Cutaneous Manifestations of Systemic Disease Flashcards
What are the potential causes of erythema nodosum?
Idiopathic
Drugs - sulphonamides, OCP
Systemic disease - IBD, sarcoidosis
Infections - strep, TB, leprosy, bacterial gastroenteritides, histoplasmosis, chlaymdia, blastomycosis
How is erythema nodosum managed?
Rest Elevation Compression NSAIDs / analgesia Treatment of underlying cause If severe - corticosteroids
What are the potential causes of pyoderma gangrenosum?
RA
IBD
Haematological malignancies
Liver disease (PBC)
Describe the appearance of pyoderma gangrenosum?
Painful erythematous nodules and pustules which develop into large ulcers which often have a purplish margin, undetermined edge and purulent surface
What is the treatment of pyoderma gangrenosum?
Treatment of underlying cause
Systemic corticosteroids
Ciclosporin
Acanthoses nigricans is mostly managed by treating the underlying disorder. However, in rare cases what treatments can be used?
Topical retinoid or calcipotrol
Necrobiosis lipoidica is usually caused by diabetes, in rare cases what autoimmune conditions can cause NL?
RA
Describe the appearance of necrobiosis lipoidica?
Spreading erythema which may turn yellowish and atrophic with central ulceration
Pruritus may be caused by primary skin disease or systemic diseases such as…?
Internal malignancies Chronic liver failure Renal failure Diabetes Iron deficiency anaemia Thyroid disease HIV Polycythaemia vera
What is porphyria cutanea tarda?
A blistering skin disease caused by a deficiency of hepatic uroporphyrinogen decarboxylase
What is the cause of porphyria cutanea tarda?
Can be sporadic due to hepatic oxidative stress e.g. in iron overload
Can be inherited enzyme deficiency
How does porphyria cutanea tarda present?
With sun-induced blisters and crusted erosions alongside hyperpigmentation, hypertrichosis, scarring alopecia and red urine
What investigations are conducted for porphyria cutanea tarda?
Plasma, erythrocyte and urine total porphyrin levels (elevated)
Plasma fluorescence emission
What is the treatment for porphyria cutanea tarda?
Phlebotomy and removal of triggering factors.
