DERMATOLOGY, VENEROLOGY & LEPROLOGY Paper XVI

Course description

Dermatologic problems are one of the most common health problems in Nepal. Some dermatopathies are highly debilitating, while others are associated with severe systemic diseases. The visible nature of the skin disease is often a cause of social stigma. Although only few skin diseases are life threatening, many can cripple life. Skin problems seem to be increasing day by day. Increase in pollutions and change in life style has contributed to this. Health institutions get quite a large number of patients with skin problems. This curriculum lays stress on the frequently encountered conditions. Both the outpatient and the inpatient clinical settings should be used to enable students to gain clinical skills.

General objectives

Students will be able to

  • outline the role and importance of dermatology in modern medicine;
  • explain the structure and function of the skin as an organ;
  • take proper history from the patients and perform clinical examination.
  • diagnose and manage common skin sexually transmitted diseases.
  • identify complicated dermatological problems and refer them.

Specific objectives

Students will be able to

  • state normal structure and function of the skin

Infective dermatoses

Students will be able to

  • diagnose and manage the most common infective skin diseases in the community:
  • Bacterial infections-Impetigo, ecthyma, folliculitis, furunculosis, skin TB
  • Parasitic infections — scabies and pediculosis
  • Fungal infections — dermatophytoses, candidiasis, pityriasis versicolor, deep fungal infections
  • Viral — infections herpes zoster, herpes simplex, common warts, molluscum contagiosum

Leprosy

Students will be able to

  • diagnose leprosy;
  • manage and treat leprosy patients;
  • recognize and treat leprosy reactions;
  • refer casss requiring further management;

Non — infective dermatoses : Eczema

Students will be able to

  • identify eczema and classify eczema
  • manage following eczemas:
  • Endogenous eczemas

atcoic, seborrheic, nummular, lichen simplex chronicus, pompholyx

  • Exogenous eczemas

irritant and ailergic contact dermatitis; photodermatitis; phytodermatitis

Papulosquamous diseases

Students will be able to

  • identify and treat psoriasis, pityriasis rosea, lichen planus;
  • refer complicated cases of psoriasis.

Bullous diseases

Students will be able to

  • diagnose and manage

pemphigus, pemphigoid, chronic bullous disease of childhood (CBDC), dermatitis herpetiformis, epidermolysis bullosa;

  • refer complicated cases

Cutaneous drug eruptions

Students will be able to

  • diagnose and manage acute drug eruptions, fixed drug eruption (FDE), erythema multiforme
  • refer severe form of erythema multiforme, Stevens Johnson syndrome and toxic epidermolysis necrosis (TEN).

Immunological diseases

Students will be able to

  • diagnose lupus erythematosus. scleroderma, dermatomvositis, mixed connective tissue disorder.

Nutritional and metabolic disorders

Students will be able to

  • diagnose and manage pellagra ;
  • diagnose and refer phryndoerma, hyperlipidemia, acrodermatitis enteropathica.

Disorders of sebaceous glands, sweat glands and hair follicle s

Students will be able to

  • diagnose and treat acne and miliaria
  • refer cases of telogen effluvium, androgenetic alopecia and complicated cases of acne.

Skin tumors

Students will be able to

  • diagnose benign and malignant skin tumors — BCC, SCC, melanoma, cutaneous lymphoma, nevus
  • treat benign skin tumors
  • refer suspected malignant tumors.

Pigmentary disorders : vitiligo, melasma

Students will be able to

  • manage vitiligo and melasma
  • counsel and refer complicated cases

Miscellaneous

Students will be able to

  • diagnose and manage urticaria, angioedema and
  • diagnose and refer vaculitis,

STI (Sexually transmitted infections)

Students will be able to

  • diagnose and treat syphilis, gonococcal urethritis, non-gonococcal urethritis, channcoroid, LGV, granuloma inguinale, genital warts, genital herpes.
  • manage STD on syndromic approach

AIDS

Students will be able to

  • diagnose suspected cases of HIV infection by its skin mainfesiai’ons.
  • provide health education regarding its D*eveni»cn;
  • refer cases of AIDS
  • provide voluntary counseling
  • diagnose and manage different problems on skin and sexually transmitted diseases by PBL
  • Handbook of leprosy — W.H. Jopling
  • Dermatology for house officers — Lynch,
  • Dermatology in Clinical Practice — DU Vivier
  • Clinical Dermatology … MV Dahl.
  • Venereal diseases — King and Nicoll
  • Dermatology in primary care — Lamgerg
  • Manual of dermatologic therapeutics — KA Arndt.
  • Colour atlas of Dermatology — LK Bhutani — Reference books
  • Textbook of Dermatology — Rook, Wilkinson, Ebling
  • Textbook and atlas of Dermatology — RG Valia
  • Dermatology in General Medicine — Fitzpatrick -
  • National STI management guidaline