2 - Derm - Skin + Systemic disease - Dermatitis herpetiformis, Generalised pruritis, RA

Question 1

RA - what skin changes? where? what else?

Answer 1

rheumatoid nodules on elbows, vasculitis

Question 2

Generalised purpura - 6 groups of causes

Answer 2

metabolic, malignancy, drugs, haematological, hepatic disease, other

Question 3

Generalised purpura - metabolic and malignant causes

Answer 3

met - thyroid problems, CKD

mal - leukaemia, lymphoma, myeloma, solid tumours

Question 4

Generalised purpura - drugs and haematological causes

Answer 4

drugs - alcohol, aspirin, opiates

haematological - polycythaemia rubra vera, Fe def anaeima

Question 5

Generalised pupura - hepatic and other causes

Answer 5

hep -cholestatic disease/jaundice

other - pregnancy, xerosis (dry skin)

Question 6

Dermatitis herpetiformis - ass w ? ass features?

Answer 6

coeliac disease

associated weight loss/anaemia due to coeliac disease

Question 7

Dermatitis herpetiformis - describe the skin changes

Answer 7

chronic, recurrent, blistering and internsely pruritic eruption
symm distribution on extensor surfaces of trunk and extremities
may see excoriated vesicles

Question 8

Dermatitis herpetiformis - Ix

Answer 8

I - skin biopsy and immunofluorescence

Question 9

Dermatitis herpetiformis - mgmt

Answer 9

topical dapsone (anti-inflam + immunomodulatory) (risk of haemolysis and agranulocytosis)
if not tolerated - ultrapotent top steroids/systemic steroids
avoid gluten