2 - Derm - Skin + Systemic disease - Cutaneous manifestations of malignancy

Question 1

Acanthosis nigricans

• describe skin
• where?

Answer 1

velvety, thickened, hyperpigmented skin

often in axillae, groin, neck, commonly with skin tags

Question 2

Acanthosis nigricans

-ass w?

Answer 2

ass w insulin resistance, metabolic syndrome / T2DM, other endocrinopathies

ass w malignancy (GI) - suspect if sudden+severe

Question 3

Acanthosis nigricans

–mgmt

Answer 3

treat underlying cause

Question 4

Pyoderma gangrenosum

- describe

Answer 4

initial inflamed nodule, ulcerates and rapidly enlarges, often with necrotic centre, purply border, heals with cribriform (x-x) scar

Question 5

Pyoderma gangrenosum

• when?
• where?

Answer 5

commonly after minor trauma/surgery, or spontaneous

commonly lower legs, buttocks, mucous membranes, peristomal sites

Question 6

Pyoderma gangrenosum

- underlying conditions (present in 50% cases)

Answer 6

• UC/CD, infl arthritis, chronic hep, diverticulitis, malignancy 10% usually haematological

Question 7

Pyoderma gangrenosum

- mgmt

Answer 7

corticosteroids (top/syst)

immsuppressants (ciclosporin, methotrexate)

Question 8

Dermatomyositis

• cause?
• consequences?
• ass w?

Answer 8

infl of muscles in ass w skin rash
symmetrical proximal muscle weakness
only adult form is ass w malignancy (breast, lung, ovarian, colon, pancreas)

Question 9

Dermatomyositis

• describe skin changes?
• distribution?

Answer 9

heliotrope (red/purple) rash - usually upper eyelids
Gottrons papules (flat violet) on bony prominences
nail fold changes

photosensitive distribution

Question 10

Dermatomyositis

• Ix
• mgmt

Answer 10

i - muscle biopsy, electromyography, serum CK

mgmt - systemic corticosteroids, immsuppressants

Question 11

Acquired icthyosis

- describe skin

Answer 11

dry scaly skin

Question 12

Acquired icthyosis

- associations

Answer 12

possibly malignancy related

also - hypothyroidism, sarcoidosis, HIV