Cutaneous Manifestations of Systemic Disease Flashcards
What cancer is associated with pruritus?
Hodgkin’s Lymphoma
List 5 causes of pruritus
- Pemphigoid prodrome
- Hodgkin’s lymphoma
- Erythropoietic protoporphyria (EPP) with exposure to sunlight
- Psychogenic (parasitophobia)
- Drug-induced (allopurinol, statins, opioids, amiodarone)
- Elevated estrogen (pregnancy)
What diagnosis is associated with fluorescing RBCs?
Porphyria
What virus is associated with erythema multiforme?
HSV
What is the most common initial rash presentation of a rheumatic or autoimmune disease?
Non-specific rash
(some form of erythema)
List 3 dermatological manifestations of SLE
- Alopecia
- Photosensitive rash with butterfly distribution on face
- Periungual telangiectasia
What are these 2 dermatological findings?
LEFT: Photosensitive rash with butterfly distribution
RIGHT: periungual telangiectasia
List 4 dermatological findings with systemic sclerosis
- Hard and sclerotic skin
- Microstomia
- Sclerodactyly
- Telangiectasias
What finding can confirm SLE with histology?
Direct Immunofluorescence
What finding is seen on histology of systemic sclerosis?
Greatly thickened collagen
What systems are primarily affected in systemic sclerosis?
What investigation can you order to help with investigations?
- Lungs
- GI tract
- Heart
- Kidneys
- Pulmonary Function Tests
- CT scan
What are these 2 dermatological findings?
LEFT: Microstomia
RIGHT: Sclerodactyly (tapered fingers)
List 5 dermatological findings in dermatomyositis
- Shawl sign
- Heliotrope rash
- Periorbital edema
- Periungual telangiectasia
- Ragged cuticles
- Proximal muscle weakness
- Gottron’s papules
- “Mechanics” hands
- Calcification of skin (juvenile form)
What cancer is associated with dermatomyositis?
Adenocarcinoma of breast, lung or GI tract
What antibodies are positive in dermatomyositis?
List 2 other confirmatory tests
+Jo antibodies
- Elevated CK
- EMG
What types of infection commonly are associated with Reiter’s syndrome?
What are the 3 diagnostic findings?
What dermatological manifestation is seen?
What is a common association?
GI tract or GU (especially Chlamydia infections)
Conjunctivitis, Arthritis, Urethritis
Keratoderma blenorrhagica
HLA B27
What is this dermatological condition?
Keratoderma blenorrhagica
List 3 skin manifestations seen with sarcoidosis
- Erythema nodosum
- Annular, papules and plaques (granulomatous on histology)
- Lupus pernio
What systems are involved in sarcoidosis?
- Lungs
- Joints
- Skin
- Eyes (slit lamp examination)
What is the classic type of lesion for sarcoidosis?
Plaques with no scale
There is a papular type of sarcoid - annular sarcoid
What are associations with yellow nail syndrome?
- Chronic lymphedema
- Unpleasant cough (productive, rattly)
Primarily a lymphatic drainage problem
Associated with middle age
What bacteria is commonly associated with HSP?
Streptococcus
What histological findings are seen with leukoclastic vasculitis?
- Nuclear dust
- Inflammation of blood vessels with leaking
- Direct immunofluorescence helps with diagnosis
What are 2 diagnoses associated with mottling of the lower extremities?
- Polyarteritis nodosa
- Livedo reticularis
- Livddo racemosa
What is this dermatological finding?
Pseudoxanthoma elasticum
Where is pseudoxanthoma elasticum seen?
What inheritance is seen with it?
What causes it?
What are associated complications?
Flexural areas
Autosomal recessive or spontaneous
Defect in elastic fibres
Angioid streaks in retina, hypertension, PVD/CAD
Name this finding
Angioid streaks
Name 5 findings associated with LEOPARD syndrome
Autosomal dominant
- Lentigines
- ECG changes
- Ocular
- Pulmonary stenosis
- Abnormal genitalia
- Retarded growth
- Deafness
What is Carney complex associated with?
Name the 2 syndromes associated with it.
Endocrine overactivity (Cushing’s)
LAMB
- Lentigines
- Atrial Myxoma
- Blue nevi
NAME
- Nevi
- Atrial Myxoma
- Myxoid neurofibroma
- Ephelides
What is associated with Peutz-Jegher syndrome?
What dermatological findings are found with this disorder?
15 X risk of cancer than average person
Lentigines (periorbital, dorsum of hands, mucosa), hamartomas (gastric polyps) in GI tract
What dermatological findings are associated with HHT (hereditary hemorrhagic telangiectasia) aka Osler Weber Rendu syndrome
Telangiectasia on skin and oral mucosa
Recurrent epistaxis
Hemorrhage from any area (skin, lungs, brain, liver, eyes, GI tract)
What is the triad associated with acrodermatitis enteropathica?
- Bullae and pustules, acral and periorificial distribution
- Diarrhea
- Alopecia
List 4 dermatological manifestations associated with diabetes
- Diabetic dermopathy
- Granuloma annulare
- Necrobiosis lipoidica diabeticorum
- Eruptive xanthoma
- Vascular - small vessel disease (peripheral) - ulceration/gangrene
What is this dermatological diagnosis?
Diabetic Dermopathy
What is this dermatological diagnosis?
What timing is it associated with?
Granuloma Annulare
At time of diagnosis of diabetes
What is this dermatological diagnosis?
When is it commonly seen?
Necrobiosis lipoidica diabeticorum
At the time of diagnosis
What is this dermatological condition?
What laboratory abnormalities are associated with this finding?
Eruptive xanthomata
Hypertriglyceridemia or hyperlipidemia
What is the diagnosis?
Hereditary Hemorrhagic Telangiectasia
What is the diagnosis?
Acrodermatitis enteropathica
What is the diagnosis?
Peutz Jegher syndrome
