Introduction to Podiatric Dermatology

1. Introduction to Podiatric Dermatology abscess desquamation Jeffrey C. Page, DPM PMED 1741 Podiatric Dermatology and Infectious Diseases Self-inflicted nail dystrophy

13. Introduction to Podiatric Dermatology • General Principles • Skin anatomy • Lesion types • Patterns & Configurations • Disorders of Sweat • Mechanical Lesions Exfoliation from reaction to gluten Depigmentation post steroid injection

14. Skin Anatomy Layers Appendages Purpose

15. Epidermal Layers • Stratum corneum • Stratum lucidum (palms and soles) • Stratum granulosum • Stratum spinosum (prickle cell layer) • Stratum basale (germinativum) • Merkel’s cells (storage granules) • Langerhans’ cells (immune system) • Melanocytes (produce melanin) • Keratinocytes (produce keratin)

16. Dermal Layers • Dermal-epidermal junction = basement membrane • Papillary dermis (superficial) • Reticular dermis (deep) • Vessels • Nerves • Appendages (adnexa) • Hair • Glands (sweat & sebaceous) • Nails

17. Subcutaneous Layer • Production and storage of fat cells • Supports blood vessels and nerves • Storage of nutrition • Thermoinsulation

18. Description of Lesions • Primary Lesions • Secondary Lesions • Elementary Lesions melanoma atrophy from injections

19. Descriptions Must Include: • Lesion type/ texture • Size/area • Moisture level • Color • Location

20. Macules Patches Papules Plaques Nodules Wheals Vesicles Bullae Pustules Cysts Tumors Primary Lesions

21. Macules & Patches Lentigo Hyperpigmentation from venous stasis Hypopigmentation from skin trauma

22. Papules verrucae nevus Kaposi’s sarcoma

23. Plaques psoriasis tinea corporis/pedis

24. Nodules Neurofibromatosis Nodular melanoma Hemangioma

25. Pustules

26. Vesicles & Bullae Vesicular tinea Chicken Pox herpes

27. Wheals (Hives) truncal placques dermatographism angioedema

28. Angioedema

29. Cysts* & Tumors Inclusion cyst Pedunculated nevus *Cysts are sometimes called special lesions

30. Scales Crusts Excoriations Fissures Ulcers Erosions Scars Induration Atrophy Lichenification? Secondary Lesions Plantar ulcer

31. Scales Icthyosis Severe edema due to heart failure Atopic dermatitis

32. Crusts Impetigo Scalp kerion

33. Erosions & Ulcers osteomyelitis Circinate balanitis Syphilitic chancre

34. Fissures & Atrophy Fissure from frequent dishwashing Atrophy and telangiectasia due to oral steroids

35. Scars keloid Hypertrophic scar following buionectomy Scars in construction worker Hypopigmented scar from acne

36. Elementary (Special) Lesions • Excoriations • Comedones • Burrows • Purpura • Petechiae • Ecchymoses • Macular or Papular • Telangiectasia • Lichenification? • Cyst? Sebacious cyst

37. Elementary (Special) Lesions Excoriations in factitial dermatitis Comedones

38. Purpura Vasculitides

39. Elementary (Special) Lesions Burrow in Scabies Telangiectasia from sun exposure

40. Elementary (Special) Lesions Spider Angioma Lichenification

42. Round Annular Discoid Targetoid Nummular Arciform-polycyclic Geographic Herpetiform-grouped Serpiginous-gyrate Linear Reticular Verrucous Guttate Patterns and Configurations

43. Round Lesions Dermatofibroma Tinea pedis/corporis Discoid Annular

44. Round Lesions Erythema multiforme Nummular eczema Targetoid Nummular

45. Arciform (polycyclic) Lichen planus

46. Geographic Lesions Pyoderma gangrenosum Pitted keratolysis Necrobiosis lipoidica diabeticorum melanoma

47. Herpetiform (Grouped) Lesions Herpes zoster Herpes zoster

48. Serpiginous (Gyrate) Poison ivy Leishmaniasis

49. Linear Lesions scratches wheals

50. Reticular (network) Lesions nevi