Dermatology Power point slides Useful, Important & Easy Way To Understand The Chapter

1. DR. BIJAY Kr. Yadav
Holy Vision Technical Campus
Shankhmul, Kathmandu
Dermatology Department

2. STD STD are group of contagious condition whose principle mode of
transmission is by intimate several activity & involving the moist
mucous membrane of penis, vulva, cervix, anus, rectum, mouth,
pharynx & their adjacent skin surfaces.
 Common sexually transmitted diseases are :
A. Bacterial
• Gonorrhoea : Neisseria gonorrhoeae
• Syphilis : Treponema Pallidum
• Chancroid : Haemophillis ducreyi
• Vaginitis : Gardnerella vaginalis & Anaerobic bacteria

3. B. Chlamydia :
C. Viral :
• Genital herpes : Herpes simplex I & II
• Genital warts : Human papilloma virus
• AIDs : HIV I & II
• Hepatitis : Hep B virus
• Molluscum contagiosum : Pox virus
• Non-Specific Urethritis
• Chlamydia trachomatis
• Ureaplasma urealyticum

4. D. Fungal :
E. Protozoal :
F. Parasites :
• Candidiasis : Candida albicans
• Trichomoniasis : Trichomonas vaginalis
• Vaginitis
• Urethritis
• Balanoposthitis
• Pediculosis : Pthirus pubis
• Scabies : Sarcoptes scabeii

5. GONORRHOEA :
 It is ssexually transmitted disease caused by
“Neisseria gonorrhoea”
 Common STD affecting the mucocutaneous surfaces
of the lower genitourinary tract.
 Incubation period is 24 hours to 10 days
Males: 90% develop urethritis within 5 days of exposure.
Females: Usually >2 weeks. However, up to 75% of
women are asymptomatic.

6. Mode of Transmission :
 Male to female via semen
 Female to male urethra
 Rectal intercourse
 Pharyngeal infection
 Perinatal transmission ( mother to infant)

7. Pathogenesis
 Gonococcus has affinity for columnar epithelium
 Stratified and squamous epithelium are more resistant
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8. Risk factors :
 Multiple or change of sex partners
 Not using condoms
 Casual sex
 Sex with CSW ( commercial sex workers ) & Partners
 Urban residence in areas with disease prevalence
 Adolescent , female particularly
 Low socio-economic status
 Alcohol & substance use
 Poverty

9. Clinical features :
1. In Male :
Symptoms:
• Pain & burning sensation in urethra during micturation
• Copious, thick, yellow purulent discharge from urethra
• Fever
• Frequency of micturation
• Malaise

10. Signs:
• Copious, thick, yellow purulent discharge from
urethra
• External urethral meatus may become red,
swollen & tender
• Tenderness

12. 2. In Female :
Symptoms :
• Purulent discharge
• The infection can become much more as
 Bartholinitis
 Cervicitis
 Vulvitis
 Salphingitis
 Lower abdominal pain
 Cervical discharge
 Contact bleeding
 Dyspareunia
 Fever

13. Signs :
• Pus may be from urethra, bartholin duct
• Cervix :
• Inflammed with mucopurulent discharge
• Bleed to touch
• Sign of PID:
• Lower abdominal tenderness

14. 3. Rectal involvement
• Common in homosexual
• Purulent discharge
4. Pharyngeal gonorrhoea
• Result of oral sex
5. Gonococcal conjunctivitis
• Purulent discharge from eyes
• Severe inflammation of conjunctivitis
• Oedema of eyelids
• Pain
• photophobia

15. 6. Disseminated Gonococcal infection
• Arthritis
• Myocarditis
• Endocarditis
• Pericarditis
• Meningitis
• Fever
• Cutaneous lesion

16. Investigations
 The specimens are taken from urethra & rectum in
males
1. Gram staining :
kidney shaped Gram –ve non motile,
non sporing, aerobic bacteria ( Neisseria
gonorrhoea) can be demonstrated.
2. Culture in Thayer martin medium :
Neisseria gonorrhoea can be cultured &
demonstrated.
3. Biochemical test
4. Cutaneous biopsy

17. Treatment
 Prevention : use of condom should be encouraged.
 There is high frequency of Chlamydia infection in
persons with gonorrhea and should be treated for both.
1. For uncomplicated cases:
Procaine penicillin G 4.8 million IU IM.
+
Probenecid 1 gm orally stat.
&
Doxycycline 100 mg BD for 7 days

18. Ampicillin / Amoxicillin 2gm or 3 gm orally stat
+
Probenecid 1 gm orally stat
&
Doxycycline 100 mg BD for 7 days
 If patient is allergic to penicillin then give
• Ciprofloxacin 500 mg orally stat
• Ofloxacin 400 mg orally stat ( contraindicated in
pregnancy)
• Azithromycin 1000 mg stat &
• Doxycycline 100 mg BD for 7 days

19.  If pregnancy & lactation
• Ceftriaxone 250 mg im stat
• Cefixime 400 mg orally as a single dose
• Spectinomycin 2 gm im stat

20. 2. For complicated infection :
 Ceftriaxone 1 gm IV or IM daily for 7-10 days
or
Spectinomycin 2 gm IM BD for 7-10 days
 Note : The inportant part of management is
that both partner should be treated at the
same time.

21. Course and Prognosis
 In men symptoms are usually acute and seek relief .
 In women initial symptoms are usually mild and
often ignored.
 Often women present with Pelvic Inflammatory
Disease.
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