Professional Documents
Culture Documents
Layers of skin
Basics
Stratum Basale
Function is division
Least keratin
Transition
Stratum basale to corneum 28 days
Hence, nucleated to non nucleated 28 days
If there is a disease that irritates basale > division speeds up
> transit time is highly shortened and enucleation does not
happen -> nucleated cells in stratum corneum PARAKERATOSIS
Parakeratosis a/w
a) Psoriasis
b) Coronoid lamella (unknown cause annular plaque with
keratotic ridge)
c) Parakeratosis is normal in mucus membranes
Terms in dermatopathology
Scales : visible shedding of skin
Hyperkeratosis : accumulation of cells in and thickening of
stratum corneum (a/w psoriasis)
Hypergranulosis : accumulation of cells in and thickening of
stratum granulosum (a/w lichen planus)
Acanthosis : accumulation of cells in and thickening of stratum
spinosum (stratum malphigi or prickle cell layer) (a/w psoriasis)
AcathoLYSIS : Loss of coherence of keratinocytes (a/w
pemphigus)
Dyskeratosis : Abnormal development of epidermal cells
resulting in rounded cells devoid of their prickles, and having
pyknotic nuclei (a/w premalignant and malignant lesions)
Terms in dermatopathology
Foam cell : lipid laden macrophage
Granuloma :
a chronic proliferative lesion consisting of mononuclear
cells and epithelioid cells / multinucleated giant cells /
both
These cells lie in groups and are surrounded by
lymphoid cells
Naked granulomas have very few of these surrounding
lymphoid cells
b) Pautrier microabscess
)Collections of 3 or more atypical
mononuclear cells in the
epidermis
)Mycosis fungoides
Terms in dermatopathology
Corps grains & Corps ronds:
Acantholytic, dyskeratotic
basophilic cells.
Corps ronds have round nuclei
with a perinuclear halo.
Grains have an elongated
grain shaped nucleus
These cells are seen in
Dariers and Grovers disease,
and in warty dyskeratoma.
Grenz Zone:
Terms in dermatopathology
Pigment incontinence : Deposition of melanin in the
dermis which is not a/w a pigmented lesion -> implies
prior basal layer damage
Hydropic degeneration/liquefaction degeneration of
basal cells type of degeneration causing vacuolization
of the basal cells seen in SLE, dermatomyositis, early
lichen planus
Spongiosis : inter-cellular edema of the epidermis may
lead to vesicle formation in epidermis
(MC ca a/w diagnosis of dermatomyositis ovarian)
Hair cycle
84% of hair is normally in the anogen
phase
Sign of growing hair : black hair bulb
Hair grows for : 3 years
Then the resting phase comes :
telogen (14%)
Telogen has a white hair bulb, grows
for 3 months
After 3 months, the new anogen
pushes out the old telogen hence
hair loss of 100 hairs per day is normal
In between anogen and telogen :
catagen
Adnexae
Acne
Keratin plugging of pilosebaceous ducts -1st stage
Comedones (black heads) are the 1st lesion in acne
vulgaris
Acne vulgaris - Rx
Acne vulgaris - Rx
Only comedones (stage 1): adapalene/tretinoin
Comedones + papules (stage 2): adapalene/tretinoin +
topical antibiotic
Stage 2 + pustules (stage 3) : adapalene/tretinoin +
ORAL antibiotic (doxy/mino/azithro)
Stage 3 + nodules (stage 4) : Isotretinoin (keratolytic +
sebolytic action)
Stage 5 : stage 4 + cystic lesions : intralesional steroids
If mentioned nodulocystic : isotretinoin best answer
Teratogenicity
Hypertriglyceridaemia
Oral
Teratogenicity
Hypertriglyceridaemia
Depression
Hormonal acne
Hormonal acne
Diferences
Acne
Face
Polymorphic lesions
Acneiform eruptions
Only on CHEST
Monomorphic lesions
Hidradentitis suppurativa
Keratin plugging of apocrine duct
3 regions of comedones = regions where apocrine
glands are present axilla, perineum, areola
Pathogenesis, c/f and Rx are the same as acne only
characteristic feature is the distribution
Fordyce spots
Ectopic sebum glands
Found on lips, buccal
mucosa, glans penis
No duct -> no blockage ->
no acne -> no Rx required
Lower limb
a)
b)
Sporotrichosis
Images
Sporotrichosis
2.Circinate balanitis
Circinate = multiple half
circles
Circinate balanitis is a
feature of Reiters
syndrome
Uveitis, urethritis, arthritis
(refer more what uveitis,
agent causing urethritis,
what arthritis, which is MC
amongst the 3)
Also seen in Reiters :
spongiform pustules of
Keratoderma blenorrhagica
3.Koebners phenomenon =
isomorphic response
The Koebner phenomenon describes the appearance of new skin
lesions on areas of cutaneous injury in otherwise healthy skin.
Lesions arising through the Koebner phenomenon:
Develop at sites of cutaneous injury (such as a scratch), in
previously healthy skin
Have the same clinical and histological features as lesions of the
patient's original skin disease
Are not due to the seeding of an infectious agent, an allergic
reaction to a contact agent, or skin breakdown.
Role of NGF (nerve growth factor) is being assessed
Types
Boyd and Neldner have classified all reported cases of
Koebner phenomenon into four diferent groups
1. True response
2. Pseudo response
3. Occasionally occurring response
4. Questionable response
Psoriasis
Lichen planus
Vitiligo
Molluscum contagiosum
Warts
Behcets disease
Pyoderma gangrenosum
Questionable isomorphic
phenomenon
There are many conditions that have been associated
with the Koebner phenomenon, many of which are
single case reports
List too extensive and probably needless to remember
Related phenomena
Other phenomena in relation to trauma or skin damage are distinct
from the Koebner phenomenon:
Reverse Koebner phenomenon: the disappearance of a skin
lesion after trauma to the area
Wolf's isotopic response: the emergence of new lesions in the
exact place of previous, healed, lesions not necessarily due to
trauma
Renbok phenomenon: the disappearance of an existing
dermatosis after the onset of a new lesion at the same location
Pathergy: altered tissue reactivity in response to trauma, with
formation of papules or pustules
Causes
Reverse Koebner
Granuloma annulare (Q)
25% of psoriasis
(Spontaneous repigmentation of
vitiligo patches distant from the
autologous skin graft sites has
been termed as a remote reverse
Koebnerphenomenon)
Pathergy
Behcets
Pyoderma gangrenosum
(Pathergy is development of pustules on sterile penetrating
trauma a feature of neutrophilic dermatoses)
Granuloma annulare
Necrobiotic palisading
granuloma
Central clearing
Association : DM
Reverse Koebners
Erythema multiforme
Commonest cause of recurrent EM in India Herpes
Minor
Major
No mucosal involvement
Mucosal involvement ++
Mucosal involvement
SJS (<10% of body surface area involved) Rx : IV steroids
TEN : (> 30% of body surface area involved) (TEN more common)
Rx : IvIG (giving steroids causes sepsis here)
If EM minor not controlled -> progresses to major
Single blisters
Eg : paracetamol
Herpes Genitalis
Grouped blisters
HSV 2
Herpes labialis
HSV 2
Spontaneous reactivation
HSV 1
Verucca vulgaris
acuminata
Non genital warts
HPV causative
Formed in areas of skin with fluctuating
immunity
Jumping lesions
Rx includes
1. Burning : cautery/lasers
2. Cryotherapy
3. Acids : salicylic acid/trichloroacetic
acid
.Imiquimod and podophyllin are not
used in verucca vulgaris as they need
moisture to act
Condyloma
Genital warts
Purpura (3mm?)
Non palpable
Thrombocytopenia
Palpable
Erythema multiforme
Target lesions are characteristic
Central dark area, surrounded by pallor, surrounded by
redness
Target lesions = result of type III hypersensitivity
Type III hypersensitivity -> blood vessel injury ->
purpura -> dark colour
Erythema multiforme
MC cause of recurrent EM in india herpes
EM minor/major
Minor target lesions 3 zones as described above, no
mucosal involvement
Major targetoid lesions 2 zones mucosal
involvement ++
Major with mucosal involvement a) TEN 30% b) SJS
10%
If EM minor is not controlled, it may progress to major.
Lichen Planus
Antigen yet unknown
It is in some part of epidermis
Antigen yet undiscovered, hence condition not curable only suppressible
Antigen stimulates C8T cells which accumulate but cannot pass through
the barrier that is epidermis band of T cells
T cells -> cytokines -> Gaps in dermoepidermal junction (max joseph
spaces) -> more cytokines pass -> Basal layer degeneration /
liquefactive degeneration / hydropic degeneration of dermoepidermal
junction
Hydropic degeneration -> dermal keratinocyte (civatte/colloid body) &
dermal melanocytes -> these cause purple colouration -> color of lesion
is purple
Lichen planus
T cell basal layer interaction leaves saw tooth
appearance
Band of lymphocytes + basal cell degeneration =
interface dermatitis
Gaps in DEJ can lead to pigment incontinence
Pigment incontinence = deposition of melanin in dermis
Civatte bodies dermal keratinocyte in lichen planus
IgM on civatte body gives a bunch of grapes
appearance
Malignant transformation to SCC may occur in oral,
esophageal and genital LP
Lichen planus
Most diagnostic of LP basal cell degeneration
Violaceous lesions
Thinned nail plate
Wickhams striae : Fine network of criss-cross grey white
lines on the lesions believed to be due to
hypergranulosis
Koebners phenomenon seen
Skin LP vs Oral LP
Skin LP
Violaceous
Oral LP
Whitish
Lichen planopilaris
Hair bulb
Hair bulge with stem cells
T cells shoot cytokines at these
Permanent destruction of hair bulb
Scarring alopecia
Alopecia areata
Alopecia areata
Food
Drugs
Infections
Chronic : PAI
Physical
Idiopathic
Physical urticarias
Scratching
Sun (solar urticaria)
Water (aquagenic urticaria)
Cold exposure (cold urticaria)
Sweat (cholinergic urticaria)
Emotion/stress (adrenergic urticaria)
DARIERs SIGN
Urticaria pigmentosa
Xanthogranuloma
ALL
Histiocytosis
Blisters
Epidermal
Dermal
Flaccid
Tense
Burst easily
Pemphigus
Pemphigus foliaceous
endemic variant : fogo selvageum
erythematous variant : senear usher syndrome
Subcorneal blisters in foliaceous
Suprabasal in vulgaris
Pemphigus foliaceous
Seen in seborrheic areas
Desmoglein 1 absent in mucosa since this is a disorder
of desmoglein 1 - mucosa not involved
Desmoglein 3 present all over means desmoglein 3
afection involves mucosa also, like in vulgaris
Blisters BURST VERY EARLY hardly seen at the time of
presentation
LEAF LIKE scaling hence foliaceous
Pemphigus erythematosus features of PF + SLE ->
rash + scaling
Fogo selvageum
Translates to wild fire
Endemic variant of PF
Due to inoculation of black fly antigen
This antigen has molecular mimicry with desmoglein 1
Immune response results in pemphigus
Pemphigus vulgaris
Commonest pemphigus in India
Desmoglein 3 afected
Ulcerative disease -> very prone to infections
Involves mucosa also (desmoglein 3 is present in
mucosa)
Steroids control the disease, but there is a great risk of
immunosuppression with steroids leading to infections
-> so much so that steroid induced sepsis is the MC
cause of death
P.vegetans
Variant of pemphigus vulgaris
Rarest pemphigus in India
Commonly seen in flexures
Brought about by rubbing of the two parts of the
flexures against each other
Paraneoplastic pemphigus
Molecular mimicry of malignant cell antigen with
desmoglein 1,3
Autoantibodies against desmoglein 1,3
Presentation with a mixture of features of foliaceous and
vulgaris, predominantly vulgaris
Diferentiation from vulgaris : presence of target lesions
+ foliaceous like lesions + vulgaris like lesions points
towards paraneoplastic pemphigus
Paraneoplastic pemphigus
Mc seen in
1. NHL
2. CLL
3. Castlemans
4. Thymoma
5. Retroperitoneal sarcoma
6. Waldenstroms macroglobulinemia
Nikolsky sign
Rotational pressure on a perilesional area of epidermis
-> causes separation of epidermis and makes the
disease clinical
Apart from pemphigus, this is also seen in :
1. TEN
2. SSSS (staphylococcal scalded skin syndrome)
Bullous pemphigoid
Elderly
TENSE, ITCHY blisters
Hemorrhagic blisters
Cicatricial pemphigoid
Dermatitis herpetiformis
Primary pathology is gluten sensitive enteropathy
A/w HLA DR3
Gluten shows molecular mimicry with transglutaminase at
the tip of dermal papilla
Resultant antibody response is against transglutaminase
-> gaps in dermal papillae -> fluid to fill gaps -> dermal
blisters
C/F -> severe itching -> hence intact blisters are not very
common, except for at the elbows -> scratching not very
common here, so tense elbow blisters seen
Dermatitis herpetiformis
Rx : Gluten free diet cereals to be avoided are BROW
barley, rice, oats, wheat
Dapsone antineutrophil agent
Dapsone is used in the THERAPEUTIC DIAGNOSIS of
dermatitis herpetiformis
Flexural afection
1. P.Vegetans
2. Hailey Hailey
3. LP
4. Inverse psoriasis (flexural psoriasis has no scaling)
EBD
Continuous scarring
Fingers fuse, thumbs separate -> Mitten hand deformity
EB
Pemphigus
EBA
DIF -ve
Hailey Hailey
EBS, EBD, EBJ
UV rays
UV rays
UV rays
UV rays
Melanocyte disorders
Congenital
Difuse : albinism
Localised
Piebaldism
Nevus depigmentosus
Nevus achromicus
Acquired
Vitiligo
Leucoderma
Hence if tyrosinase is
deficient, no melanin ->
albinism
Congenital
Difuse
risk of SCC, BCC,
Melanoma
Piebaldism
Congenital, localized
Neural crest cell disorder
Autosomal dominant
Mutation of C-kit gene
Areas of normal skin
within white patch
(location of white macules
: forehead)
White forelock
Piebaldism + deafness +
interpupillary distance -> Waardenburg syndrome
Vitiligo
Leucoderma
Xeroderma pigmentosum
Melasma
Pigment disorder
Brownish patches on
cheeks
Etiology
1. Genetic predisposition
2. Sun exposure
3. Hormonal disturbances :
OCPs, pregnancy
) Melasma in pregnancy is
called chloasma
Psoriasis
Spectrum : stable -> -> -> unstable
Exacerbating factors
1. Withdrawal of oral steroids
2. Drugs : blockers, lithium, chloroquine, NSAIDs
3. Smoking
4. Alcohol
5. Emotional stress
6. Infections like HIV, strepto
7. Pregnancy
Pathophysiology
Ag (unknown?) -> APC (Langerhans cells) -> presented
to lymphocyte -> stimulation of basal keratinocyte ->
division -> accumulation in epidermis
To remove Langerhans cells : phototherapy
To remove lymphocytes : cyclosporine
Prevent keratinocyte division -> methotrexate
Prevent hyperkeratosis : oral retinoid -> acitretin
Erythrodermic psoriasis vs
generalized pustular
Erythrodermic
Impetigo herpetiformis
Von Zumbusch in pregnancy
Fetus is Ag -> molecular mimicry
Ab cross reacts with skin
Rx
1. If near term : deliver
2. 1st month : DOC -> steroids -> give without tapering
till delivery taper after delivery
.Here no rebound with steroids since antigen disappears
after delivery
Guttate psoriasis
Rain drop psoriasis
Antigen is streptococcal
Treatment is antibiotic
CURABLE PSORIASIS
Psoriatic arthritis
Seen in 5-10% psoriatics
Classical/most characteristic joint involvement is : DIP
Rx : methotrexate
Rare form : arthritis mutilans DOC is etanercept
UV light
UV A
used with psoralen
320 400 nm
Psoralen for 2 hrs, then
UV A (PUVA)
A/e of psoralen : nausea
and vomiting
Psoralen C/I in preg
UV B
no psoralen
290-320 nm
Broad based : 290-320 nm
Narrow based : 311 nm
used in Goeckermans regimen ??
CTCL points
Sezary syndrome :
1. Exfoliative dermatitis
due to erythrodermic
MF
2. Sezary cells in blood
3. Generalised
lymphadenopathy
Vasculitis classification
Large vessel
Medium Vessel
Small vessel
Takayasu
Kawasaki
HSP
GCA
PAN
Wegeners
Churg Strauss
Cryoglobulinemic vasculitis
Leucocytoclastic vasculitis
Scabies
Burrow entry point in scabies
mite
Burrow is the 1st lesion gen
seen in finger webs
Adults : papular, face spared
Infants : papulovesicular, face
palms and soles all involved
Rx : 5% permethrine from neck
to toe in all groups including
infants and pregnancy
All contacts are to be treated
Scabies
Transmission is by close physical contact
Indirect contact is not important
MC symptom is itching, which is worse at night
Nodular scabies
characteristically seen on scrotum
Hypersensitivity response to scabies mite
Topical steroids
Scabies
Immunocompetent
individuals
HIV
STDs - chancroid
H.ducreyi
IP : 2-5 days (syphilis 9-90
days)
Painful and soft ulcer
Unilateral bubo
Diagnosis
Donovanosis
Calymmatobacter
granulomatis (=klebseilla
granlomatis)
Ulcer full of granulation
tissue (red) and bleeds on
touch
PSEUDOBUBO
Rx : Azithro 1g preferred
> DOC tab doxycycline
100mg BD x 14d
LGV
C.trachomatis
Ulcer never seen
10 stage : transient
20 stage : B/L bubo
Groove sign : swelling of LN
above and below inguinal
ligament
30 stage : genital
lymphedema, proctocolitis
Rx : Doxy 100mg BD x 21 d
Syphilis
Primary
Secondary
Gummata (chronic
granulomas)
Roseolar/papular rashes
Cardiovascular lesions
Mucus patches in
oropharynx
If syphilis transmitted by
blood transfusion, chancre
does not occur
Condyloma lata in
mucocutaneous junctions
MC site groin/inner thigh
Latent
Early and late latent
Spirochetes inactive
No symptoms
TPPA is IOC
Secondary syphilis
Congenital syphilis
1. Condyloma lata
2. Corona veneris
3. Buschke Ollendorf
sign : deep tenderness
elicited over papules
4. Moth eaten alopecia
5. Lichen syphilliticus
6. Leucoderma colli / collar
of venus
7. Lui maligna or
malignancy syphilis
8. Snail track ulcers
Pemphigus syphiliticus
blisters, only congenital
Stigmata of congenital
syphilis
1. Hot cross bun skull
2. Olympian brow
3. Higoumenakis sign
4. Sabre tibia
5. Hutchinsons teeth
6. Mulberry / Moon
Molars
7. Hutchinsons triad
Hutchinsons teeth,
interstitial keratitis,
8th nerve deafness
Syphilis
Syphilis tests
Most sensitive : TPPA
Most specific : TPPA
Earliest to become +ve : FTA-ABS
Primary syphilis IOC : dark ground illumination
Monitor response to therapy : VDRL
Rx kits
Condition
Kit colour
Rx
Urethral,
cervical
discharge
GREY
Thick : Gonococcus
Strawberry cervix :
trichomonas
Clue cells : gardnerella
Tab
Tini/metro/ornidazole
2g
Vaginal
discharge
GREEN
Rx kits
Condition
Kit
colour
Rx
Bubo
BLACK
Chancroid
LGV
Genital
ulcer
Acyclovir
Lower
abdominal
pain/PID
YELLOW
Gonococcus
Cefixime
Anaerobes
Metronidazole
Benzathine/Doxy
Green
Pityriasis versicolor
Yellow
Burrow of scabies
Green
White
Vitiligo
White
Pink Red
Red
Piebaldism
Albinism (oculocutaneous)
Phenylketonuria
Ataxia telangiectasia
WITCH
Incontinentia pigmenti
Waardenburgs
Tuberous sclerosis
Homocystinuria
Leprosy
TB
Nail diseases
Irregular fine pitting : psoriasis
Regular pitting : alopecia
areata (t shaped pitting)
Dorsal Pterygium :
pathognomonic of lichen
planus
Thickening of nails and
longitudinal ridges also seen
in lichen planus
Salmon patch or oil drop sign :
pathognomonic of psoriasis
Misc
Ca pt receiving chemo with transverse lines on the
nails Beaus lines
Dimple sign (=Fitzpatrick sign) : Dermatofibroma
Types of collagen in Keloid : type 1 and 3
Beefy red tongue can be a/w hypothyroidism,
amyloidosis, acromegaly, Downs BUT NOT TURNERS
Pityriasis rosea : one herald patch -> Christmas tree
pattern
Rosacea a/w bacterial overgrowth
Sweet syndrome (acute febrile neutrophilic dermatosis):
a/w AML M2
Misc
Dermatomes
Blaschkos lines
Along nerves
HZV
Developmental
Incontinentia pigmenti
MCQs
Definitive diagnosis of leprosy is by : skin biopsy
Wavelength of UV B wave : 280 nm
Scabies does not show Koebners
DLE causes scarring alopecia
Childhood atopic eczema persists into adulthood
Cutaneous vasculitis is not pruritic
Icthyosis is a side efect of clofazimine
Goeckerman regimen : coal tar + UV-B
MCQs
Podophyllin is used for the treatment of genital warts
Photosensitive rash : erythropoietic porphyria
Type II lepra reaction : LL > BL
Mepacrine does not produce fixed drug eruptions
Time period b/w emotional psychic stress and hair loss :
3 months
Concentration of hydroquinone for treating
hyperpigmentation : 2-5%
Crocodile skin or sauroderma : icthyosis vulgaris
Daily dose of thalidomide for ENL : 200-300mg
MCQs
Dose of zinc used in acrodermatitis enteropathica :
2mg/kg
CTCL is NOT caused by PUVA
Max no of lepra bacilli : LL
Most infective stage of leprosy : lepromatous
Munros microabscess : no eosinophils
Stratum lucidum between : corneum and granulosum
Zoophilic species of Trichophyton : T.mentagrophytes
Dermatopathic lymphadenopathy : mycosis fungoides
MCQs
Variation in skin color is NOT due to number of
melanocytes it is rather due to number, size and
degradation of melanosomes, synthesis and transport of
melanin by melanocytes. NUMBER SAME IN ALL.
Minocycline causes pigmentation of skin
Molluscum sebaceum is another name for :
keratoacanthoma
Dimple sign = Fitzpatrick sign = dermatofibroma
Follicular hyperkeratosis is related to deficiency of
vitamin A
Carpet tack sign : DLE
MCQs
Paracetamol causes : photosensitivity
MCC
Air borne contact dermatitis and plant dermatitis : parthenium
Allergic contact dermatitis due to metal : nickel
Allergic contact dermatitis in Indian females :
1. Hands : detergent
2. Forehead : para tetra butyl phenol in bindi
3. Ear lobe : nickel
)Allergic contact dermatitis due to cosmetics : Balsam of peru
) Allergic contact dermatitis due to drug : neomycin
MCQs
Bowens disease, xeroderma pigmentosum, actinic
keratosis are premalignant lesions of skin.
Psoriasis is NOT premalignant
Giant cell arteritis, being a large vessel vasculitis, does
NOT show any palpable purpura
Rifampicin, cyclosporine are NOT used in Lepra
reactions
Vitamin D is synthesized by keratinocytes max
production is in stratum basale
MCQs
Acid increased in comedones : palmitic acid
Solar urticarias
4th or 5th decade
lesions subside spontaneously on avoiding exposure
within 24 hrs
some cases may develop severe
urticarial/bronchospasm
almost all cases are idiopathic
Rapid, difuse, excessive hair loss 3m after preg :
telogen effluvium
MCQs
Acrodermatitis enteropathica :
AR
Low zinc levels
Wound healing afected
Zinc sulfate used for Rx
Prolonged Rx into adulthood required
MCQs
Steroids are not C/I in eczema
Linear discontinuation of skin : fissure
Buschke Ollendorf sign : secondary syphilis
Psoriasis does not show pigment dilution
Salt and pepper skin : scleroderma
Apple jelly nodules : lupus vulgaris
SSSS does not show Asboe Hansen sign
Immunocompromise + umbilicated papules + budding yeast :
cryptococcosis
Plantar wart : painful on exertion of lateral pressure
MCQs
Linear deposition of IgG and C3 in lamina lucida : BP
Row of tombstones : PV
Saw tooth rete ridges : lichen planus
Vagabonds disease : pediculus corporis
Wavelength of carbon dioxide laser : 10600 nm
Koenens tumor : tuberous sclerosis
Heavy bacterial colonization of tongue presents as : black
tongue
Child presents with multiple skin colored papules over lips
bedside investigation : tzanck smear
MCQs
Peak wavelength on Woods lamp : 360nm
Erythema marginatum : rheumatic fever
MC skin cancer : BCC > SCC
Calcipotriol is used in psoriasis
Rx for tinea unguim : griseofulvin + ketoconazole
Skin blister resulting from a burn is an example of :
serous inflammation
Ringworm infection afects : stratum corneum
MCQs
Drug induced pemphigus MC caused by : penicillamine
Lesions of cutaneous anthrax are not painful
Intraepidermal bullae : pemphigus
Subcutaneous granulomas : Donovanosis
Urticarial lesions are best described as evanescent
DVT additions
Internal malignancy
MC Ca lung