Dermatology

1. SIDE LAB PROCEDURES
M.BHARATHI KUMARAN
SECOND YEAR MBBS
TSRMMCH&RC,TRICHY

2. WOOD’S LIGHT EXAMINATION
● LOW INTENSITY UV LIGHT (~365 NM)
INDICATIONS
● SUPERFICIAL FUNGAL INFECTIONS
● ERYTHRASMA
● PORPHYRIA

3. T.CAPITIS-BLUISH GREEN FLUORESCENCE

4. ERYTHRASMA-CORAL RED FLUORESCENCE

5. TINEA VERSICOLAR-YELLOW FLUORESCENCE

6. KOH MOUNT
INDICATIONS
● SUSPECTED FUNGAL OR YEAST INFECTION
● KOH-DISSOLVES KERATIN OF KERATINOCYTES,HAIRS, NAILS
● 5%KOH-SUPERFICIAL FUNGAL INFECTIONS
● 40%KOH-FUNGAL INFECTION OF HAIR OR NAILS

7. DERMATOPHYTES-BRANCHING SEPTATE HYPHAE

8. TENIA VERSICOLAR-SHORT STUMPY HYPHAE WITH THICK SPORES
(SPAGHETTI AND MEAT BALLS APPEARANCE)

9. CANDIDA ALBICANS-BUDDING YEAST (PSEUDOHYPHAE)

10. SCRAPING FOR SCABIES
● LESION-BURROW
● SCRAPPING MATERIAL EXAMINED WITH MINERAL OIL UNDERLIGHT
MICROSCOPE
● PRESENCE OF MITES, EGGS, FECAL CONCRETIONS

11. SARCOPTES SCABIEI

12. DARK GROUND MICROSCOPY
● FOR VERIFYING THE DIAGNOSIS OF SYPHILIS

13. WET MOUNT PREPARATION
● DIAGNOSIS OF TRICHOMONAL INFESTATION OF GENITAL TRACT

14. GRAM STAINING
● INDICATED FOR PYOGENIC BACTERIAL INFECTIONS
STREPTOCOCCUS STAPHYLOCCUS

15. GRAM NEGATIVE BACILLI

16. TZANCK SMEAR
● SKIN DISORDERS CHARACTERIZED BY VESICLES,PUSTULES,BULLAE
● VIRAL INFECTIONS - HSV,HERPES ZOSTER,VARICELLA ZOSTER
● STAIN-GIEMSA STAIN/TOLUIDINE BLUE
INTERPRETATION
● MNG CELLS- HERPES SIMPLEX , HERPES ZOSTER , VARICELLA ZOSTER
● ACANTHOLYTIC CELLS-PEMPHIGUS VULGARIS

17. MULTINUCLEATED GIANT CELL
ACANTHOLYTIC CELLS

18. SLIT SKIN SMEAR
● FOR DEMONSTRATION OF AFB IN HANSEN’S PATIENTS
● SMEAR - TAKEN FROM 6 SITES - BOTH EAR LOBES,FOUR ACTIVE SKIN
LESIONS
● STAINING- MODIFIED ZIEHL NEELSEN TECHNIQUE

20. RIDLEY’S LOGARITHMIC SCALE
● FOR GRADING OF SLIT SKIN SMEAR
● 1 to 10 bacilli in 100 fields -1 +
● 1 to 10 bacilli in 10 fields -2 +
● 1 to 10 bacilli in an average field -3 +
● 10 to 100 bacilli in an average field -4+
● 100 to 1000 bacilli in an average field -5 +
● Clumps and globi in an average field -6+

21. LEPROMIN TEST
● USED FOR CLASSIFICATION OF LEPROSY
● LEPROMIN -SKIN TEST ANTIGEN
● INTRADERMAL INJECTION OF LEPROMIN-FERNANDEZ AND MITSUDA
REACTION
● STRONGLY POSITIVE IN TT HANSEN

22. TISSUE SMEAR
● DIAGNOSIS OF DONOVANOSIS(GRANULOMA INGUINALE)
● STAIN USED- GIEMSA STAIN OR WRIGHT’S STAIN
INTERPRETATION
● DONOVAN BODIES IN MONONUCLEAR CELLS-INDICATES DONOVANOSIS

23. MONONUCLEAR CELLS CONTAINING DONOVAN BODIES

24. DERMOSCOPY
● SKIN SURFACE MICROSCOPY
● ASSESSING MELANOCYTIC SKIN TUMORS , HEMANGIOMAS, FIND MITES
IN SUSPECTED SCABIES

25. TRICHOGRAM
● METHOD FOR ANALYSING HAIR BULBS
● USED TO DISTINGUISH BETWEEN DIFFERENT TYPES OF HAIR LOSS

26. PATCH TESTING
● USED TO IDENTIFY THE CAUSE OF ALLERGIC CONTACT DERMATITIS
● EXPOSING PATIENT’S SKIN TO VARIOUS ALLERGENS

27. SKIN BIOPSY
● TO CONFIRM A CLINICAL DIAGNOSIS OR TO AID IN ESTABLISHMENT OF A
CLINICAL DIAGNOSIS
● DIAGNOSTIC AS WELL AS TREATMENT
SITE OF BIOPSY
● EARLY UNTREATED LESION REPRESENTATIVE OF THE SKIN DISORDER

28. ELLIPTICAL SURGICAL BIOPSY
● SIZE-12x5mm
● PERFORMED ON PIGMENTED SKIN LESIONS LIKE DYSPLASTIC NEVI ,
MELANOMAS, AND NON MELANOMA SKIN CANCERS
● PREFERRED BIOPSY BY PATHOLOGISTS
PUNCH BIOPSY
● MINIMUM SIZE-5mm
● SUITABLE FOR INVESTIGATING ALOPECIA

29. PUNCH BIOPSY ELLIPTICAL BIOPSY

30. IMMUNOFLUORESCENCE
● TWO TYPES-DIRECT AND INDIRECT
● USED FOR DIAGNOSIS OF AUTOIMMUNE CONDITIONS LIKE
VESICOBULLOUS DISORDERS LIKE PEMPHIGUS VULGARIS;SLE,LICHEN
PLANUS , VASCULITIS

31. FISH NET PATTERN-PEMPHIGUS VULGARIS

32. REFERENCES:
● DM THAPPA ESSENTIALS IN DERMATOLOGY (SECOND EDITION)
● OXFORD HANDBOOK OF MEDICAL DERMATOLOGY