Clinical Dermatology Flashcards
(40 cards)
Compare the skin lesions seen in Dermatomyositis and Lupus
Dermatomyositis:
- Involves the knuckles (Gottron’s papules)
- More epidermal atrophy
- Heliotrope Rash
- Shawl sign
- Very itchy
Lupus:
- Spares the knuckles
- Malar rash sparing the nasolabial folds
- Discoid lesions are scarred, depressed plaques with a hypopigmented center
- Scarring alopecia
Dermatomyositis
What may be associated with increased risk of malignancy?
P155/p140 (TIF-y)
What are Gottron’s papules?
Violaceous erythema overlaying the knuckles
May also be on elbows or tendons
Seen in dermatomyositis
What is a heliotrope rash?
Violaceous rash around eyes (upper lid common)
Seen in dermatomyositis
What is a shawl sign?
Lavender erythema in a shawl pattern on back, may be surrounded by flagellate erythema
Seen in dermatomyositis
Describe the Malar rash of Lupus
Comes across bridge of nose and both cheeks, sparing the nasolabial folds
Can be somewhat scaly
Transient
Most highly associated with SLE
Someone with a malar rash sees you in the office. They should NOT leave without doing a…
Urinalysis
Worried about underlying kidney disease in lupus
Describe the lesions in Discoid lupus
Scarring depressed plaques
Hyperpigmented rim and hypopigmented center
Commonly located on head, neck, ears
causes SCARRING ALOPECIA on the scalp (hair will NOT grow back in that area)
A patient comes in whose skin demonstrates tenting. You are worried about what disease?
Scleroderma = systemic sclerosis
Symptoms of CREST Syndrome
Calcinosis Cutis Raynaud's phenomenon Esophageal dysmotility Sclerodactyly Telangiectasias
CREST Syndrome is associated with what antibody?
Anti-centromere antibody
What is Lichen Sclerosis? What does it look like and where might it appear?
White-atrophic appearing plaques
Cigarette paper scale, most commonly in female genital area
Sarcoidosis
- Histology
- Serology
- Skin path
Non caseating granulomas, often in areas of scars or trauma
Elevated serum ACE
Erythema nodosum (ill-defined tender plaques on ant legs)
Necrobiosis Lipoidica
Appearance and cause
Yellow-pink atrophic plaques on pretibia
Caused by diabetes, even if well controlled
Pyoderma Gangrenosum
Cause
Autoinflammatory disease causing ulcers in the skin
Very painful
NOT infected
Associated with underlying systemic disease (Crohn’s, arthritis, heme disorders)
Pyoderma Gangrenosum
Appearance
Often appears infected with yellow necrotic debris in center
Overlaying ledge of blue/gray skin
Calciphylaxis
- Cause
- Appearance
Retiform (stellate) shape due to relation to blood supply
Calcium deposition in the vessels, causes ischemia in tissues perfused by that vessel
High mortality, often associated with end stage renal disease
Purpura
How do you know a lesion is purpura?
It doesn’t blanch with pressure!
Purpura
Palpable vs Non-palpable
What does it tell you?
Palpable – think inflammation, often due to vasculitis
Non-palpable– vasculopathy, thromboembolic cause
Leukocytoclastic Vasculitis
Caused by…
Type III HSR (immune complex)
PMN infiltrate around superficial vessels, leaks blood into skin
Assoc with infection, connective tissue disease, meds
Leukocytoclastic Vasculitis
Appearance
Small pruritic papules
Venous Stasis Dermatitis
Appearance
Chronic edema and leaking of blood into skin causes orange-brown color (hemosiderin deposition)
Bilateral
Acutely, may cause inflammation from skin stretching and weep fluid
Venous ulcers are commonly seen where?
Ankle (side, near the malleolus)
AV malformation
Locations, what is it?
Commonly on face
Congenital vascular anomaly that may flare up in puberty
