Chapter IV - Dermatology

COMMON SKIN PROCEDURES
Biopsy
Sometimes, a small piece of tissue is excised through a surgical process for some microscopic examination. This
excision is called biopsy and such an act is performed with the help of a needle or syringe. The general purpose of
getting a biopsy is to arrive at a diagnosis. The different kinds of biopsies performed are aspiration or needle
biopsy, punch biopsy, shave biopsy, endoscopic biopsy, and chorionic villus biopsy. In aspiration or needle biopsy,
the specimen is aspirated through a needle or trocar that penetrates the skin, the outer surface of the organ, or
the underlying tissue to be examined. In punch biopsy, the specimen removed is in the form of a cylinder. Shave
biopsy is a technique performed with surgical or razor blades, chiefly for the lesions of the dermis or epidermis.
Cryosurgery
Cryosurgery is a kind of operation performed using freezing temperature. This temperature is achieved by
employing liquid nitrogen or carbon dioxide. This freezing temperature is used either as an agent or in an instrument to destroy tissues.
Dermabrasion
Dermabrasion is a technique to wipe out the acne scars (cicatrix) or the pits (small depressions in the skin). The
physicians use sandpaper, rotating wire brushes, or other abrasive materials to efface these scars.
Electrocauterization
Scarring, burning, or cutting the skin by means of heat, cold, electric current, ultrasound, or caustic chemicals is
called cauterization. During electrocauterization, a high-voltage current is passed through the tissues or the metal
device that has been electrically heated.
Electrodesiccation
Lesions of the skin, sometimes of the mucous membranes, are destroyed and blood vessels sealed off by the
monopolar high-frequency electric current. This process is known as electrodesiccation.
Frozen section
In this process, a thin slice of tissue is excised from a frozen specimen and sent for microscopic examination. This
procedure is used for rapid diagnosis of malignancy, while the patient awaits surgery. This generally helps in
determining the approach towards the surgery, i.e. conservative or radical.
Incision and drainage
Incision and drainage is a simple procedure to drain the fluids from a wound or cavity, An incision is made to allow
the free flow or withdrawal of fluids from the wound or cavity.
Patch test
A small, circumscribed, flat area, not more than 1 cm in diameter, differing in color or structure from the
surrounding surface, is called a patch. Patch test is done to ensure the sensitivity of the skin. A small piece of
paper or tape is soaked with a non-irritating diluted test fluid and applied on the skin of upper back or upper outer
arm and covered. After 48 hours, the covered area is compared with the uncovered area. The presence of
erythema and vesicles indicate the allergy towards that substance.
Scratch test
Scratch test is one of the various skin tests performed to diagnose a pathology of the skin. In scratch test, an
antigen is applied through a scratch in the skin.
Tzanck smear
Arnault Tzanck was a Russian dermatologist (1886- I 954). Tzanck smear is the examination of fluid from the
bullous lesions of the altered epithelial cells, rounded and devoid of intercellular attachments, also known as Tzanck
cells. These cells are basophilic in nature, with spherical nucleus and enlarged prominent nucleoli. They are
characteristic of lesions due to varicella, herpes, and pemphigus vulgaris.
Now, lets take a look at the pharmacopoeia of skin.

and dexamethasone sodium phosphate. salicylic acid. Abrasion: scraping away or excoriation of the superficial layer of the skin or mucous membrane 2. sulfonamides. zinc oxide. Examples: selenium sulfide.). eczema. and trunk. and as preoperative antiseptics. and comedos. methyl prednisolone acetate. After application to the skin. etc.Chapter IV . psoriasis. Antifungal: agents acting against fungus (syn antimycotic) 11. Emollients improve the dryness of skin but are not to be used on exudative lesions (oils like coconut. groundnut. VOCABULARY 1. Allograft: a graft between the individuals of the same species 7. propylene glycol. topical erythromycin. tretinoin. Alopecia: falling hair. scalp. impetigo. and chest. and meclocycline Antipsoriatic Psoriasis refers to the circumscribed discrete. coal tar. elbow. These antifungals include scabicides. and etretinate. The antiseptics used are chloroxylenol. and leg ulcers. clotrimazole which is used for Tinea infections. loss of hair 8. and ketoconazole for fungal infections of the skin. Topical Antifungals These agents kill the fungus selectively. chloroxine. hydrocortisone. Example: Malathion. emollients prevent evaporation of water by forming a thin greasy layer on the skin surface. paronychia. and athlete foot. Adenopathy: disease of the glands (lymph nodes) 5. folliculitis. eczema. which kill scabiei that invade the epidermis. Emollients and keratolytics Emollients are agents used to soothe and hydrate the skin. Adipose: of or related to fat 6. Areola: any small area (also used for the areola of nipple) . candida vulvitis. Anesthetics: agents which suppress the ability to feel pain or other sensations 9. confluent reddish lesions that primarily occur on knees. Examples: benzoyl peroxide. fungal nappy rash. Anti-inflammatory: agents to reduce inflammation 12. Example: beclomethasone dipropionate. keloid scars. lindane.PHARMACOLOGY AND VOCABULARY Acne vulgaris drugs These drugs control the inflammatory eruptions composed of cysts. seborrheic dermatitis. papules. and vulvovaginal candidiasis. nitrofurazone. benzyl benzoate. candida balanitis. triamcinolone acetate. They are also used for abrasions. Topical steroids Topical steroids are used to treat various dermatological disorders like contact dermatitis. Topical anti-infectives Topical anti-infectives are used for treatment of bacterial infections of skin. tetracycline. benzoic acid. Abscess: a pus-filled cavity caused by tissue destruction and associated with swelling 3. cetrimide. coal tar. Keratolytics are agents applied to soften the epidermic cells and desquamate them. and vulval pruritus. Disinfectives) 13. silvery-scaled. Antiseborrheics These drugs are effective for treatment of seborrheic dermatitis manifested by erythematous and scaly lesions. There are many drugs for treatment of psoriasis like Calcipotriene. and dimethicone. Some other antifungal are miconazole. predominantly on the face. Antibacterial: agents acting against the growth of bacteria 10. candidiasis of skin and nails and also for eczema with bacterial infection. which has a broad spectrum of antifungal activity and is used for fungal and eczematous infections of tinea. Example: mupirocin. and povidone-iodine. for example. cuts. and sulfur and sulfacetamide. upper back. Acne: papular follicular eruptions characterized by pus and inflammation 4. and acyclovir. Antiseptics: agents that prevent growth of infective agents (syn. aminoglycoside. The condition occurs in a majority of people during puberty and adolescence.

Frostbite: a condition caused by extreme cold or frost in which tissues are killed 53. Graft: tissues used for transplantation 56. Impetigo: skin pathology characterized by vesicles which rupture and form thick yellowish crust 66. Excoriation: scraping or peeling of the pathological tissues from the skin 49. Desquamation: shedding or peeling of the outer layer or surface 40. Hair shaft: non-growing portion of hair protruding 59. Syn. Extravasation: passing out of blood or lymph. Carbuncle: skin infections of the subcutaneous tissue. Corium: dermis 26. Electrodesiccation 54. Cellulitis: inflammation of the cellular tissues 21. Ichthyosis: abnormal condition characterized by hardening. non-malignant 16. Dermatomycosis: fungus infection of the skin 34. Biopsy: process of taking out a specimen of tissue for diagnostic purposes 17. Dermatotherapy: treatment of skin pathology 38. Dermabrasion: operation performed to remove the acne scars 30. and scaling of the skin 65. Hidradenoma: tumor or neoplasm caused by sweat glands 60. Ecchymosis: a purple spot or patch caused by passing of the blood into the skin 41. flattened pieces of layer 52. urticari2. Exanthem: skin eruptions. Dermatophytosis: skin abnormality in which vesicles. Epidermis: outer layer of the skin 44. Integument: skin and related structures . Hirsutism: excessive hair on the body especially in women 61. Benign: mild. accompanied by fever 20. Flaking: eruption of small. drying.14. Dermatologist: specialist in the study of skin and its diseases 32. Cyst: a bladder or sac containing some sort of fluid 28. Hair follicle: the cavity from which the hair shaft develops 57. cleft. Blemish: unaesthetic circumscribed alteration of the skin 18. Dermis: corium. and/or fissures are caused by dermatophytes 35. 62. papules. Chloasma: skin infections characterized by irregular brown patches 22. Crust: a hard outer layer or covering (sometimes referred to the one formed by pus or blood) 27. Fulguration: the act or process of destroying tissues or lesions by applying electric current. mostly as a result of viral disease 48. Hypodermis: the second layer of skin below the dermis 64. Bulla: a large bubble-like blister 19. Fissure: a narrow opening. Atopic: related to hypersensitivity to environmental allergens 15. Hyperhidrosis: abnormal condition of excessive sweating 63. Dermatology: specialty. Cicatrix: scar 23. Eczema: inflammatory condition of the skin characterized by erythematous edematous papular vesicles of the skin 42. Dermatosis: abnormalities of the skin 37. Electrodesiccation: destroying the lesions or pathological skin tissues by applying a high frequency electric current 43. or break in the body parts or between the tissues 51. In situ: confined in the original place 67. dealing with skin 33. Contusion: injury in which skin does not break 25. Debridement: the process of taking out the dead tissues from a wound site 29. Erythema: redness of the skin 46. Hair root: part of the hair embedded in the hair follicle 58. skin 39. Eschar: a crust or scar formed after the burn or cauterization of the skin tissues 47. thin. Dermatitis: skin inflammation 31. into the tissues 50. Glandular: relating to a gland 55. Eruption: breaking out of the lesions 45. Hives: itching wheals. Comedo: dilated hair follicle filled with bacteria and sebum 24. Dermatoplasty: surgical repair of the skin 36.

Scale: a small thin plate of hardened epithelium 120. Metastasize: spread (of the disease) to other areas from the point of origin 94. Mammoplasty: plastic surgery of the breast. Neoplasms: abnormal pathological growth of cells 97. Pores: hole. Onychocryptosis: ingrown nail producing a pus-filled granuloma 102. Pilonidal: relating to the presence of hair in a sinus opening of the skin. Scleroderma: hardening of the skin 121. Keratolytics: agents acting against the excessive shedding of the epidermis 73. Rash: skin eruptions 117. Onychomalacia: softening of the nails 103. Pallor: paleness. Purpura: lesions characterizing the hemorrhage into the skin 115. Psoriasis: circumscribed discrete lesions of macule or papule size which are confluent and silvery-scaled 114. Pemphigus: a pathological condition of skin blisters 109. yellowish coloration of the skin 104. Lipoid: resembling fat 81. hair or nails 118. syn. Mole: birthmark. Melanodendrocyte 91. Lumpectomy: removal of a lump (mass) from the breast 82. Mammography: x-ray. Petechia: small hemorrhagic spots 110. Mastectomy: excision of the breast. Nulliparous: a lady who has not experienced childbirth 101. Lipocyte: fat cell 80. Pediculosis: lousiness. Macule: a small discolored spot 84. Mastoplasty 88. Keloid: a firm movable nodule 71. Lesion: a wound. Microscope: an instrument used to view extremely small objects 95. Lactic: relating to milk 76. mri or any other radiologic examination of the breast 87. Keratosis: lesions on the epidermis characterized by the horny layer 74. Nipple: a projection at the apex of the breast where lactiferous ducts open 99. Site: place. Keratin: a kind of protein found in hairs or nails 72. Pruritus: itching 113. syn. Itching: uncomfortable skin condition inducing rubbing or scraping of the affected part 70. Nevus: birthmark. Menarche: beginning of tile menstruation cycle 93. Mammogram: the radiographic record of breast examination 86.68. Malignant: spreading and difficult to control (neoplasm) 85. Lunula: a semilunar pale arched area at the beginning of the nail place 83. ultrasound. Melanoma: malignant neoplasm of the skin 92. Sclerosis: abnormal condition of becoming too firm or hard 122. opening 112. Mammectomy 89. mole 98. Ringworm: dermatophytosis. 111. Mammoplasty 90. Lactiferous: giving milk 77. Syn. Sebaceous: relating to sebum or fat 123. Melanocytes: pigment-producing cell. fungus infection of the skin. Pustule: small circumscribed pus-filled elevation 116. syn. or in jury 79. location . Laceration: a cut 75. Irritation: inflammation with roughness or soreness 69. presence of lice 108. cut. Papule: small elevation on the skin 106. Mastoplasty: surgical repair of the breast. Lentigo: freckle-like brown macule 78. Parasiticides: agents that destroy parasites 107. Nodule: a small circumscribed swelling 100. Scabies: vesicular eruptions and intense pruritus due to mites 119. Sebum: secretion of the sebaceous glands 124. nevus 96. Papilla: small nipple-like orifice 105.

SC: subcutaneous 19. relating to scales Stage: extent or severity of the disease Stasis: stagnation. decub. UV: ultraviolet 10. steat/o: fat 5. 141. 143. 127. wheal. 126. lip/a: fat 4. adeno: glands 2. 135. verruca Welt: lesions occurring because of urticaria. ung. dermat/o: skin . IM: intramuscularly 13. 140. 145.125. pus formation Thelitis: nipple or nipple-like structure Tinea: a fungus infection of hair. I&D: incision and drainage 7. 146. 138.: ointment 9. 132. Dx: diagnosis 16. 144. 130. swelling Ulcer: an inflammatory lesion on the skin surface or surface of the mucous membrane Ungual: relating to nail Urticaria: itching condition of the skin characterized by wheals Verruca: circumscribed growth of the papillae Vesicle: small circumscribed fluid filled elevation of skin Vitiligo: skin condition characterized by white patches of varied sizes Wart: flesh-colored growth. Squamous: scaly. 147. PE: physical examination 18. hives Xenograft: graft from an individual of one species to that of another species Xeroderma: dry scaly skin Xeromammography: xeroradiographic breast examination Xeroradiography: radiography using the dry powder in stead of liquid chemicals ABBREVIATIONS 1. adip/o: fat 3. 137. 136. HSV: herpes simplex virus 6. FH: family history 17. Bx: biopsy 2. derm: dermatology 4. 151. 133. 149. FS: frozen section 5.: decubitus 11. skin or nails Trichopathy: diseases associated with hairs Tumor: neoplasm. crypt/a: hidden 6. IV: intravenously 14. 150. subcu: subcutaneous 15. 131. 134. C&S: culture and sensitivity 3. 128. 129. ID : intradermal 12. 139. WBC: white blood cell COMBINING FORMS 1. 148. KOH: potassium hydroxide 8. the condition of not changing Steatoma: tumor or neoplasm related to fat Stratum: layer Stratified squamous epithelium: epithelium containing scaly keratin cells Stratum corneum: outer layer of the epidermis Stratum germinativum: the deepest layer of the epidermis Subcutaneous: referring to the laver below the dermis Sudoriferous: of or related to sweats Suppuration: pyogenesis. 7. cutane/o: skin I. 142.

scaly 11. -cyte: cell 2. onych/o: nail 17. ichthy/o: dry. -logy: study of 7. scler/o: hardening 20. hyper-: excessive 3. hypo: below normal. pillo: hair 19. thel/o: nipple 22. mammo/o: breast 14. trich/o: hair 23. derm/o: skin 9. kerat/o: hardening 12. mast/o: breast 15. hidr/o: sweat 10. squam/o: scaly 21. less 4. lact/o: milk 13.8. -logist: specialist in the study of 6. -gram: record 4. -therapy: treatment PREFIX 1. xerlo: dry SUFFIX 1. sub: below . epi-: above 2. ungu/o: nail 18. -graphy: process of recording 5. myc/o: fungus 16. -derma: skin 3.