| FIRST YEAR | SECOND YEAR | THIRD YEAR | |||
| Duration 1 | 1 month | Duration 11 months | Duration 44 weeks | ||
| Area I | Area II | Area II. Clinical dermatology | Area III | Area IV. Clinical | |
| I P | Clinical | D | T | dermatology | |
| N R | dermatology I | Mod 6. Immunological-type | E | R | |
| S O | skin disorders | R | A | ||
| T C | Mod 3. Generalities | Duration 24 weeks | M | I | Mod 9. Disorders of |
| R E | in clinical | A | N | cutaneous | |
| U D | dermatology | Mod. 7. Dermatosis of | T | I | appendages |
| M U | generic or unspecified etiology | O | N | ||
| E R | Duration 12 weeks | Duration 12 weeks | L | G | Mod. 10. Aesthetic and |
| N E | O | cutaneous defects and | |||
| T S | Mod 8. Structural dermatosis | G | disorders | ||
| A | Mod. 4 Contagious | Duration 12 weeks | I | ||
| L | and parasitic | C | |||
| dermatosis | A | ||||
| L | Pediatric hosp. | ||||
| Duration 24 weeks | 4 weeks | ||||
| Mod. 5 Allergic or irritable-type | |||||
| Modules 1, 2 | cutaneous diseases
Duration 24 weeks |
||||
| Holidays 4 weeks | Holidays 4 weeks | Holidays | 4 weeks | ||
40 HOURS PER WEEK
FIRST YEAR
Area I. Instrumental procedures
Completed together with Area II
Objective: Carry out specialized techniques applied to the diagnosis, prognosis and treatment of different types of dermatological lesions
Module 1. Auxiliary diagnostic techniques and special dermatological prognoses
Based on the corresponding theoretical foundation, carry out different diagnostic tests or specialized prognoses, including those corresponding to the taking of skin samples or skin appendages for processing, and their subsequent definitive examination for the same purpose
- Contact tests
- Histamine and pilocarpine tests
- Lepromin tests
- Sampling for biopsy
- Sampling for mycological examination
- Sampling for Tzanock
- Collection of parasites or nits
- Wood’s Lamp examination
- Sampling for ultra-microscopic examination
Suggestions
- Sampling for smear microscopy
Suggestions
Module 2. Special techniques in dermatology treatment
The different instrumental procedures for dermatology treatment, including medicinal and radio surgical therapies
- Surgery techniques in dermatology treatment
- Electrocoagulation
- Resection of small lesions
- Acne microsurgery
- Radiotherapy techniques
- Superficial radiotherapy
- Ultraviolet light 2.3. Medicinal techniques in dermatology treatment
- Caustic products
- Refrigerant products
- Intradermal injections
The resident acquires the knowledge and skills that allow him/her to carry out specialized techniques applied to the diagnosis, prognosis and treatment of different types of dermatological lesions
Area II. Clinical dermatology I
It is completed jointly with Area I during the first year
Objectives: Acquire knowledge and skills regarding the diagnosis, prognosis and treatment of diseases, especially contagious, the most common, and the most serious or disabling diseases, within the great variety of epistemological entities that correspond to dermatology, based on the principles of the basic sciences that are applicable, and also perfect the knowledge and skills acquired in the corresponding modules
Module 3. Generalities in clinical dermatology (12 weeks)
Carry out dermatological procedures to diagnose elementary skin lesions and select the appropriate medications based on the corresponding theoretical foundation
- Introductory basic dermatology
- Basic dermatological therapy
Module 4. Infectious and parasitic dermatoses (24 weeks)
Carry out the diagnosis of different types of infectious and parasitic dermatoses and their different clinical pictures based on dermatological examination, anamnesis, and the results of the indicated complementary tests, and execute the procedures required to establish their preventive control, omit prognosis, indicate treatment, prevent, diagnose and treat complications, and carry out follow-up until the final report, guide prevention and health promotion measures
- Dermatological bacterial infections (syphilis, leprosy, contagious impetigo)
- Dermatological viral and chlamydial infections (herpes zoster simple, warts in general)
- Dermatological infections by superficial-subcutaneous and deep fungi
- Dermatological infections by parasites (scabies, lice)
Module 5. Allergic and irritable skin diseases (12 weeks)
Establish a diagnosis for the different entities that make up the group of allergic and irritable dermatoses, identify as well as possible the causal agent, and advise its elimination and replacement
Carry out symptomatic treatment and follow-up until discharge
- Medicinal rashes
- Erythema multiforme
Teaching Strategy (Modules 1 to 5)
Teaching-patient care activities:
- Rounds
- Instrumental activities in facilities for dermatological treatment and surgery
- Presentation of admitted clinical cases
- Clinical histopathological sessions
- Clinical pathological discussion
- Outpatient consultations (primary and secondary care) suggested
Academic activities:
- Discussions on:
- Clinical history methodology for dermatology
- The skin as an organ
- Reactive cutaneous pathophysiology
- Cutaneous pathophysiology of mycoses
- Leprosy program
- Syphilis program
- Reactions to
- Topical therapy
- Importance of biopsy in dermatology and sampling techniques
- Contact tests
- Diagnostic and prognostic tests
- Fundamentals of electrosurgery
- Caustic application
- Uses of ultraviolet light
- Ultra-short reactions (removal suggested)
- Seminars
- Introductory dermatology
- Dermatological therapy
- Syphilis, leprosy, mycosis, cutaneous viruses, pyoderma
- Parasitic infections
- Dermatitis
- Drug reactions
- Hives
- Erythema multiforme
- Literature reviews
- Corticosteroids and antihistamines
- Syphilis serology
- Immunology of leprosy
- Dermatitis pathogenesis
Assessment (Modules 1-5)
Theory
Questions about the material indicated in the modules, in the form of:
- Short answer
- Open answer
- Simulation response
Practice
There will be a continuous assessment of the techniques and skills of the following instrumental procedures:
- Histamine test
- Lepromin test
- Completion of biopsy sampling
- Collection of parasites and nits
- Electrosurgery
- Surgical resection of small lesions
- Sampling for Tzonck test
- Caustic application
- Refrigerant application
- UV light application
- Wood’s Lamp application
- Completion of contact tests
- Interpretation of biopsy results
To be evaluated:
Time used
Technique
Results
Theoretical and practical
There will be a continuous assessment of acquired knowledge and mastery of techniques
- Preparation and control of dermatological TLC
- Discussion of cases
There will be a continuous assessment of the depth of knowledge and skills achieved in the following:
- Quality of the clinical history
- Completion of dermatological examination
- Instrumental procedures
- Tests and terms of diagnosis and indicated prognosis
- Diagnostic approaches
- Alternative solutions
- Ability to establish a definitive diagnosis and prognosis
- Treatment proposed or used
- Final results
- Doctor-patient-family relationship
Teaching literature: (Modules 1-5)
Basic texts:
- Andrews Domonkos, 1977.
- Lener-Histopatologica (last edition).
- Minsap- Normas de Dermatología (last edition).
- Programa de Lepra (last edition).
- Minsap- Programa de Sífilis (last edition).
- Text-book and dermatology- Ropk and Wilkinson.
- Epstem E. Skin Snigery 1956.
Complementary texts
- Sheard, C: Treatment of Skin Diseases: Normal Year Book Medical Publisher, 1978.
- Wancker B.A.: I-Ray and Radmin in Dermatology, 1959.
- Castañedo C: Alergia Dermatológica y Fenómenos Asociados, Ciencia y Técnica, instituto del Libro, Habana, 1973.
Other teaching resources:
- Archive of dermatoses slides
- Archive of skin biopsy slides
- Audio slide show on:
- The skin as an organ
- Topical therapy
- Caustic application
- Slides on:
- Clinic, diagnosis and treatment of syphilis
- Clinic, diagnosis and treatment of leprosy
- Contact test
- Printed materials
- Dermatological clinical history
SECOND YEAR
Area II. Clinical dermatology (duration 11 months)
Clinical dermatology II
Module 6. Immunological cutaneous disorders (duration 24 weeks)
Visually recognize the skin lesions typical of each entity or group, as well as the groupings of lesions, their location and assessment with or without treatment, establish the preventive diagnosis, define complementary therapies and achieve a positive and differential diagnosis, prevent its development and possible complications, specify medications and indicate and select the routes of administration and the methodology to be used
- Lupus erythematosus
- Generalized scleroderma
- Localized scleroderma
- Duhring’s disease
- Pityriasis lichenoid
- Dermatomyositis (suggested to add)
Module 7. Dermatosis of genetic or unspecified etiology (duration 12 weeks)
Locate genetic dermatoses or dermatoses of undefined etiology among skin conditions, differentiate the genetic elements involved in their production and maintenance, specify the pathogenesis of the pathological processes involved in them and the factors that promote, develop and condition them; characterize the expressed skin lesions; carry out the procedures to discover their pathogenic signs; indicate and interpret complementary tests that constitute their diagnosis or classification or serve as treatment controls and adequately prevent the complications and the prognosis of these diseases; clearly inform the patient or their relatives, give genetic counseling when possible, and maintain permanent surveillance and follow-up of patients
- Psoriasis
- Lichen planus
- Ichthyosis vulgaris
- Acanthosis nigricans
- Epidermolysis bullosa
- Neurofibromatosis
- Granuloma annulare
- Hidradenitis
- Pseudoxanthoma elasticum
- Sarcoidosis
- Hypo hidrosis
- Geographic tongue
- Progressive pigmented purpuric dermatosis (capillaritis is suggested)
Module 8. Structural dermatoses (malformations and neoformations)
(duration 12 weeks)
Recognize the characteristics of fundamentally structural dermatoses within skin diseases
Diagnose by gnoseological entity, define the differential and complementary prognoses for the positive diagnosis and the differential diagnosis for each one of the entities
Prevent, diagnose and treat possible complications of each, advise prevention methods to avoid worsening, relapses and the appearance of new injuries
Carry out curative or ongoing treatments and identify and direct rehabilitation processes when needed
- Epidermal nevi and skin appendages
- Inclusion cyst
- Borderline nevus
- Dermatofibroma
- Precancerous dermatoses
- Epithelial tumors
- Mycosis fiongoides or T-cell lymphoma
- Xanthomas (deposit disease is suggested)
- Primary cutaneous amyloidosis and lichen amyloidosis
- Eosinophilic granuloma
- Cutaneous lipomas
Teaching strategy
Teaching-care activities
1, 2, 3, 4, 5, 6 and 7 follow the same previous strategy
- Discussion of outpatient cases
- Clinical-radiological session
Academic activities
- Conversations on:
- Auto-antibodies and complement in dermatology
- Antibodies, anti-glomerular basement membrane disease
- Foundational knowledge of genodermatosis
- (Electrolyte disorders) It is suggested to put hydromineral balance in the skin diseases that require it
- Conduct of the specialist in genodermatoses
- Epidermolysis bullosa
- Fundamental concepts of malignant tumors
- Squamous cell carcinoma
- Malignant melanoma
- Inclusion cyst
- Basic principles of tumor removal
- Varieties of lupus erythematosus
- Classification of sclerodermas
- Puófigos, varieties
- Puófigos treatment
- Cutaneous vasculitis
- Genodermatosis classification
- Erythematous squamous dermatosis
- Treatment of psoriasis
- Lichen planus
- Borderline nevus
- Senile and seborrheic keratosis
- Classification of xanthomas
- Etiopathogenesis of eruptive xanthomas
- Clinical varieties of basal-cell carcinoma
- Treatment of basal-cell carcinoma
- Pre-cancerous dermatoses
- Treatment of hemangiomas
- Bibliographic reviews
- Discoid lupus erythematosus
- Pemphigus
- Borderline nevus
- Deficiency-related diseases
ASSESSMENT MODULES 6-8
Theory:
Same as before in the indicated topics
Practice:
The mastery of techniques and skills achieved in the taught practical procedures from the first year will be assessed
Theoretical and practical:
- Preparation and management of clinical histories
- Discussion of cases
Continuous assessment will be used to evaluate the depth of knowledge and the acquired skills of the following:
- Quality of the clinical history
- Dermatological examination techniques
- Instrumental procedures
- Diagnostic and prognostic exams and techniques
- Diagnostic approaches
- Alternative solutions
- Ability to establish a definitive diagnosis and prognosis
- Treatment proposed or used
- Final results
- Doctor-patient-family relationship
Teaching literature: Modules 6, 7, 8
Basic texts:
- Rook A., Wielkinson: Text Book of Dermatology, 3rd. 1979.
- Burcklardt W.: Atlas y compendio de Dermatología, Barcelona. 1967.
- Stmart W.D.; Santo J.L.: Dermatology, Mosley co. Saint Louis, 1978.
- Fitzpatrick T.B.: Dermatological, differential Diagnosis Year Book Medical Publisher, 1962.
- Simons R.D.: Dermatología Tropical y Micología Médica, Prensa Médico Mexicana, 1957.
Complementary texts
- Piñol Aguadé J.: Citogenética en Dermatología. Científico Médica, Barcelona, 1968.
- Cay Prieto J.: Dermatología Cient. Med., Barcelona, 1971.
- Chinaranta A.F.: Breviano Dermatológico. Universitaria B. Aires, 1962.
Other teaching resources:
- Dermatology slide archive
- Archive of slides of skin biopsies
- Audio slide show on:
- Electrolyte disturbances in pemphigus
- Squamous cell carcinoma
- Slides with printed materials: a) anti-glomerular basement membrane antibodies
- Printed materials:
- Basic concepts of genodermatosis
- Basic principles of tumor removal
THIRD YEAR
Area II. Clinical Dermatology
Duration____________
Module 9. Cutaneous appendage disorders
Duration_____
Based on the corresponding theoretical foundation, carry out the different procedures necessary to arrive at the presumed and differential diagnoses of skin appendage disorders, define their prognosis and indicate treatment, guide prevention measures, follow their evolution until they are permanently under control or disappear
- Endocrine hypertrichosis
- Male idiopathic alopecia
- Alopecia areata
- Traumatic alopecia
- Post-infectious and post-partum alopecia
- Keratosis pilaris
- Benign and malignant sweat and sebaceous gland diseases
Module 10. Disorders and defects of skin aesthetics
Duration_________________
Recognize the dermatoses in which alterations in the patient’s aesthetics predominate over pathological disorders (broad concept of health), adequately classify the clinical pictures of pigmentation disorders; of keratinization and sebaceous gland hyperplasia, define to what extent the patient’s concern is controllable by the dermatologist and which patients need the cooperation of a psychiatrist or psychologist
Establish the diagnosis, prevent worsening and relapse, and carry out corrective treatments
- Vitiligo
- Romofin
- Seborrheic dermatitis
- Juvenile acne or acne vulgaris
Teaching strategy:
Teaching-care activities:
The same as before
Academic activities:
- Physiology and development of pilosebaceous follicles (D-F)
- Etiopathogenic factors of male alopecia
- Androgenic alopecia in women
- Follicular hyperkeratosis (suggested)
- Keloid acne of the neck
- Classification and mechanism of pigmentation
- Differential diagnosis of tylosis
- Etiopathogenesis of acne
Seminars:
- Etiopathogenesis of hypertrichosis
- Classification of alopecia
- Hormonal alopecia
- Traumatic alopecia
- Arcata and pseudopelade alopecia
- Pityriasis rubra pilaris
- Etiopathogenesis of melasma
- Estrogenic pigmentation
- Differential diagnosis of vitiligo
- Varieties of acne
- Medical treatment of acne
- Keratosis pilaris
- Seborrheic dermatitis
Area III. Training in the practice of clinical dermatology
Objectives: Deepen knowledge and refine skills acquired in the modules of the relevant areas and apply them with a high degree of autonomy in the care of adult and child patients with skin diseases
Supervision by the teaching specialist, carried out while serving as a member of the care in pediatric hospitals and clinical-surgical hospitals
- In clinical dermatology pediatric hospitals
Duration
Module 4. Contagious and parasitic dermatosis
- Contagious impetigo
- Ringworm in children
- Tinea carcinata of hairless skin and skin folds
- Candidiasis in mucous membranes and semi-mucous membranes
Module 7. Dermatosis of genetic or unspecified etiology
- Ichthyosis vulgaris
- Epidermolysis bullosa
- Granuloma annulare
Module 8. Structural dermatoses (malformations and neoformations)
- Borderline nevus
Module 9. Cutaneous appendage disorders
Keratosis pilaris
It also deals with the contents of modules 3 to 19 in relation to pediatric clinical dermatology
Teaching-patient care activities:
- Outpatient consultations
- Polyclinical interconsultations
- Instrumental activities in facilities for dermatological treatment and surgery
- Clinical histopathological sessions
- In-room interconsultations
- Discussion of cases
Academic activities:
Seminars or colloquia:
- Adequacy of therapy in accordance with the characteristics of the infant-juvenile patient
Training in clinical dermatology in clinical-surgical hospitals:
Carried out in dermatology services for 10 months
Objectives: Provide comprehensive care to adult patients with dermatological conditions with a high degree of autonomy under the guidance of the teacher, as a member of the healthcare team
The knowledge and skills correspond to modules 3 to 10
- Teaching-patient care activities
- Rounds
- In-room interconsultations
- Instrumental activities in facilities for dermatological treatment and surgery
- Clinical pathology
- Discussion of cases
- Mortality analysis meeting
- Clinical-pathological discussion
Academic activities:
- Group discussion
- Drug iatrogenesis
- Clinical research methods
- Therapy by physical means
Bibliographic reviews:
About 3 current topics that will be chosen by the instructor
- Tropical diseases (suggested)
Assessment:
Theoretical and practical:
- Attention and care of child dermatological patients
The depth of knowledge and the acquired skills of the following will be assessed:
- Quality of the clinical history
- Dermatological examination techniques
- Diagnostic approaches
- Alternative solutions
- Planned treatment (adequacy according to age)
- Doctor-patient-family relationship
Assessment: Modules 9-10
Theoretical: Same as before in the indicated topics
Teaching literature: Modules 3-10
- Castañedo C: Afección Dermatológica Medicina General Integral III, 251-280, Editorial C. Médicas, Habana, 1985.
- Hoving P.T.: Picaduras y Parásitos. Clínica Pediat, Norteam 553-570, 1983.
- Korting B.W.: Atlas de Dermatología, 1969.
- Seider M.: Dermatología Pediátrica, Edit. Bibliog., 1959.
- Ramírez: Verrugas Vulgares y Bleonicos. Medicina Cutánea II: 337-342. 1983.
- Schadner L.: Tratamiento del Acné, Clínica Ped. Nort 493-501, 1983.
- Turnessen W.W.: Infecciones Cutáneas. Clin. Ped. 507-522. 1983
Other teaching resources:
Slides, retro transparencies, videos, etc.
