03a: Systemic Disease Flashcards
Painless, red-brown papules and plaques primarily found on shins that may signify underlying metabolic abnormality.
Necrobiosis lipoidica (20-35% have diabetes)
Necrobiosis lipoidica: as plaques progress, how do their features change?
Start as red-brown papules/plaques; progress to yellow-brown atrophic plaques with irregular violaceous borders and telangiectasias
Rx for necrobiosis lipoidica:
Compression stockings, topical steroids
Pretibial myxedema is associated with which underlying disease?
Autoimmine thyroid disease (Graves’)
Spontaneous bruising around eyes in elderly patient is sign of which underlying disease?
Amyloidosis
Amyloidosis causes spontaneous bruising, especially in (X) location, via which mechanism
X = periorbital (large blood vessels close to skin)
Amyloid binds Factor X, causing bleeding diathesis (due to factor deficiency)
(Primary/secondary) amyloidosis, aka AL, occurs as result of:
Primary
Untreated multiple myeloma
(Primary/secondary) amyloidosis, aka AA, occurs as result of:
Secondary Chronic illness (RA, Hodgkin's, RCC)
T/F: Cutaneous involvement is more common in secondary amyloidosis.
False - rare cutaneous involvement in AA; deposits in kidney, liver, and spleen
Dermatitis herpetiformis presents as (X) and is associated with which disease?
X = very pruritic lesions on extensor surfaces of elbows, shins, buttocks (bilaterally)
Celiac’s
Dermatitis herpetiformis: auto-(X) attacks which self antigen?
X = IgA Epidermal transglutaminase (very similar structure to tissue transglutaminase)
Pyoderma grangenosum associated with which underlying disease?
Mainly IBD (Ulcerative colitis);
Also RA and malignancy
First-line Rx for Pyoderma grangenosum:
Systemic steroids
(X) syndrome is an AD-inherited mutation in (Y) gene. Abnormal findings include oral and digital lentigines as well as multiple (Z) growths in GI tract.
X = Peutz-Jeghers Y = tumor suppressor Z = hamartomatous polyps
Pt with Peutz-Jeghers syndrome is at increased risk for which malignancies?
Visceral (colon, rectum, pancreas, stomach, testicles, ovaries, lung, cervix)
Most common cause of porphyria cutanea tarda:
Liver dysfunction
Others: EtOH, exogenous estrogens (OCPs), Fe overload
Renal dialysis patient presents with severe pruritis on bilateral arms. You notice hyperkeratotic papules with occasional white tip. What process is occurring?
Perforating disorder (degenerated collagen and elastin is being extruded through stratum corneum)
Renal dialysis patient has angulated plaques with an adherent black eschar/crust. This is likely (X) and is treated with (Y).
X = Calciphylaxis Y = IV Na thiosulfate (Ca chelator)
Renal failure patient that gets an MRI is at risk for which skin complication?
Nephrogenic systemic fibrosis (due to exposure to gadolinium) - progressive skin fibrosis causing joint contractures; rarely seen anymore (renal function checked before MRI)
Tuberous sclerosis: initial skin findings include
- Ash leaf-shaped hypopigmented macule
2. Collagenoma (Shagreen patch)
Tuberous sclerosis: typical skin finding on presentation to doctor
Facial angiofibroma (red/brown papules)
Tuberous sclerosis: complications include (X) growths in multiple areas such as..
X = fibromas (periungal), angiomyolipoma (kidney), nodules (brain)
Sign of Leser-Trélat:
Sudden onset of many seborrheic keratoses associated with GI adenocarcinoma
Most common site of basal cell carcinoma is (X), squamous cell carcinoma is (Y), and melanoma is (Z).
X = head and neck Y = head and neck and dorsal hands Z = back for men; legs for women
