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4TH YEAR - CSIM2 > Cutaneous Manifestations of Systemic Disease > Flashcards

Cutaneous Manifestations of Systemic Disease Flashcards

1
Q

What is the difference between a dermal and epidermal rash?

A

Epidermal - wet/weepy/flaky/dry, this is the majority of rashes

Dermal - skin feels smooth but elevated, due to granulomas or proteins or vasculitis under the skin

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2
Q

What are the 4 types of epidermal rash?

A

Eczema - flaky, scaly, dry skin
Psoriasis - thickened skin, flaky, red
Lichenoid - purplish rash, lymphocytes eating skin
Vesiculobullous - blistering

The latter two can be autoimmune

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3
Q

What are the 2 types of dermal rash?

A

Vasculopathic - urticaria, vasculitis

Granulomatous - brown/purple colour, raised

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4
Q

What are the skin manifestations of Cushings?

A

Stria, acne, bruising

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5
Q

What are the skin manifestations of Addisons?

A

Hyperpigmentation (in buccal mucosa and palmar crease)

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6
Q

What are the skin manifestations of hypothyroidism?

A

Periorbital oedema, loss of outer third of eyebrow, dryness

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7
Q

What are the skin manifestations of hyperthyroid?

A

Acropachy, fat infiltration around eye, pretibial myxoedema

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8
Q

What is porphyria?

A
  • Skin sensitivity
  • Hirsutism
  • Blood filled blisters and scarring
  • Milia

These are due to build up of porphyrins in the skin.
It is usually a sign of liver disease as the enzyme that breaks this compound down is produced in the liver.

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9
Q

Why do you get milia?

A

Severe blistering from porphyria that has ripped through the sweat glands, causing formation of hard keratin white cysts

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10
Q

What are the skin manifestations of hyperlipidemia?

A 
Xanthelasma
Tendon xanthomas
Eruptive xanthomas (high triglycerides)
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11
Q

What are the skin manifestations of diabetes?

A

Acanthosis nigricans - due to IGF

Necrobiosis lipoidica - granulamotous skin infiltration

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12
Q

What conditions cause pyoderma gangrenosum?

A

Leukemia, myeloma, IBD, vasculitis

pustular, sterile necrotic blue black

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13
Q

What is Sweets syndrome?

A

Red rashers when systemically unwell, marker of haematological malignancy

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14
Q

What is cutaneous T cell lymphoma?

A

Lymphoma presenting as patchy plaques (looks like psoriasis) - can be used for staging.

Treat with phototherapy but this doesn’t alter prognosis just appearance, as the cancer is pushed back into the body

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15
Q

What is the name of a rash due to a virus?

A

Exanthem

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16
Q

What conditions cause morbilliform rashes?

A

Measles/rubella

17
Q

What conditions causes vesicular rashes?

A

Chickenpox/shingles

18
Q

What are the skin manifestations of syphillis?

A
  1. Primary painless chancre
  2. Copper brown rash on palms/soles and snail track ulcer
  3. Gummata
19
Q

What are the skin manifestations of Lyme disease?

A

Borellia spp.

  1. Ring rash ‘erythema migrans’
  2. Severe neuro/joint/cardio problems
20
Q

What rashes are associated with IBD?

A

Erythema nodosum

Pyoderma gangrenosum

21
Q

What is pathergy?

A

Exaggerated skin injury from a minor trauma

22
Q

What are the skin manifestations of sarcoidosis?

A

Granulomatous inflammation

Lupus pernia - facial rash

23
Q

What are the skin manifestations of SLE?

A

Malar, photosensitive rash
Discoid rash
Nail fold changes
Livedo reticularis

24
Q

What are the skin manifestations of RA?

A

Nodules
Nailfold infarcts
Vasculitic leg ulcers

25
Q

What are the skin manifestations of systemic sclerosis?

A

Skin thinking and claw hands ‘sclerodactly’
Raynauds
Telangectasia
Nailfold changes

26
Q

What are some paraneoplastic skin manifestations?

A

Acanthosis nigricans

Dermatomyositis

27
Q

What are the skin manifestations of scurvy?

A

Ruptured haemorrhages around the skin follicles and corkscrew hairs
Bleeding gums

28
Q

What is pellagra?

A

Dermatitis, diarrhoea and dementia, due to vitamin B3 deficiency

Patients have very bad photosensitive rashes

29
Q

What is pseudoxanthoma elasticum?

A

Mutation of elastin fibres causing skin that looks like a plucked chicken
Angiod streaks in the back of the eyes
Arterial aneurysms

30
Q

What are the skin manifestations of neurofibromatosis type 1?

A

Cafe au lait spots
Neurofibromas
Lisch nodules

31
Q

What are the skin manifestations of neurofibromatosis type 2?

A

Cafe au lait spots
Schwannomas
Juvenile cataracts

32
Q

How is pyoderma gangrenosum treated?

A

Give steroids

33
Q

In which disease do you see blue-red nodular lesions on the nose and hands?

A

Sarcoidosis - this is a description of lupus pernio

34
Q

In which disease do you see ash-leaf hypopigmentation?

A

Tuberous sclerosis

35
Q

What do you get in vitamin B1 deficiency?

A

Beriberi - neuropathy and cardiomyopathy

36
Q

What do you get in vitamin B6 deficiency?

A

Neuropathy and eruptions of dermatitis

37
Q

In which condition do you get bleeding gums, easy bruising and frank purpura?

A

Scurvy from vitamin C deficiency

4TH YEAR - CSIM2 (20 decks)

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