Department of Dermatovenereology School of Medicine, University of Belgrade

Transcription

1 Department of Dermatovenereology School of Medicine, University of Belgrade Address: Pasterova 2, Beograd Phone: ; Fax THE COURSE IN DERMATOVENEREOLOGY FOR UNDERGRADUATE STUDENTS Academic Year AIMS AND OBJECTIVES OF THE COURSE Aims: The students are to be introduced with basic principles and major concepts of dermatology and venereology science and clinical practice: 1. Basics in specific features of dermatological examination skin lesions 2. Etiology and pathogenesis of different dermatoses 3. Clinical features, diagnosis and differential diagnosis of the most frequent and important pathological conditions of skin and venereal diseases in adults and chlidren 4. Treatment, prognosis, and prophylaxis of the most frequent and important pathological conditions of skin and venereal diseases in adults and chlidren Objectives: The knowledge achieved during the course in Dermatovenereology will enable doctors of medicine to: 1. Diagnose and treat skin disorders that are most common in human population, possible to be treated at primary medical care facilities 2. Recognize and diagnose life threatening skin diseases 3. Recognize and diagnose all skin disorders which could be the signs or manifestations of serious internal medicine diseases 4. Make a difference between common and other eruptions that could be the onset of the most serious diseases 5. Have the basic knowledge of Dermatovenereology necessary for their future education and residency training in other fields of medicine

2 STRUCTURE OF THE COURSE Total: 75 hours 15 weeks - 8th Semester A. THEORETICAL CLASSES (20 HOURS) Lectures (ex catedra): 20 hours; B. PRACTICAL CLASSES: EXERCISES, OTHER FORMS OF CLASSES - (55 HOURS) Exercises - Practical clinics: 35 hours; Seminars: 20 hours; TIMETABLE - SCHEDULED ON MONDAY Lecture ex catedra Break Practical - Clinic Break Clinical lecture - seminar The course is held at the Department of Dermatovenereology, School of Medicine, University of Belgrade, Clinic for Dermatovenereology, Clinical Center of Serbia, Belgrade PLAN AND PROGRAM A. THEORETICAL CLASSES (20 HOURS) Lectures (ex catedra): 20 hours Adverse Cutaneous Drug Reactions, Reactive erythema and Purpura Exantematous Drug Eruption Urticaria, Angioedema and Anaphylayis Drug hypersensitivity Syndrome Fixed Drug Eruption Erythema multiforme (Minor and Major Type) Toxic Epidermal Necrolysis Hipersensitivity Vasculitis Schönlein-Henoch, Diseaase

3 Group of Eczema and Dermatitis Contact dermatitis Atopic dermatitis Infantile, Child and Adult Type Atopic dermatitis Child - type Atopic dermatitis Adult - type Atopic dermatitis Lichen Simplex chronicus Nummular Eczema Dyshidrotic Eczematous Dermatitis Asteatotic Dermatitis Neurodermatitis Stasis dermatitis Psoriasis and other scaling eruptions, Erythroderma Psoriasis Chronic plaque type Psoriasis Guttate type Psoriais of the Body Folds Pustular Psoriais Palmoplantar pustulosis Generalized Acute Piyriasis Rosea Seborrhoic dermatitis Exfoliative Erythoderma Syndrome Papular Disorders Lichen Planus Strophuluis infantum Non-infective Granulomas of the Skin Sarcoidosis Granulloma annulare Necrobiosis lipoidica Panniculitis /Nodular dermatoses Erythema nodosum Nodular vasculitis Connective tissue panniculitis Autoimmune Bullous Diseases Pemphigus (Group) Pemphigoid

4 Epidermolysis bullosa acquisita Linear IgA dermatosis Dermatitis herpetiformis Skin manifestations of Immune, Autoimmune, and Rheumatic Diseases Connective Tissue Disorders Lupus erythematosus Dermatomyositis Sclerodermia and Morphoea Raynaud, s Disease and Phenomenon Disorders of Hair and Nails Alopecia areata Scarring Alopecia Androgenetic Alopecia Hirsutism and hypertrichosis Infections of the Nail Apparatus Nail signs of Multisystem Diseases Onycholysis Onychogriphosis Disorders of Keratinization Ichthyosiform Dermatoses Dyskeratosis follicularis (Dariers, s Disease) Palmoplantar Keratoderma Disorders of Sebaceous, Appocrine and Eccrine glands Acne vulgaris, Acne Cystica and Conglobata Rosacea Peiroral dermatitis Hidradenitus suppurativa Miliaria Viral and Bacterial Skin Infections Human Papilloma Virus Inections Verruca vulgaris, plantaris, plana Condylomata acuminata Molluscum contagiosum Herpes simplex Herpes zoster Impetigo and Ecthyma

5 Superficial Folliculitis Furuncle, Carbuncle and Absces Staphylococcal Scalded Skin Syndrome Erythrasma Cellulitis, Erysipelas, Erysipeloid Tuberculosis of the Skin Lyme Boreliosis Fungal Infections of the Skin and Infestations Dermatophyte Infections of the Skin, Hair, and Nails Epidermophytoses Candidiasis of the Skin and of the Mucous Membranes Pityriasis Versicolor Scabies Pediculosis (capitis, corporis, pubis) Cutaneous manifestations of vascular insufficiency Atherosclerosis Acrocyanosis Trombophlebitis and Deep Venous thrombosis Chronic Venous insufficiency Leg ulcers Pressure ulcers Skin disordes proveced by the physical factors Skin reaction to Cold or Heat Skin reactions to Sunlight Sunburn Solar urticaria Chronic Photodamage Skin Reaction to Ionizing R diation Pruriginous dermatoses Pruritus Prurigo Disorders of Oral mucosa and Non-venereal diseases of genital mucosa Angular cheilitis Aphtous ulceration Leukoplakia Cutaneous Disordewrs involving the Mouth

6 Lingua nigra Lingua geographica Lingua scrotalis Glossodynia Oral Hairy Leukoplakia Balanithis Phymosis Paraphymosis Pigmentary disorders Vitiligo Albinism Melasma Post-inflammatory hyper- and hypopigmentation Benign Neoplasms, Nevi and Neurokristopathia Seborrheic Keratosis Skin Tag (Acrochordon) Keratoacanthoma Dermatofibroma Hypertrophic scars and Keloids Mucocutaneous Cysts and Pseudocysts Common Melanocytic Nevocellular (Junctional, Dermal, Compound ) Halo nevus, Blue nevus Angiomas and Pyogenic Granuloma (Botriomycoma) "Adenoma Sebaceum" and Tuberous Sclerosis Neurofibromatosis Precancerous Lesions and Paraneoplastic disorders, Hyperplasias, Cutaneous Carcinomas and Melanoma Leukoplakia, Bowen, s Disease, Erythroplasia Queyrat Sqamous Cell Carcinoma and Basal Cell Carcinoma Dysplastic Melanocytic Nevus (Clark Nevus) Markers and Precursors of Cutaneous Melanoma Melanoma ( ALM, SSM, NM, LMM ) Cutaneous Lymphomas and Kaposi, s Sarcoma T - cell Leukemia / Lymphoma Sezary, syndrome Cutaneous B-cell Lymphoma

7 Kaposi, s Sarcoma ( Classic and HIV associated ) Sexually Transmitted Diseases I Syphilis Gonorrhoea Ulcus molle Lymphogranuloma venerum Granuloma inguinale Sexually Transmitted Diseases II Urethritis non-gnonorrhoica Herpes genitalis Condylomata acuminata AIDS B. PRACTICAL CLASSES: EXERCISES, OTHER FORMS OF CLASSES - (55 HOURS) Exercises - Practical clinics: 35 hours; Seminars: 20 hours; Practical clinical work with Dermatovenereology patients, both inpatients and outpatients, in real time History and Physical Examination; Diagnosis and Differential Diagnosis, Laboratory and Special Examinations (Microbiologic examination of skin material: csales, crusts, exsudate; Wood s lamp examination; Dermatopathology); Topical and Systemic Pharmacotherapy, Physical Therapy and Phototherapy. Practical clinics I. History and Physical Examination 1. History A. Duration of onset of skin lesions B. Relation of skin lesions to season, travel history, heat, cold, sun exposure, erpvious treatment, drug ingestion, occupation, hobby, effects of menses and pregnancy C. Skin symptoms as pruritis, pain, paresthesia D. Constitutional symptoms E. Systems review

8 2. Physical examination A. Apperance of patient B. Vital signs C. Glossary of Basic Dermatologic Lesions (Type, Shape, Arrangement, Distribution) D. Hair and Nails E. Mucous membranes II. Diagnosis and Differential Diagnosis A. Hospitalized patients - seriously ill or with rare dermatoses B. Outpatients with common skin disorders III. Laboratory and Special Examinations A. Microbiologic examination of skin material: csales, crusts, exsudate 1. Direct microscopic examination of skin For yeast and fungus: ( 10% Potassium hydroxyde preparation ) For Gonococci: ( Loeffer, s Methylene blue ) For autoimmune bullous and viral diseases: Tzanck smear For Treponema pallidum: dark-field examination For parasites: scabies mite from a burrow 2. Mycologic Culture ( identification of sonic common fungal species) B. Wood, s lamp examination in: - Microsporia, Tinea Versicolor, Erythrasma (diagnosis and cure ) and "ash leaf "patches in Tuberous Sclerosis C. Dermatopathology 1. Light microscopy: site, process, cell types ( common dermatoses ) a) special techniques ( stains... ) 2. Immunofluorescence ( theoretical aspects ) D. Phlebology: diagnostic procedures; application of hydrocolloid dressings (wound healing) IV. Topical and Systemic Pharmacotherapy General considerations Therapeutic implications of percutaneous absorption The vehicle Topical agents

9 Topical cytotoxic therapy Systemic agents V. Physical and Surgical Therapy Local anaesthesia Excision Curettage Electosurgery Cryosurgery Intralesional therapy VI. Phototherapy PUVA Therapy STUDENT EVALUATION EXEMINATION (COLLOQUIUM, TEST / EXAM STRUCTURE) PRE-EXAM DUTIES Colloquium VIII - X week of the course. Areas: selected, most important chapters. Colloquium is in the form of a test with 40 questions. In order to pass the exam, it is necessary to give correct answers to the 50% + 1 questions (21 questions). The results of the colloquium are entered into the student card. Each question carries 0.5 points, the maximum number of points from the colloquium in 20. Practical classes Evaluation is entered in the card and consists of the evaluation of timeliness in attendance and evaluation of activities during the practical classes. Neat attendance is assigned with six points, for obligations fulfilled with a delay (catch-up) - 3 points; when a student has not done a catch-up, for neatness in school attendance gets 0 points. The remaining 4 points are given based on the engagement and commitment during classes (interactive teaching) by assessment of the assistants and teachers. The maximum total number of points is 10.

10 PRE-EXAM DUTIES are shown in Table 1 STRUCTURE OF THE FINAL EXAM 1. Written theoretical part of the exam test consists of 50 multiple choice questions of which 40 are from dermatology and 10 are from venereology. In order to pass the test, it is necessary to give correct answers to 50 % + 1 question from the field of dermatology and 50 % + 1 question from the field of venereology (dermatology = 21, venereology = 6). Each question on the test carries 1 point; the maximum number of points from the test is 50. Passed test is valid only in one examination period. If the student gets less than points in the test, the points are not given, the student falls the exam, and the score 5 (five) is entered in the card. 2. Practical part of the exam is taken with the teacher and consists of five areas - 3 from dermatology, 1 from venereology, 1 from histopathology/dif test, each area is assessed with point range of 0-4 points, the maximum number of points is 20. The exam consists in recognizing and describing 5 photos of skin diseases which are given in the textbooks. The students are expected to recognize and describe the clinical picture shown in the photo, establish the diagnosis and differential diagnosis, and to discuss therapeutic modalities and prognosis. If the student gets less than 11 points at the practical exam, the points are not given, the student falls the exam, and the score 5 (five) is entered in the card. FINAL SCORE The final score is based on the success achieved during the course (30 % of the final grade) see table 1, practical part of the exam (20 %) and the achieved knowledge and success in the written part of the exam - test (50 %) - see Table 2. GRADINGSCHEME TABLE 1 - Pre-exam duties - TOTAL 30/100 points; 30% of the final grade TYPE OF ACTIVITY Number of points Regularity in attendance /6 Activity during the practical classes /4 Colloquium /20 Pre-exam activities - total /30

11 TABLE 2 - FINAL SCORE Pre-exam activities Written examination - test Practical exam Total points Points Date Points Date Points /30 /50 /20 /100 Teacher s signature TABLE 3 TOTAL NUMBER OF POINTS TOTAL NUMBER OF POINTS FINAL SCORE (1+2+3) Note: If a student gets a total of 50.5, 60.5, 70.5, 80.5, or 90.5 points, number of points will be rounded to the next whole number (51,61,71,81,91), and the appropriate score will be assigned. RECOMMENDED TEXTBOOKS: 1. Wolff K, Johnson KW, Saavedra AP. Fitzpatrick s Color Atlas and Synopsis of Clinical Dermatology. 7th ed. New York, St. Louis: McGraw-Hill; James G. Marks Jr. MD, Jeffrey J. Miller MD. Lookingbill and Marks' Principles of Dermatology: 5 th Ed, Website: (large number of photographs of various skin diseases).

12 TEACHERS AND ASSISTANTS: Teachers: 1. Prof. Dr. Ljiljana Medenica 2. Prof. Dr. Miloš Nikolić 3. Prof. Dr. Jelica Vukićević-Sretenović 4. Assoc. Prof. Dr. Mirjana Milinković 5. Assoc. Prof. Dr. Snežana Minić 6. Assoc. Prof. Dr. Dusan Skiljevic Assistants: 1. Asst. Prof. Dr. Jelena Stojković-Filipović 2. Asst. Prof. Dr. Danijela Milčić 3. Asst. Prof. Dr. Mirjana Popadić Course Director: Assoc. Prof. Mirjana Milinković