Clinical Dermatology Flashcards
What is the difference between dermatomyositis and cutaneous lupus?
Cutaneous histology almost identical to acute lupus except frequently more epidermal atrophy
What are the clinical findings with dermatomyositis?
- Violaceous papules on the knuckles (Gottron’s Papules)
- Heliotrope rash on the upper eyelid
- Shawl sign over the upper back that is VERY itchy
What are the clinical findings of cutaneous lupus - acute lupus erythematosis?
- Butterfly rash that spares the nasolabial folds
- Photosensitivity
What is cutaneous lupus highly associated with?
Systemic Lupus Erythematous
What are the clinical features of Discoid Lupus Erythematosus?
- Scarring depressed plaques
- Lichenoid dermatitis with vacuolar interface change
Do most patients with DLE have SLE?
No
What areas of the hand are spared in lupus?
Knuckles
What are the clinical features of scleroderma?
- “Bound‐down” skin
- Sclerodactyly
- Decreasedoral aperture
- May affect other organ systems
- 75% Female
What is CREST syndrome?
More mild scleroderma – Calcinosis cutis – Raynaud’s – Esophageal dysmotility – Sclerodactyly – Telangiectasias
What is the Ab found in CREST?
Anti-centromere Ab
Who does Raynaud’s generally affect?
Women
Raynaud’s Disease
Vasospasm of small vessels with pain and color change
White atrophic plaques that are often associated with localized scleroderma - can be seen in the genital area
Lichen Scelrosus
- Non-caseating granulomas
- Often seen in scars or sites of trauma
- Elevated ACE levels
Sarcoidosis
What is necrobiosis lipoidica associated with?
Diabetes
Pyoderma Gangrenosum
Autoimmune disease that leads to ulceration
What is pyoderma gangrenous associated with?
- Inflammatory arthritis
- Inflammatory bowel disease
What is calciphylaxis associated with?
End stage renal disease
- Type III Hypersensitivity Reaction
- Small purpuric papules
- Predominantly lower legs
Leukocytoclastic Vasculitis
Where are arteriovenous malformations most commonly found?
On the face
Viral Exanthem
Erythematous blanching macule and papillose that coalesce - most common in the summer and fall
- Vesicles on the pals and soles of the feet as well as oral lesion
- Fever prodrome
- Benign course
Hand, Foot and Mouth Disease - Coxsackie Virus
- Slapped cheecks
- Reticulated eruption on extremities
- Arthralgia
Parovirus B19 Infection
What can fetal infection by parvovirus B19 cause?
Anemia, fetal hydrops or death
- Pruritic edematous non-scaly plaques - wheals
- Swelling from plasma leakage
- Type 1 Hypersensitivity
Urticaria
Urticaria Pigmentosa
- Red-brown papules
- Mast Cells are present
- NOT the same as urticaria
- Numerous pink papillose coalescing over torso and proximal extremities due to a “bug or drug” reaction
- Found in folds of skin mostly
Exanthematous Drug Eruption
DRESS Syndrome
- Facial swelling and LAD
- Delayed onset
- Visceral involvement
What are the causes of erythema multiforme?
Drug reactions
- Anti-convulsants
- Antibiotics
- Sulfonamides
- Allopurinol
What are the causes of Stevens Johnson Syndrome?
Infections - HSV and Mycoplasma
What does SPF measure?
ONLY UVB protection
Lichenoid dermatitis with superficial and deep perifollicular dense lymphocytic inflammation often with dermal mucin and thickening of the basement membrane.
- Scarring alopecia
DLE
Spares lichenoid dermatitis with basal vacuolar change.
- Butterfly rash
- Spares nasolabial folds
Acute Lupus
- Shawl sign
- Gottron’s papules on knuckles
- Holster sign on hips
- Cuticular hypertrophy
- Violaceous “heliotrope” color
- Associated with proximal muscle weakness
Dermatomyositis
