Cutaneous Manifestations of Systemic Disease Flashcards
jaundice
liver disease
scleral yellowing
diffuse yellowness of the skin
gynecomastia
liver disease
arises because of relatively higher levels of circulating estrogen
usually the liver clears the estrogen but when the liver is damaged that doesn’t happen
Kaput Medusa
liver disease
increased portal pressure and results in engorged periorbital veins
spider angiomas
liver disease
can happen de novo, ut in liver disease, patients have high levels of estrogen which leads to broken blood vessels with podlike extensions
in patients with severe disease, this spreads throughout the body
lichen planus
liver disease
viral hepatitis serology because of association
prototypical skin lesion is purple, puritic, polygona, papules, placques
can have oral mucosal lesions in some cases
some reticulations is common, sometimes can be the sole manifestation
overgrowth of nail plate, typical
hemochromatosis
liver disease
patients develop hyperpigmentation from disease causing increased melanin deposits
autosomal dominant
diabetes, arthritis, iron overload (primary process)
Kayser-Fleisher Ring
Wilson’s Disease (liver disease)
autosomal recessive, copper metabolism defect
cryoglobulinemia
Hep C (liver disease)
variety of causes - acquired condition of autoantibodies
these cause vasculitis, which has many different manifestations
ischemic changes in severe cases
puritis
renal disease
itching of the skin, no primary lesions - lesions here are self-inflicted from scratching
theory is that kidney filters out itch-causing agents, so when they fail this happens
dialysis will improve itch
calciphylaxis
renal disease
end result of derangement in calcium and phosphate metabolism
from calcium that has precipitated out
patients have pain, get septic and die quickly without proper management
uremic frost
renal disease
result of urea and uric acid precipitating once the sweat dries on top of the skin
cyanosis
pulmonary disease
blue lips and reddish-blue hands, especially tips of fingers
clubbing
pulmonary disease
long-standing pulmonary disease
Schamroth’s windis is missing in clubbing
can be idiopathic or familial
lupus pernio
sarcoidosis (pulmonary disease)
sarcoidal involvement of the skin around the nose
priminent papular placque
harbinger that a patient has sarcoidosis
need biopsy to prove
Lofgren’s Syndrome
sarcoidosis (pulmonary disease)
associated with hilar adenopathy that is subclinical and bilateral
peniculitis - inflammation of subcutaneous fat
typically involving anterior and peritubular areas of the leg
not sarcoidosis involving the skin
good prognosis
causes of erythema nodosum
Behcet disease
Estrogens
Drugs
Recent infection (pneumococcus)
Enteropathies (IBD)
Sarcoid
Tuberculosis
lupus valgaris
cutaneous TB (pulmonary disease)
dissemination of TB onto the skin from the lungs
can be reactivation or reinfection
erythema induratum
pulmonary disease
nodular vasculitis - reactive panniculitis from past or present TB infection
typically posterior calf or side
indication of tuberculosis in the lungs
scrofuloderma
lung disease
direct extension of TB lymphadenitis
biopsy for diagnosis
Osler’s nodes
cardiovascular disease
sign of dissemination of bacterial lesions in cardiac valves into the skin
painful, palpable red lesions usually on fingers/toes
they are caused by immune complexes
Janeway’s Lesions
cardiovascular disease
non-painful, macular lesions, usually onpalms/soles
they are caused by septic emboli, more common in Staph aureus endocarditis
splinter hemorrhages
endocarditis (cardiovascular disease)
small clots in the vessels of the nail plate
can happen randomly as well
eruptive xanthoma
cardiovascular disease
lipid metabolism disorder, can happen anywhere
xanthomas
cardiovascular disease
tendinous xanthomas, nothing morthan cholesterol or lipid deposition in the skin
can be palmar, tendinous, or tuberous
xanthelasma
cardiovascular disease/billiary cirrhosis
yellowish bumps around eyelids
normal lipids, cholesterol from skin cells
usually, not lipid metabolism disorder but can be associated with high LDL or cholesterol
cholesterol emboli
cardiovascular disease
can happen spontaneously
claudication symptoms of the lower extremities
cholesterol emboli can cuase dots in the feet
usually resolves spontaneously
can also happen after an angioplasty
stasis dermatitis
venous disease (cardiovascular disease)
poor venous blood flow, inability of the veins to squeeze blood back to the heart
leakage of RBCs back into the skin
with enough inflammation, can get skin breakdown and ulceration
brown discoloration because of extravasation of RBCs into the skin - permanent discoloration
moon facies
adrenal/pituitary disease
caused by increase in relative amounts of cortisol - often due to pituitary tumors
also exogenous corticosteroids
buffalo hump
adrenal/pituitary disease
lipodystrophy changes where fat normally distributes
striae
adrenal/pituitary disease
happens in overweight or pregnant individuals