Lecture 1 Sept 13th

Pg 5. Disadvantages of having a skin condition: • Emotional effect • Impact on employment Advantage/benefit of having a skin condition? • Sign of something internal: an early sign • Barometer of stress levels • Attention… sometimes any attention is good (eg. Kids “acting out”) SUBCONSCIOUS! Pg 6: nothing to add Pg 7: Detoxification: Need to ensure proper GI function BEFORE beginning detox, or patients will detox and not be able to eliminate toxins. This will result in further skin eruptions. Epidermis: very thin • Most superficial layer • Thin but tough • No blood vessels in this layer (if you cut the epidermis only, you won’t bleed) Dermis: • Inner, supportive layer • Well-supplied with blood Pg 8: Appendages of skin: Most pathologies occur here, not in the dermis or epidermis on their own. Hair: a. Vellus hair is the hair on our arms (for example). It is fine, not conspicuous. b. Terminal hair includes pubic, axillary hair, and the hair on our head. Sebaceous Glands 1. secrete sebum 2. Have to be careful with what skin is cleansed with. If product is too acidic, more oil will be produced. Sweat Glands: • Widely distributed; produce sweat (dilute saline) Apocrine glands: Sweat odour: due to bacterial flora on skin reacting with sweat

Be sensitive and respectful: You don’t have to touch lesions, but touch may help connect with the patient, put them at ease. Pg. 9: When describing type of lesion, be specific. “Red bumps” not very helpful: specify papules, etc. Especially important for referrals to other practitioners. KOH: dissolves keratinocytes allowing hyphae and spores to be more readily identified. Other tests: Wood’s lamp is a fluorescent light that shows fungus as neon green. Pg 10: Nothing to add Pg 11: The end organ mentioned under “etiology and pathogenesis” is the skin. Follicular hyperkeratosis results in accumulation… Pg. 12: DDX: 1. Folliculitis: inflammation/infection of the hair follicle. Hair will be piercing pustule in this condition. Physical examination: Special lesions: • Rhinophyma: thickening of tissue of nose. Due to appearance of nose, patient may be thought to drink heavily although they do not. Pg. 13: Lesions: Smooth presentation of butterfly rash, not mottled like acne. Discrete border.