DERMATOLOGY

BLISTERING blistering
DISORDERS disorders
 Situation A –
- Flaccid blisters
- Raw skin situation A stiuation B stiuation C
- Mucosal lesions

RAW SKIN MUCOSAL ULCERS – irregular

margins (Round margins are
apthmous ulcer in mouth)
Differential – PEMPHIGUS VULGARIS

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Raw areas on mucosa and skin – NO targetoid lesions, NO black necrotic
skin – PEMPHIGUS VULGARIS

TEN –toxic epidermo necrolysis PV – pemphicus vulagris

1% 99%
Bleeding crusts on lip, eyelids Raw lesions on lip, eyes, mouth, but
no bleeding crusts
Targetoid lesions on skin No targetoid lesions
h/o drug intake No blaxk necrotic skin
Nikolskiy + Nikolskiy

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 ENT

DIFFUSE OTITIS EXTERNA

H/O - ear obstruction, young patient, H/O – ear discharge, redness on the
bilateral, a growth abnormality, there pinna – DIFFUSE OTITIS EXTERNA
is an obstruction in the external SWIMMERS EAR,
auditory canal, age 5-20 years TELEPHONIST EAR,
KERATOSIS OBTURANS SINGAPORE EAR,
NO NECROSIS TROPICAL EAR (ONE LINERS)
Rx – remove the squamous cells from
the external auditory canal by acetic
acid, but if the patient is not
responding – can go for canaloplasty
If necrosis is present, it is
CHOLESTEATOMA

Ear discharge School going child, young age – SEROUS

A diabetic patient, pus in the OTITIS MEDIA (SOM)
external auditory canal, granulation No fever
in the canal, facial palsy – No congestion

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MALIGNANT OTITIS EXTERNA
(EXPECTED QUESTION)
Technicium 99 (T99) – for diagnosis
Gallium for prognosis, but if patient
is poor, we use ESR
MOE – MENIERE – treatment is
medical, antibacterial – Pseudomonas
– 3rd generation cephalosporins and
then debridement
Bulging tympanic membrane
Treatment – myringotomy, anteroinferior
quadrant
If patient doesn’t respond till 3 months,
GOURMET insertion
If high grade fever – ASOM

PHYSIOLOGY
BASIC CONCEPTS
 Distribution of the body water and measurements of different body
fluid compartments (MCQ)
 ECF – 1/3rd and ICF – 2/3rd of the total body water
 ECF – plasma and interstitial fluids and transcellular fluids (cant be
measured, while measuring ECF)
 75% of ECF is present in interstitial fluid
 Plasma is 5% of total body weight
 Interstitial fluid – 15% of total body weight
 V = Q-e (where is the known amount of the indicator used, e is
C the amount metabolised or excreted, C – concentration
of the dye in a sample withdrawn after mixing has
taken place)
CELL MEMBRANE
 Lipid bilayer

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  Hydrophilic heads towards ECF/ICF and hydrophobic tails towards
inside
 Proteins present in cell membrane –
- Proteins:lipids = 1:1
- Functions & Types: transport, channel, structural, receptors,
antigens, enzymes
- Proteins – 55% dry weight of cell membrane

GAP JUNCTIONS
 Made up of
connexon
 Each
connexion has
6 subunits
with a central
core
 Diameter of a
connexion is
2nm and of
central core is
0.8-1.4 nm
(NEET)
 Seen in cardiac muscle, single unit type of smooth muscles, retina

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 Permit the movement of substances upto 1000 daltons between the
cells