267. C.T. Diseases

Question 1

Clinical Presentation of Discoid Lupus on skin

Answer 1

Head and upper body
scaly pink brown plaques, annular appearance, heals with atrophic/hypopigmented scars
Scalp lesions may cause alopecia

Question 2

Clinical Presentation of Subacute Cutaneous Lupus Erythematosus

Answer 2

Photosensitive on sun-exposed areas
Scaling, annular pink papules/plaques with central clearing
No scarring
Anti-SSA+

Question 3

Clinical Presentation of Acute Cutaneous Lupus Erythematosus

Answer 3

Malar/Butterfly rash
SPARES nasolabial folds
Mild erythema, edema, telangiectasia, erosions
Triggered by sun
Assoc with SLE
anti-dsDNA+

Question 4

Clinical Presentation of Neonatal Lupus Erythematosus and Assoc.

Answer 4

Similar to SCLE: annular pink scaly plaques in periorbital location
No sun exposure needed
From anti-SSA/Ro moms
Assoc with congenital HEART BLOCK

Question 5

Clinical Presentation of Dermatomyositis on Skin and other Sx

Answer 5

Sx: Proximal extensor inflammatory myopathy: weakness, decreased function (hard for stairs, brushing hair)
Skin: Heliotrope eruption - violaceous and periorbital edema on central part of face, Gottron’s papules on extensor joints - pink/violaceous papules/plaques with scale,
Dilated capillary loops on nailbed
“Shawl Sign” rash
Calcinosis Cutis

Question 6

What labs should you order for dermatomyositis? What tests should you order? Why?

Answer 6

CHECK Aldolase and CK for muscle inflammation

GET PFTs due to ILD risk

Evaluate for underlying malignancy!

Question 7

Clinical Presentation of Leukocytoclastic Vasculitis

Answer 7

Crops of palpaple purpuric papules + constitutional symptoms

Question 8

Clinical Presentation of HSP

Answer 8

• Preceding URI
• Acute Onset: Palpable purpura, arthralgias, colicky abd pain
• DIF Skin Biopsy shows IgA deposits in vessel walls!
• may have renal vasculitis