Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DERM > Cutaneous Manifestations of Systemic Disease > Flashcards

Cutaneous Manifestations of Systemic Disease Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

discoid LE (lupus erythematosus)

  • has what other name
  • pathogenesis
  • demographics
  • presentation
  • dx
  • complications
A

= chronic cutaneous LE

  • pathogenesis: UVB radiation triggers a exlusively cutaneous reaction
  • demographics: AA women
  • presentation:
    • indurated erythematous plaques on face/neck/scalp ears with:
      • scarring
      • surrounding hair loss
      • follicular plugging
    • NO systemic sx!
  • dx: only 5% ANA positive
  • complications: can progress to -> SLE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

subacute cutaneous LE (SCLE)

  • pathogenesis
  • demographics
  • presentation
  • dx
  • complications
A
  • pathogenesis: sun exposure triggers cutaneous disease + some internal involvement
  • demographics: female caucasion
  • presentation:
    • polycyclic plaques on sun-exposed areas that are:
      • annular with central clearing
      • no scarring
  • dx:
    • 60-80% ANA
    • anti-Ro/SSA (overlaps with sjogrens)
  • complications: can progress to SLE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

compare and contract discoid LE and SCLE in terms of

  • location of lesions
  • presence of scarring
  • presence of systemic sx
  • lab findings
  • progression to SLE
A
  • discoid LE (chronic cutaneous LE)
    • localized to face / neck / scalp / ears
    • heals with scarring
    • no systemic sx
    • lab findings: 5% ANA
    • less likely to progress to SLE
  • subacute cutaneous LE (SCLE)
    • lesions on sun exposed areas
    • NO scarring
    • mild systemic sx - arthalgia/arthritis
    • lab findings: 80% ANA + anti-Ro/SSA
    • more likely to progress to SLE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

neonatal lupus erythema

  • pathogenesis
  • demographics
  • presentation
  • dx
  • complications
A
  • pathogenesis: transplacental passage of maternal anti-Ro/SSA Abs
  • demographics: neonates
  • presentation: similar to SCLE, but more facial involvement
    • annular lesions
    • periorbital erythema
  • dx: anti-Ro / SSA antibodies
  • complications: heart block
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

acute cutaneous lupus (ACLE)

  • pathogenesis
  • demographics
  • presentation
  • dx
  • complications
A
  • pathogenesis:
  • demographics: AA women
  • presentation:
    • skin: malar erythema (“butterfly rash”) + dorsal hands
      • malar erythema: overal nasal bridge & bilateral malar cheeks + spares nasolabial fold
      • dorsal hands: spares the knuckles
    • systemic: kidney, heart
  • dx: ANA, anti-dsDNA, anti-Smith
  • complications: can progress to SLE (more likely than DLE or SCLE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

systemic lupus erythematous (SLE)

  • pathogenesis
  • demographics
  • presentation
  • dx
  • complications
A
  • pathogenesis: autoimmune, predipsposed by complement deficiency
  • demographics: AA females
  • presentation: SOAP-BRAIN MD
    • S - serositis (pleuritis, pericardiits)
    • O - oral ulcers
    • A - alopecia
    • P - photosensitivity
    • B - blood
    • R - reynauds / acronyanosis
    • A - arthritis
    • I - immune: ANA, anti-dsDNA, anti-Smith
    • N - neurologic
    • M - malar rash
    • D - discoid rash
  • dx: ANA, anti-dsDNA, anti-Smith
  • complications:
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

drug induced SLE

  • m/c causes?
  • dx?
A
  • drugs
    • hydralazine
    • procainamide
    • isoniazid
    • quinidine
  • dx: anti-histone positive & dsDNA negative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

which variations are lupus are most / least likely to progress to lupus?

A

in order of most to least:

acute cutaneous lupus (ACLE) > subacute cutaneous lupus (SCLE) > discloid lupus (DLE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

summarize the lab findings for each type of lupus

A
  • DLE (chronic): 5% ANA
  • SCLE/neonatal: 80% ANA, + anti-Ro/SSA
  • ACLE/SLE: 99% ANA, + anti-Sm + anti-dsDNA
  • drug induced SLE: + anti-histone, - anti-dsDNA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

lupus - management

A
  • prevention: sunscreen !!
  • treatment: hydrochloroquine (systemic) + topical steroids (cutaneous)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the variations of scleroderma?

A
  • localized scleroderma
    • morphea
    • linear
  • systemic scleroderma
    • limited aka CREST syndrome
    • diffuse aka progressive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

localized scleroderma

  • pathogenesis
  • demographics
  • presentation
  • treatment
A
  • pathogenesis: CT disease characterized by excess collagen deposition in skin/organs
  • demographics: female predominant
  • presentation: plaques of expanding erythema -> become hairless
    • morpheoa form: trunk + proximal extremities
    • linear form: lower extremities (l for lower)
      • “en coupe de sabre” is a linear lesion on the forehead
  • treatment: steroids; if severe - METHOTREXATE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

limited systemic sclerosis

  • pathogenesis
  • demographics
  • presentation
  • diagnosis
A
  • pathogenesis: excessive collagen deposition
  • demographics: female predominant
  • presentation: = CREST syndrome
    • C = calcinosis cutis
    • R = reynaud’s phenomenon
    • E esophageal dysmotility
    • S = sclerodactyolyl
    • T = telagiectasia
  • diagnosis: anti-centromere antibodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

diffuse scleroderma

  • pathogenesis
  • demographics
  • presentation
  • diagnosis
  • treatment
A
  • pathogenesis: CT disorder characterized by excess collagen deposition
  • demographics: female predomoinant
  • presentation:
    • skin:
      • shiny, “leather like” skin - “loss of wrinkles”
      • beaked nose
      • fingers:
        • edema
        • sclerodactyl
        • digital pitting ulcers on tips
    • systemic (more involvement than limited)
      • esophageal dysfunction (m/c)
      • renal & pulmonary
  • diagnosis: anti-Scl-70 (anti-topoisomerase)
  • complications: bilateral basilar pulmonary fibrosis is the m/c cause of death
  • treament: most important to control internal organ involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

reynaud’s syndrome

  • can present in what systemic-cutaneous disorders?
  • is treated how?
A
  • disorders
    • SLE
    • systemic scleroderma (limited & diffuse)
  • treamtment:
    • first line:
      • AVOID COLD
      • SMOKIN CESSATION
    • next: vasodilating drugs (calcium channel blockers)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what features do limited scleroderma and diffuse scleroderma and diffuse scleroderma share? what are their differences?

A
  • both present with
    • esophageal dysmotility
    • reynaud’s
    • sclerodactyl
  • limited scleroderma only:
    • calcinosis
    • telangectiasis
  • diffuse scleroderma only:
    • finger edema w/ ulcers at the tip
    • significant renal & pulmonary involvement:
      • m/c cause of death = bilateral pulmonary dibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

dermatomyositis (DM)

  • pathogenesis
  • demographics
  • presentation
  • diagnosis
  • complications
  • treatment
A
  • pathogenesis: autoimmune CT disease
  • demographics: biomodal distribution - juvenile, adult forms
  • presentation: skin findings → muscle weakness
    • ​skin findings:
      • ​grotton’s papules: lichenoid papules over IP joints including knukcles
      • helitrope sign: red eyelids surrounded by white circle
      • shawl sign: redness on neck
    • muscle weakness that is
      • proximal
      • painless
      • disruptive of rising from seated position
  • diagnosis:
    • elevated CK (>1000)
    • antibodies
      • ​anti-Jo L (histadyl tRNA synthetase) - specific
      • Anti-Mi-2 (helicase) - if skin only, no muscle px
  • treatment:
    • ​skin only = photoprotection + topical steroids
    • muscle = prednisone until CK normalizes (if skin also: add MTX & azahthioprine = steroid sparing)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the muscle dysfunctions seen in dermatomyotisis?

A
  • proximal weakness
  • painless
  • diffuctly rising / walking up stairs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

which antibodies are seen in dermatomyositis? explain.

A
  • anti-Jo (histadyl tRNA syntase) - highly specific
  • anti-Mi-2 (helicase) - in skin presentation only
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how to tx dermatomyotisis with both skin & muscle presentation?

A

steroids (prednisone) + steroid sparing agents: MTX + azothioprine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

peutz-jeghers syndrome

  • pathogenesis
  • presentation
  • complications
A
  • pathogenesis: STK11 mutation (tumor suppressor gene)
  • presentation:
    • skin: pigmented papules on oral mucosa
    • systemic: harmatomatous GI polyps - esp in jejunem
  • complications: increased risk of GI and non-GI malignancies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

gardner syndrome

  • pathogenesis
  • presentation
  • complication
  • treatment
A
  • pathogenesis: APC gene mutation (adenematous polypolsis coli)
  • presentation:
    • systemic: premalignant colon polyps by age 20 -> GI bleeding + abdominal pain
    • skin: cysts:
      • osteomas - in mandible
      • odontogenic cysts
      • epidermoid / desmoid cysts
    • other: CHRPE (congenital hypertrophy fo the retinal pigment)
  • complications: 100% risk of GI adenocarcinoma
  • treatment: prophylactic total colectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the treatment for gardner syndrome?

A

prophylactic total colectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what two systemic-cutaneous diseases increase risk of GI malignancies?

  • what mutations do they result from?
  • what are their skin manifestations?
  • what specific risks do they each pose?
A
  • peutz-jegher:
    • STK-11 mutation
    • skin: pigemented macules on oral mucosa
    • risk: inc risk of GI and NON-GI malignancies
  • gardner syndrome:
    • APC gene mutation
    • skin: cysts - osteomas (mandible, maxilla), odontogenic cysts, epidermoid cysts
    • risk: 100% chance of developing GI adenocarcinoma without total prophylactic colectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

pyoderma gangrenosum

  • pathogenesis
  • presentation
  • diagnosis
  • treatment
A
  • pathogenesis: m/c IBD (or other underlying systemic inflammatory dz)
  • presentation:
    • systemic: IBD symptoms
      skin: painful ulcer that is surrounded by a irregular, undermined, violaceous border
  • diagnosis: diagnosis of exclusion
  • treatment: steroids good wound care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

dermatitis herpetiformis

  • pathogenesis
  • presentation
  • diagnosis
  • treatment
  • complications
A
  • pathogenesis: formation of antibodies against transglutaminase (TTG), which found in the skin & GI tract
  • presentation: extremely pruritic papulovesicular eruptions on
    • buttocks
    • extrensor surfaces
  • diganosis: anti-TTG
  • treatment: strict gluten free diet (no wheat, rye, barley)
  • complications: increased risk of MALT lymphoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

porphyria cutanea tarda (PCT)

  • pathogenesis
  • presentation
  • treatment
A
  • pathogenesis: defect in heme synthesis d/t uroporphyrinogen decarboxylase
  • presentation: tense bullae + erosions + hyperpigmentation + scarring on sun exposed skin
  • treatment: photoprotection + hydroxychloroquine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the skin manifestations of hyper and hypothyroidism?

how is each treated?

A
  • hyperthyroidism (low TSH, elevated T3 & T4)
    • manifestations:
      • pretibial myxedema: indurated red-brown pretibial plaques
      • smooth / moist skin (even hyperhyrdosis) d/t hypermetabolic state
      • vilitgo
    • tx: anti-thryoid drugs, radioactive iodine
  • hypothryoidism
    • manifestations:
      • loss of lateral eyebrows (madarosis)
      • course / dull / brittle skin d/t hypometabolic state
    • levothyroxine
29
Q

acanthosis nigricans

  • pathogenesis
  • presentation
  • treatment
A
  • pathogenesis: associated with insulin resistance (DM)
  • presentation: thickening of the neck / axilla that is
    • symmetrical
    • velvety
    • grayish-brown
  • treatment: topical retinoids +/- ammonium lactate
30
Q

necrobiosis lipoidica

  • pathogenesis
  • presentation
A
  • pathogenesis: cell death due to microangiopathy of diabetes
  • presentation: patches that are
    • yellow orange -> red brown
    • associated with telangectasias
    • over the pretibial areas
31
Q

what major cutaneous presentations are associated with diabetes?

A
  • aconthosis nigricans
  • necrobiosis lipoidica
  • recurrent candidiasis
32
Q

neurofibromatosis type I

  • pathogenesis
  • presentation
  • complications
A
  • pathogenesis: mutation of NF1 gene
  • presentation:
    • cafe-au lait macules and / or neurofibromas
    • crowe’s sign: freckling in the axillary / inguinal lesion
    • lisch nodules: melanocytic lesions in the iris
  • complications:
    • Wilm’s tumor
    • scoliosis
    • high BP
33
Q

ehlers danlos syndrome (EDS)

  • pathogenesis
  • presentation
  • complications
A
  • pathogenesis: mutation in type 5 collagen leads to abnormal collagen structure within skin, joints & vasculature
  • presentation:
    • hyperextensible skin
    • hypermobile joints
    • tendency to bleed
34
Q

marfan syndrome

  • pathogenesis
  • presentation
  • complications
A
  • pathogenesis: FBN1 (fibrillin) mutation
  • presentation:
    • tall stature
    • long limbs & digits (arachodatylyl)
    • long ears
    • etopia lentis - lens subluxation
  • complications: cardiac complications - esp aortic aneurysms / mitral valve prolapse
35
Q
A

discoid rash (discoid LE)

indurated plaques with follicular plugging localized to neck / face / ears / scalp that heal with scarring

36
Q
A

discoid rash (discoid LE)

indurated plaques with follicular plugging localized to neck / face / ears / scalp that heal with scarring

37
Q
A

discoid rash (discloid LE)

indurated plaques with follicular plugging localized to neck / face / ears / scalp that heal with scarring

38
Q
A

discoid rash (discloid LE)

indurated plaques with follicular plugging localized to neck / face / ears / scalp that heal with scarring

39
Q
A

SLCE

annular, scaly plaques on sun-exposed regions

40
Q
A

SCLE

annular, scaly plaques on sun-exposed regions

41
Q
A

nenoatal lupus erythematosis

annular lesions w/ central clearing (like SCLE) - but more facial involvement

42
Q
A

ACLE

rash on dorsal hands that spares the knuckles (vs dermatomyotitis - glotton’s)

43
Q
A

ACLE / SLE

malar rash that involves nasal ridges + bilateral malar cheeks & spares melolabial folds

44
Q
A

localized scleroderma - linear scleroderma

linear expanding erythema on lower extremities or face (right pic = “en coupe de sabre”)

46
Q
A

localized scleroderma - morphea scleroderma

expanding erythema on trunk + proximal extremities

47
Q
A

diffuse scleroderma

48
Q
A

polydactyl

limited sclerosis / scleroderma (CREST syndrome)

49
Q
A

dermatomyositis (DM)

heliotrope sign

50
Q
A

dermatomyositis (DM)

heliotrope sign

51
Q
A

dermatomyositis (DM)

grotton’s papules: lichenoid papules that include knuckles (vs ACLE)

52
Q
A

peutz-jeghers syndrome (STK11)

pigmented mucutaneous macules on oral mucosa

53
Q
A

gardner syndrome (APC mutation)

osteomas on mandible & maxilla

54
Q
A

gardner’s sydnrome (APC mutation)

odontogenic cysts

55
Q
A

gardner syndrome (APC gene mutaiton)

CHRPE: congenital hypertorphy of retinal pigment

56
Q
A

pyoderma gangrenosum (IBD)

ulcers with a irregular, undermined violaceous border

57
Q
A

dermatitis herpetiformis (anti-TTG IgA antibodies)

extremily pruritic papulovesicular eruptions on EXTENSOR SURFACES + BUTTOCKS

58
Q
A

porphyria cutanea tarda (uruoporphyrinogen dexcarboxylase)

tenase bullae + erosins + hyperpigmentation on sun exposed skin

59
Q
A

hypothryoidism

loss of lateral eyebrow

60
Q
A

necrobiosis lipoidca (diabetes)

atrophic yellow-orange -> red-brown patches w/ tenalgetctasia over pretibial areas

61
Q
A

acanthosis nigricans (diabetes)

symmetrical, hyperpigemented velvety, gray-ish-grown thickening of the neck + axilla + groin

62
Q
A

recurrent candiasis (associated with DM)

beefy-red demarcated plaques surrounded by satellite lesions

63
Q
A

ndurofibromatosis type I (NF1 gene mutation)

plexiform neurofibroma

64
Q
A

neurofirbromatosis type I (NF 1 gene mutation)

lisch nodules

65
Q
A

ehler’s danos syndrome (mutated type 5 collagen )

hypermobile joints

66
Q
A

ehler’s danlos syndrome (type 5 collagen mutation)

hypermobile joints

67
Q
A

marfan syndrome (FBN1 mutation)

arachnodactylyl

68
Q
A

marfan’s syndrome (FBN1 mutation)

tall stature

69
Q
A

pretibial myxedema

hyperthyroidism

79
Q
A

neurofibrmotosis type I

neurofibromas

DERM (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions