 Reconstruction . . . . . . . . . . . . . . . . . 502
17.2.10 Healing by Secondary Intention . . . 503
17.2.11 Flaps . . . . . . . . . . . . . . . . . . . . . . . . . . 503

17.2.12 Grafts . . . . . . . . . . . . . . . . . . . . . . . . . 504
17.2.13 Sutures . . . . . . . . . . . . . . . . . . . . . . . . 505
17.2.14 Safety/Needlesticks . . . . . . . . . . . . . . 509
17.2.15 Other Surgical Rules . . . . . . . . . . . . 509
17.2.16 Margins. . . . . . . . . . . . . . . . . . . . . . . . 510
17.2.17 Cryosurgery/Cryotherapy . . . . . . . . 510
17.2.18 Electrosurgery . . . . . . . . . . . . . . . . . . 511
18 Basic Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513
18.1 Keratinocyte Adhesion . . . . . . . . . . . . . . . . . 514
18.2 Basement Membrane . . . . . . . . . . . . . . . . . . . 516
18.3 Cornified Envelope . . . . . . . . . . . . . . . . . . . . 519
18.4 Extracellular Matrix (ECM) . . . . . . . . . . . . . 522
18.5 Molecular Biology Review . . . . . . . . . . . . . . 525
18.5.1 Important Tumor
Suppressor Genes. . . . . . . . . . . . . . . 526
18.5.2 Important Oncogenes. . . . . . . . . . . . 526
18.5.3 Genes in Melanoma . . . . . . . . . . . . . 527
18.5.4 Ultraviolet Radiation-Induced
Mutagenesis. . . . . . . . . . . . . . . . . . . . 530
18.5.5 Other Important Pathways
and Categories of Gene Defects . . 530
18.5.6 Transmembrane
Transporter Defects . . . . . . . . . . . . . 532
18.5.7 Defects in Pyrin/NOD
Family Related Proteins . . . . . . . . . 532
18.5.8 Defects in Nuclear Envelope. . . . . . 532
18.5.9 Defects in DNA Repair Genes . . . . 532
18.6 Embryology . . . . . . . . . . . . . . . . . . . . . . . . . . . 533
18.7 Melanocyte Biology . . . . . . . . . . . . . . . . . . . . 534
18.8 Nail Biology. . . . . . . . . . . . . . . . . . . . . . . . . . . 535
18.9 Sebum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 536
18.10 Hair. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 536
18.11 Itch Review . . . . . . . . . . . . . . . . . . . . . . . . . . . 538
18.12 Immunology Review . . . . . . . . . . . . . . . . . . . 539
18.12.1 Innate Immune Response . . . . . . . . 539
18.12.2 Adaptive Immune Response . . . . . . 543
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 549

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