Butterfly Rash

Butterfly Rash

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 photo SKIN009_zps6c65d79f.jpg


  1.  Describe the clinical finding?
  2. What underlying diseases give rise to this condition?
  3. Name 4 diagnostic criteria for diagnosis of the condition.
  4. Write the modalities of treatment.

Answer Sheet:

  1.  Describe the clinical finding?
    C/F: This is a photograph showing Butterfly Rash,
  2. What underlying diseases give rise to this condition?
    Systemic Lupus Erythematosus (SLE)
  3. Name 4 diagnostic criteria for diagnosis of the condition.
    a. Malar Rash
    b. Discoid Rash
    c. Serositis
    d. Oral ulcer
    e. Arthritis
    f. Photosensitivity
  4. Write the modalities of treatment.
    a. Avoid sun and UV light exposure
    b. Use of high factor sun blocks
    c. Intermittent analgesics.
    d. NSAIDs: In mild disease
    e. Short courses of oral corticosteroid for mild to moderate
    f. For severe : High dose corticosteroid
    g. Other immunosuppressive drugs

Primary Lesions of Skin

Macule: Small spot (Less than 5 mm), different in color from surrounding skin, that is neither elevated nor depressed below the skin surface.

Patch: Large spot (>5mm) different in color from surrounding skin.

Papule: Small (less than 5mm diameter) circumscribed solid elevation on the skin.

Plaque: Large (>5mm) superficial flat lesion, often formed by a confluence of papules

Nodule: Large cirumscribed solid skin elevation .

Pustule: Small circumscribed skin elevation containing purulent material.

Vesicle: Small (<5mm) circumscribed skin blister containing serum.

Bulla: Large(>5mm) vesicle containing free fluid.

Wheal: Irregular elevated edematous skin area, which often changes in size and shape.

Cyst: Enclosed cavity with a membraneous lining which contains liquid or semisolid matter .

Tumor: Large nodule, which may be neoplastic .

Telangiectasia: Dilated superifical blood vessel.

Burrow: A linear or curvilinear papule, caused by a burrowing scabies mite.

Comedone: A plug of keratin and sebum wedged in a dilated pilosebaceous orifice.


Distribution of Collagen Tissue

Distribution of different types of Collagen tissue:

There are 4 types of Collagen Tissue. They are distributed as follows –

  1. Type-1: Bone
  2. Type-2: Cartilage
  3. Type-3: Many places
  4. Type-4: Basement membrane of Kidney

How to memorize these easily:

  1. Type-1: Bone (Here contain One, So type-1)
  2. Type-2: Cartilage (Cartwolage) [If we write cartilage as Cartwolage,it contain two, so type-2)
  3. Type-3: It present in many places (so no need to mention)
  4. Type-4: Basement membrane ( just memorize a this line ” four under the floor” ‘Under the floor ‘ means basement . [ So type -4 is basement membrane]


Examination Of Pulse In Clinical Medicine

Radial Pulse Clincal Procedure


Pulse means the expansion and elongation of arterial walls passively produced by the pressure changes during systole and diastole of ventricle.

 Different Pulses:

  1. Radial pulse
  2. Brachial pulse
  3. Carotid pulse
  4. Femoral pulse
  5. Popliteal pulse
  6. Posterior tibial pulse
  7. Pulse of arteria dorsalis pedis


  1. Rate
  2. Rhythm
  3. Volume
  4. Character
  5. Condition of arterial wall
  6. Symmetry
  7. Radio-femoral delay

Findings of different characteristics:

  • Rate, Rhythm & Condition of the vessel wall: by Radial artery.
  • Character & Volume: by Carotid pulse.
  • Symmetry: by Simultaneous assessing both right & left radial pulse.
  • Radio-femoral delay: by Simultaneous assessing of right radial pulse & right femoral pulse.

Radial Pulse :

Radial Pulse Clincal Procedure
Radial Pulse examination

At wrist , lateral to flexor carpi radialis tendon , place your three middle fingers over the radial pulse.

Brachial Pulse:

Brachial Pulse- Clinical procedure
Brachial Pulse Examination

In antecubital fossa medial to biceps tendon. Use your thumb with your fingers cupped round the back of elbow.

Carotid Pulse:

  • Palpate carotid pulse with the patient lying on a bed / couch
  • Never compress both carotid arteries simultaneously.
  • Use your left thumb for right carotid pulse & vice versa.
  • Place tip of thumb b/w larynx & ant.border of sternocleidomastoid.

ECG Notes Interpretation and management guide

ECG Notes Interpretation and Management Guide

This book contains:

  • ECG Basics
  • 12-Lead Interpretation
  • Clinical Tips

and more.

Special Feature:

  • The graphical presentation of the ECG are shown in clear lines.
  • The topics are described from the basic structure of heart. So any medical student can learn ECG without the help of their teacher.
  • All the ECGs are described in different categories, so that reader can easily search out the topics.

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