Derm Signs of Systemic Diseases

Question 1

Hyperpigmentation

Answer 1

Addison’s Disease

Question 2

Moon facies, buffalo hump, stretch marks

Answer 2

Cushing Syndrome

Question 3

seborrheic dermatitis, tremor

Answer 3

Parkinson’s

– tremor: PTSD, TBI

Question 4

seborrheic dermatitis, rapid onset psoriasis, proximal subungual onychomycosis

Answer 4

HIV

Question 5

acanthosis nigracans, DM (and/or obesity)

Answer 5

insulin resistance

Also can be caused by medications like nicotinic acid and systemic steroids

Also can be caused by underlying conditions like hyperandrogenemia, polycystic ovary syndrome, Cushings, lipodystrophy

Question 6

acanthosis nigracans, weight loss

Answer 6

cancer, esp. stomach

Question 7

painless foot ulcers, disseminated granuloma annulare, necrobiosis lipoidica

Answer 7

DM

Question 8

splinter hemorrhages in nails, Janeway lesions, Osler nodes

Answer 8

infectious endocarditis

Question 9

increased joint and skin elasticity,

poor wound healing with large scars, increased ecchymoses, fragile skin

Answer 9

Ehler-Danlos Syndrome

Concerns: aortic and valve disease, fragile vessels and intestines

Question 10

Child w/ large hemangioma of face and

neck

Answer 10

PHACES Syndrome

Concerns: aortic coarctation, atrial and ventricular
septal defects and abnormal cervical and vertebral arteries

Question 11

decreased subcutaneous fat, stretch marks with no weight gain, very tall and thin with long extremities

Answer 11

Marfan Syndrome

Concerns: dilation and dissection of the ascending aorta,
mitral valve prolapse and regurgitation

dislocation of lens of eye

Question 12

thickened skin over fingers/hands, skin tightening around mouth, Raynaud’s, salt & pepper skin changes, vasculitis

Answer 12

Systemic Scleroderma

Concerns: pulmonary hypertension, pericarditis (poor prognosis)

Question 13

Erythema nodosum, discoid eczema (nummular dermatitis), erythema multiforme, calcinosis cutis, lupus pernio, pruritis

granulomas on histology

Answer 13

Sarcoidosis

Concerns: affects multiple organ systems.

Question 14

Purple, polygonal, pruritic papules; mucosal lesions; Wickham striae

Answer 14

Lichen Planus

Associated with Hepatitis C

Question 15

fragile, easily sun-damaged skin on the back of hand and forearm (blistering lesions); hypertrichosis

Answer 15

Porphyria cutanea tarda

Associated with hepatitis

Question 16

Spontaneous recurrent epitaxis,

multiple telangiectases on skin and mucous membranes

Answer 16

Osler-Rendu-Weber (hereditary hemorrhagic telangiectasia)

Question 17

Punched-out, rapidly enlarging ulcer, underlying IBD or rheumatoid arthritis

Answer 17

Pyoderma Gangrenosum

NEVER DEBRIDE

(AI where neutrophils attack skin)

Question 18

Grey Turner’s Sign

Answer 18

retroperitoneal bleed

Question 19

Cullen’s sign

Answer 19

abdominal bleeding/trauma, acute pancreatitis

Question 20

Koilonychia

Answer 20

Iron Deficiency

Question 21

Lindsay’s nails: nail half white, half red

Answer 21

Chronic Kidney Disease

Question 22

Terry’s nails: mostly white

Answer 22

liver failure, congestive heart failure

Question 23

child (esp. blonde girl) who’s never had a haircut

Answer 23

loose anagen hair syndrome

Question 24

M – Malar rash
D – Discoid rash
S – Serositis 
O – Oral Ulcers
A – ANA +
P – Photosensitivity 
B – Blood disorders
R – Renal Involvement
A – Arthritis (joint effusions can be seen)
I – Immunologic 
N – Neurologic

Answer 24

Systemic Lupus Erythematosus

Question 25

a number of concentric and erythematous whirling rings

Answer 25

Erythema gyratum repens

Concern: Cancer

Question 26

rapid growth of long, fine, lanugo-type (i.e.: fetal) hair particularly around the eyebrows, forehead, ears and nose

Answer 26

Hypertrichosis lanuginosa acquisita

Concern: Cancer

Question 27

thickened velvety palms that have the appearance of the stomach lining of beef, pork, or sheep

Answer 27

Tripe Palms

Concern: Cancer, particularly lung or gastrointestinal carcinoma.

Question 28

explosive onset of multiple seborrheic keratoses

Answer 28

Lesser-Trelat Sign

Concern: Cancer

Question 29

purple, heliotrope rash on eyelids,
shawl sign on upper torso, erythema/dryness/fissuring or palms, cuticle changes, erythema on dorsal hands over joints (Gottron’s papules)

Answer 29

Dermatomyositis

Concerns: pulmonary fibrosis and genitourinary cancer (esp. with rapid onset)

Question 30

red papular lesions in the umbilicus

Answer 30

Sister Mary Joseph Node

Typically metastasis of advanced peritoneal adenocarcinoma

Question 31

Typically metastasizes to skin

Answer 31

renal, lung, breast cancer