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  • Extended Patient Contact
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  • Introduction to Year 3 and Year Outcomes
  • Clinical Science and Professionalism (Weeks 1-3)
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  • Introduction and Year 4 Outcomes
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  • Dermatology
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  • Student Selected Component (SSC)
• Year 5
  • Introduction to Year 5 and Year Outcomes
  • Teaching Week 1
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  • Community Care
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  • Student Selected Component (SSC)
• Year GEP 1
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  • Human Sciences and Public Health
  • Digestion, Growth and Metabolism
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  • Ethics
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  • Medicine in Society (GEP)

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Year 4 DERM4: Dermatology

• Dr Jane McGregor
• j.mcgregor@qmul.ac.uk

Teaching Material for this Module

Introduction

General practitioners report that up to 20% of their consultations involve some aspect of skin disease. In addition, signs present in the skin often provide clues to systemic disease that is otherwise hidden. Dermatology is a very visual subject and close observation and description is a clinical skill that you will develop during the course of the module. However, just like other areas of medicine, the diagnosis and management of skin disease requires a logical approach to history taking, examination and investigation.

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Index

• General Outcomes for Dermatology
• Systemic Disease in Dermatology
• Dermatological Emergencies
• Blisters
• Skin Lumps and Bumps
• Skin Infections
• Inflammatory Skin Disease
• Hair Loss and Gain
• Skin Cancer

• General Outcomes for Dermatology
  • Medical knowledge: CLINICAL FEATURES of DISEASE (TD 8 b)
    • General Outcomes for Dermatological Diseases
      1. Can describe the clinical features of common skin disorders, using appropriate terminology, and to relate the signs to the underlying pathology eg eczema, urticaria, psoriasis, benign and malignant skin lumps
  • Medical knowledge: SOCIOLOGY (TD 10 a-e)
    • Chronic Illness and Disability
      1. Demonstrate an ability to understand the impact that chronic skin diseases have on a patient’s quality of life.
  • Clinical skills: HISTORY (TD 13 a-b)
    • Taking a History
      1. Be able to obtain an appropriate dermatological history from a patient presenting with a skin complaint.
    • Examination of the Skin
      1. Be able to demonstrate an appropriate level of skill in skin examination, including nails, hair and mucosa.
  • Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)
    • Dermatological Investigations
      1. To interpret and apply results of common investigations employed in dermatological diseases, including skin biopsy, full blood count, ESR, CRP, autoimmune screen, serum biochemistry and skin swab results for mycology and bacteriology.
  • Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)
    • Diagnosis of Skin Disorders
      1. Be able to construct an appropriate differential diagnosis and plan of investigation for a patient presenting with the index dermatological conditions
  • Clinical skills: FORMULATING A TREATMENT PLAN (TD 14 g)
    • Management of Skin Disorders
      1. Be able to outline strategies available including education, drug therapy, physical treatments, psychosocial interventions) for the management of skin disorders
  • Clinical skills: INTERACTION WITH PATIENTS (TD 15 a-b)
    • Interacting with Patients - General
      1. Demonstrate the ability to communicate the nature of the condition and its management to the patient
  • Clinical skills: PRESCRIBING DRUGS SAFELY AND EFFECTIVELY (TD 17 a-h)
    • Pharmacological Therapy - Dermatological Disorders (General)
      1. Demonstrate knowledge of the basic pharmacology and use of topical treatments, including emollients and steroids
      2. Can describe the common or important adverse effects, including important drug interactions, of the systemic treatments commonly used in the index dermatological conditions.
      3. Demonstrate knowledge of the basic pharmacology of common and important systemic therapeutic agents used in skin disease including methotrexate, roaccutane, prednisolone, azathioprine and the biologics.
• Systemic Disease in Dermatology
  • General
    1. Demonstrate an ability to recognise skin signs of common or important systemic diseases including: Granuloma Annulare; Dermatitis herpetiformis, Necrobiosis lipoidica; Acanthosis nigricans; Splinter haemorrhage; Dermatomyositis; Systemic lupus erythematos
    2. Describe the relevant investigations for confirmation of the following systemic diseases: Granuloma Annulare; Dermatitis herpetiformis, Necrobiosis lipoidica; Acanthosis nigricans; Splinter haemorrhage; vasculitis, Dermatomyositis; Systemic lupus erythema
    3. The above, but also for Erythema nodosum; Erythema multiforme and Pruritus
• Dermatological Emergencies
  • General
    1. Demonstrate an ability to recognise a dermatologic emergency including the following conditions: Erythroderma; Toxic Epidermal Necrosis; Necrotising Fascitiis and Stevens Johnson Syndrome
    2. Describe the relevant investigations required for the following conditions: Erythroderma; Toxic Epidermal Necrosis; Necrotising Fascitiis and Stevens Johnson Syndrome
    3. Outline a basic management plan for first contact care of a patient with a life threatening skin disease including: Erythroderma; Toxic Epidermal Necrosis; Necrotising Fascitiis and Stevens Johnson Syndrome
• Blisters
  • General
    1. Demonstrate an ability to recognise the signs and symptoms of a patient with a blistering dermatosis.
    2. Describe the relevance of the investigations employed in a patient with Blistering Dermatosis
    3. Have a working knowledge of the functional biology of the basement membrane in relation to blisters.
    4. Have a working knowledge of the treatments available and any complications for the following conditions: Bullous Pemphigoid; Pemphigus Vulgaris and Dermatitis Herpetiformis
• Skin Lumps and Bumps
  • General
    1. Demonstrate an ability to recognise and distinguish common benign skin lumps including: Moles; Freckles; Dermato-fibroma; Pyogenic Granuloma; Seborrheic Keratosis and Haemangioma
    2. Have a working knowledge of the treatment options available for the following: Moles; Freckles; Dermato-fibroma; Pyogenic Granuloma; Seborrheic Keratosis and Haemangioma
• Skin Infections
  • General
    1. Be able to demonstrate an ability to recognise presentation of common skin infections including: Cellulitis; Impetigo; Fungal infection; Herpes simplex; Herpes zoster; Human papillomavirus and Yeast infections
    2. Describe the relevant investigations required for the following skin infections: Cellulitis; Impetigo; Fungal infection; Herpes simplex; Herpes zoster; Human papillomavirus and Yeast infections
    3. Describe the basic management outline for following conditions: Cellulitis; Impetigo; Fungal infection; Herpes simplex; Herpes zoster; Human papillomavirus and Yeast infections
• Inflammatory Skin Disease
  • General
    1. Demonstrate an ability to recognise common inflammatory skin disorders including: Psoriasis; Eczema and Lichen Planus
    2. Have a working knowledge of the treatments available for common inflammatory skin disorders including: Psoriasis; Eczema and Lichen Planus
    3. Describe important adverse effects or complications of common therapies employed in the treatment of Psoriasis; Eczema and Lichen planus
• Hair Loss and Gain
  • General
    1. Demonstrate an ability to discriminate between different patterns of hair loss eg distribution, pathology (scarring, non-scarring alopecia)
    2. Be able to list the common causes of hair loss
    3. Demonstrate an understanding of the impact of hair loss/gain on the patients quality of life
    4. Describe relevant investigations for a patient presenting with hair loss/gain including: Adrogenetic Alopecia; Hirsutism and Alopecia Areata
• Skin Cancer
  • General Outcomes for Skin Cancer
    1. Demonstrate an ability to recognise and distinguish malignant lesions including; Actinic Keratoses; Basal Cell Carcinoma; Squamous Cell Carcinoma and Melanoma
    2. Demonstrate an ability to recognise and distinguish malignant lesions including; Actinic Keratoses; Basal Cell Carcinoma; Squamous Cell Carcinoma and Melanoma
    3. Have a working knowledge of the treatment options available.
    4. Demonstrate competence in the recognition of moles, dysplastic moles and melanoma
    5. Have a working knowledge of the public health strategies for increasing awareness of skin cancer and to understand the major risk factors for skin cancer.
    6. Have a working knowledge of the public health strategies for increasing awareness of skin cancer and to understand the major risk factors for skin cancer.
  • Malignant Melanoma
    1. Understand the significance of the prognostic factors associated with melanoma.
    2. Have a working knowledge of the treatment options available

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