PLAN NASTAVE DERMATOVENEROLOGIJE



Department of Dermatovenereology

School of Medicine, University of Belgrade

Address: Pasterova 2, 11000 Beograd

Phone: +381 11 264 264 8; Fax +381 11 2682 652

Email: derma@kcs.ac.rs

|THE COURSE IN DERMATOVENEREOLOGY |

|FOR UNDERGRADUATE STUDENTS |

|Academic Year 2019-20 |

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

STRUCTURE OF THE COURSE

Total: 75 hours

15 weeks - 8th Semester

A. THEORETICAL CLASSES (30 HOURS)

▪ Lectures (ex catedra): 30 hours;

B. PRACTICAL CLASSES: CLINICS, OTHER FORMS OF CLASSES - (45 HOURS)

▪ Practical clinics: 30 hours;

▪ Seminars: 15 hours;

TIMETABLE - SCHEDULED ON MONDAY

09.00 – 10.30 Lecture ex catedra

10.30 – 10.45 Break

10.45 – 12.15 Practical - Clinic

12.15 – 12.30 Break

12.30 – 13.15 Clinical 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

Lectures (ex catedra): 30 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, Disease / IgA Vasculitis

|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

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

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

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

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

C. PRACTICAL CLASSES: CLINICS, OTHER FORMS OF CLASSES - (45 hours)

• Practical clinics: 30 hours;

• Seminars: 15 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

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

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 20 questions. In order to pass, it is necessary to give correct answers to the 50% + 1 questions (11 questions). The results of the colloquium are entered into the student card. Each question carries 1 point, the maximum number of points from the colloquium is 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 (make-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.

PRE-EXAM DUTIES are shown in Table 1

STRUCTURE OF THE FINAL EXAM

1. 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 does not pass the exam, and the score 5 (five) is entered in the card.

2. Written theoretical part of the exam – test consists of 48 multiple choice questions of which 39 are from dermatology and 9 are from venereology. The value of each question is 1 point, except the clinical questions, where the value is 2 points. To pass the test, the student must have at least (minimum) 50% + 1 point in each part of the test (dermatology – 21 points, and venereology – 6 points). The maximum number of points from the test is 50. The test must be finished within 50 minutes. Passed test is valid for 6 months period. If the student gets less than 21 +6 points in the test, 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.

GRADING SCHEME

    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 |

TablE 2 - FINAL SCORE

|Pre-exam |Written examination - |Practical exam |Total points |Teacher’s signature |

|activities |test | | | |

|Points |Date |Points |Date |Points | | |

|__ /30 | |__/50 | |__/20 |___/100 | |

TablE 3 – TOTAL NUMBER OF POINTS

|TOTAL NUMBER OF POINTS (1+2+3) |FINAL SCORE |

|91-100 | 10 |

|81-90 |9 |

|71-80 |8 |

|61-70 |7 |

|51-60 |6 |

|≤ 50 |5 |

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 RA, Saavedra AP, Roh EK. Fitzpatrick’s Color Atlas and Synopsis

of Clinical Dermatology. 8th ed. New York, St. Louis: McGraw-Hill; 2017. (7th ed. New York, St. Louis: McGraw-Hill; 2013)

2. James G. Marks Jr. MD, Jeffrey J. Miller MD. Lookingbill and Marks'

Principles of Dermatology: 5 th Ed, 2013

3. Website: (large number of photographs of various skin diseases).

TEACHERS AND ASSISTANTS:

Teachers:

1. Prof. Dr. Miloš Nikolić

2. Prof. Dr. Jelica Vukićević

3. Prof. Dr. Mirjana Milinković Srećković

4. Prof. Dr. Snežana Minić

5. Assoc. Prof. Dr. Dušan Skiljević

6. Assoc. Prof. Dr. Svetlana Popadić

7. Assoc. Prof. Dr. Mirjana Gajić-Veljić

8. Assoc. Prof. Dr. Jelena Stojković-Filipović

9. Assoc. Prof. Dr. Dubravka Živanović

10. Assoc. Prof. Dr. Srđan Tanasilović

Assistants:

1. Clinical Assistant Dr. Danijela Milčić

2. Clinical Assistant Dr. Mirjana Popadić

3. Clinical Assistant Dr. Jelena Perić

4. Clinical Assistant Dr. Vesna Reljić

Course Director:

Prof. Mirjana Milinković Srećković, E-mail: milinm@eunet.rs

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