Skincancer909 is an online textbook designed for medical students. It is media rich with hundreds of high quality images, over fifty bespoke videos, and Q&As. Although it is primarily aimed at medical students others have found it useful. It is published under an Attribution Non-Commercial ShareAlike International Creative Commons license (CC BY-NC-SA 4.0).
Below, I list most of the other material I have produced for undergraduate medical students at the University of Edinburgh. Hyperlinks to the videos, audio tracts or other supporting material are shown. Students of the SKIN2022 class can find the password protected videos via the instructions already sent to you via Learn.
Core concept videos
There are nine Core Concept videos below. Some of them have been used for first year teaching. The approach is unashamedly about placing skin disease within a biological framework. There is a PDF that accompanies the videos here. There are also some audio Q&A on Soundcloud here.
Video 01: Introduction to the basic cellular anatomy of skin (an introduction to skin biology) (13 mins).
This is a whirlwind tour of the basics of skin biology. I describe the two main compartments of skin, the epidermis and the dermis. The main cells of the epidermis are the keratinocytes, melanocytes and Langerhans cells. In the dermis we need to know about fibroblasts, the extracellular materials such as collagen and ground substance fibroblasts produce, and mast cells. I then describe the appendageal structures: the hair follicles, sebaceous glands and the eccrine sweat glands. Most of this material will be expanded upon in the subsequent videos. (Notes, Figures, Questions, Soundcloud Q&A)
Video 02: Sunburn, DNA and skin cancer (9 mins)
In this video I link why some people develop erythema in the sun, with DNA damage and, in the long term, skin cancer. Erythema is a consequence of UVR (ultraviolet radiation) induced DNA damage. The erythema subsides because you repair (most) of the damage induced by UVR. We know this to be the case because (i) the action spectrum for erythema and DNA damage is very similar and (ii) because we see abnormal erythema and high cancer rates in the disorder xeroderma pigmentosum (XP). XP is an autosomal recessive disorder, in which subjects are unable to repair UVR induced DNA damage. The failure of repair leads to the accumulation of mutations, leading to the development of many different types of skin cancer. (Notes, Figures, Questions, Soundcloud Q&A).
Video 03: The biology of human pigmentation (15 mins)
DNA repair (see previous video) is not the only way humans protect against the harmful effects of UVR. In this video, I explain how melanin pigmentation protects against UVR. In particular I seek to answer a few related questions: how do we know melanin works; how does melanin work; how well does tanning work in comparison with baseline pigmentation (constitutive pigmentation); and how did evolution come up with this novel purpose for melanin? Along the way, we learn what pigmentary disorders like vitiligo and albinism can teach us (Notes, Figures, Questions, Soundcloud Q&A).
Video 04: Urticaria, from nettle stings to autoimmunity (10 mins)
In this video I make an analogy between what happens to your skin when you roll around in the nettles, and the groups of conditions called urticaria. In the former, exogenous chemicals provoke the reaction; in the latter, it is a variety of stimuli that provokes the release of endogenous chemicals. Key to the pathogenesis of urticaria is the mast cell. We need to understand what mediators mast cells contain, what provokes mast cells to release these mediators, and how these mediators produce the rash — characterised by erythema and weals — we see with our eyes. I explain the triple response, and use as examples, dermographism (literally writing on the skin), and solar urticaria. This account suggests ways that urticaria might be treated, and also explains why our current treatments are not wholly effective (Notes, Figures, Questions, Soundcloud Q&A).
Video 05: Itch, and the utility of scratch (8 mins)
In this video I explain some of what we know about itch, and it’s reflex response, scratch. Itch is a cardinal feature of skin disease, and whereas once itch was viewed as being transmitted along ‘pain’ fibres, we now know different. The major clinical issues are that whilst we know histamine and histamine sensitive itch fibres play a role in some skin diseases, the majority of itch is not histamine mediated. I describe the peripheral mechanisms
The bricks and mortar model reflects the formation of the heavily crosslinked cornified envelope, and surrounding lipid. Unfortunately, many agents we are exposed to can attack this hydrophobic lipid rich barrier. One result is irritant dermatitis, and one risk factor for irritant dermatitis, is the syndrome of atopic dermatitis. Mutations of filaggrin are common in many populations, and increase the risk of developing atopic dermatitis (Notes, Figures, Questions, Soundcloud Q&A).
Video 06: The biology of the skin barrier: the eczema connection (10 mins)
In this video I explore in greater depth the biology of the epidermis with a focus on barrier formation and the creation of of the stratum corneum. Skin is a stratified squamous epithelium, and keratinocyte stem cells reside in the basal layer. Differentiation leads to the production of a range of proteins, including keratins and filaggrin, and the production of lipid. A key enzyme is transglutaminase.
The bricks and mortar model reflects the formation of the heavily crosslinked cornified envelope, and surrounding lipid. Unfortunately, many agents we are exposed to can attack this hydrophobic lipid rich barrier. One result is irritant dermatitis, and one risk factor for irritant dermatitis, is the syndrome of atopic dermatitis. Mutations of filaggrin are common in many populations, and increase the risk of developing atopic dermatitis. (Notes, Figures, Questions, Soundcloud Q&A).
Video 07: Physics matters! UVR and the skin (20 mins)
Few people may go to medical school because of a love of physics, but physics and engineering underpin whole areas of modern medicine. In this video I focus on the area of physics of great interest to the dermatologist and student of skin disease, the physics of one part of the electromagnetic spectrum: ultraviolet radiation (UVR).
We run through what an erythema action spectrum is, the distribution of UVR emitted from the sun (and received at ground level), and the crucial importance of understanding the relation between wavelength and biological activity. I end by highlighting the problems that have arisen from a failure to understand basic photobiology, and highlight some of the myths surrounding ultraviolet radiation (Notes, Figures, Questions, Soundcloud Q&A).
Video 08: Blisters, molecular glues and pemphigus (4 min)
Blisters are — to paraphrase Yeats — all about when the centre cannot hold. A simple design constraint on skin (in particular) is that it has to be physically resilient. How is this achieved? This brief video explores how keratinocytes are designed to resist stress and how a family of adhesion molecules (desmogleins) are targeted in the autoimmune disease pemphigus (Notes, Questions, Soundcloud Q&A).
Video 09: Skin immunology (KISS!) (4 min)
Clinical dermatology falls naturally into two halves: cancer and rashes. Some of the earlier core concept videos have covered the scientific underpinnings of skin cancer (and skincancer909 says more about them, too). By contrast, the foundational science for most rashes is immunology. In this short video, I use the traditional classification of hypersensitivity reactions, to provide insights into some common inflammatory diseases of skin. This video uses examples from core concept videos 4, 6 and 8. I suggest you will get the most out of it if you have already watched these other videos. (No supporting material).
Diseases in five minutes
The four videos below are meant to provide quick introductions to common skin diseases.
Video 10: Skin cancer in five minutes
Video 11: Psoriasis in five minutes
Video 12: Eczema in five minutes
Video 13: Acne in five minutes
Skincancer909: ‘One Minute’ video series
Skincancer909 is a self-contained online textbook of skin cancer for medical students. Most chapters start with a ‘topic in one minute’ video. These One Minute videos are listed immediately below. Other videos within Skincancer909 are listed in the next section.
Video 14: Skin Biology in One Minute
Video 15: Sunburn,DNA and Skin cancer in One Minute
Video 16: Pigmentation in One Minute
Video 17: Bench to Clinic in One Minute
Video 18: Skin Surgery in One Minute
Video 19: Basal Cell Carcinoma in One Minute
Video 20: Squamous Cell Carcinoma in One Minute
Video 21: Premaligant Lesions in One Minute
Video 22: Melanoma in One Minute
Video 23: Mimics of Skin Cancer in One Minute
Video 24: Rarer Skin Cancers in One Minute.
Video 25: The Clinician’s Approach
Skincancer909: other videos
There are some videos that are included in skincancer909 that are parts of other collections on this page. These are:
Video 01: An introduction to skin biology
Video 02 : Sunburn, DNA and Skin Cancer
Video 03: The Biology of Human Pigmentation
Video 07 : Physics matters! UVR and the skin
Video 10 : Skin cancer in five minutes
The following videos are also included in skincancer909 and are not listed elsewhere on this page.
Video 26: Quiz on Skin Structure (Chapter 3)
Video 27: Quiz on Sunburn, DNA and Skin Cancer (Chapter 4)
Video 28: Quiz on Skin Pigmentation (Chapter 5)
Video 29: Quiz: Bench to Clinic (Chapter 6)
Video 30: Putting on Sterile Gloves (presented by Dr Lisa Naysmith
Video 31: Quiz on Skin Surgery
Video 32: What say to patients who have a BCC? (A dialogue with my doppelgänger).
Video 33: Why does brown melanin appear blue?
Video 34: Pigmented lesion: what to do next?
Video 35: Is the tumour out? ( a video about the concepts behind Mohs surgery)
Video 36: SPF (sun protection factor) in five minutes
Video 37: Should you lie in the sun? (my doppelgänger returns)
Video 38: Virtual clinic 1
Video 39: Virtual clinic 2
Video 40: Virtual clinic 3
edderm101:core-diseases related videos (‘rashes’)
If Skincancer909 is a self-contained online textbook for skin cancer for medical students, the videos below mainly relate to inflammatory skin diseases (aka ‘rashes’). Some of the videos below are self-contained, but many are designed to be viewed within the context of reading edderm101:corediseases . There is a Soundcloud Q&A to accompany the edderm101:core diseases questions at the end of many of the chapters.
I am not a big fan of PowerPoint style lecturing but here are three I have used in the past (after requests from students).
Video 41 Psoriasis Lecture: Part 1 (of 2) (30 minutes, PowerPoint style lecture)
Video 42 Psoriasis Lecture: Part 2 (of 2) (23 minutes, PowerPoint style lecture)
Video 43 Acne Lecture (32 minutes, PowerPoint style lecture)
Most of these videos below are either very short introductions to individual chapters in edderm101, longer Q&A on the various chapters, or simple short explanatory videos on topics some students find confusing.
Video 44 Why does psoriasis sometimes look white? (2 minutes)
Video 45 Antihistamines and eczema: confused? (4 minutes)
Video 46 Problems with gloves? (5 minutes)
Video 47 Q&A Chapter 1 Psoriasis in edderm101: core diseases (20 minutes)
Video 48 Q&A Chapter 2 Acne in edderm101: core diseases (13 minutes)
Video 49 Q&A Chapter 3 on Urticaria in edderm101:core diseases
Video 50 Eczema. Introduction to Eczema /Dermatitis Chapter 4 in edderm101:core diseases (4 minutes)
Video 51 Q&A Chapter 4 on Eczema/Dermatitis in edderm101:core diseases (24 minutes)
Video 52 Introduction to Blisters part 1, Chapter 5, edderm101:core diseases (2 minutes)
Video 53 Introduction to Blisters part 2, Chapter 6, edderm101:core diseases (4 minutes)
Video 54 Q&A Blisters 1, edderm101:corediseases (8 minutes)
Video 55 Q&A Blisters 2, edderm101:corediseases (4 minutes)
Video 56 Introduction to Vasculitis, Chapter 7, edderm101:corediseases (2 minutes)
Video 57 Introduction to Photosensitivity, Chapter 8, edderm101:corediseases (2 minutes)
Video 58 Introduction to Drug Reactions, Chapter 9, edderm101:corediseases (2 minutes)
Video 59 Introduction to Pigmentary disorders, Chapter 10, edderm101:corediseases (1 minute)
Video 60 Introduction to Facial rashes, Chapter 11, edderm101:corediseases (1 minute)
Video 61 Introduction to the ‘ragbag of disoders’, Chapter 12, edderm101:corediseases (1 minute)
Video 62 Introduction to Infections and infestations, Chapter 13, edderm101:corediseases (1 minute)
Video 63 Introduction to Skin Disease and the Mind, Chapter 14, edderm101:corediseases (1 minute)
Video 64 Introduction to Pregnancy and the skin, Chapter 15, edderm101:corediseases (1 minute)
Video 65 Introduciton to Hair Disorders, Chapter 16, edderm101:corediseases (1 minute)
Video 66 Introduction to Skin and Internal Disease, Chapter 17, edderm101:corediseases (1 minute)
Other miscellaneous videos
Below are some miscellaneous videos that I have used for undergraduate teaching. Video 67 is the introduction that used to be on the student’s LMS. Video 68 is a rear-view mirror take on the changes in clinical practice in dermatology over my lifetime.