Derm Signs of Systemic Diseases Flashcards
Hyperpigmentation
Addison’s Disease
Moon facies, buffalo hump, stretch marks
Cushing Syndrome
seborrheic dermatitis, tremor
Parkinson’s
– tremor: PTSD, TBI
seborrheic dermatitis, rapid onset psoriasis, proximal subungual onychomycosis
HIV
acanthosis nigracans, DM (and/or obesity)
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
acanthosis nigracans, weight loss
cancer, esp. stomach
painless foot ulcers, disseminated granuloma annulare, necrobiosis lipoidica
DM
splinter hemorrhages in nails, Janeway lesions, Osler nodes
infectious endocarditis
increased joint and skin elasticity,
poor wound healing with large scars, increased ecchymoses, fragile skin
Ehler-Danlos Syndrome
Concerns: aortic and valve disease, fragile vessels and intestines
Child w/ large hemangioma of face and
neck
PHACES Syndrome
Concerns: aortic coarctation, atrial and ventricular
septal defects and abnormal cervical and vertebral arteries
decreased subcutaneous fat, stretch marks with no weight gain, very tall and thin with long extremities
Marfan Syndrome
Concerns: dilation and dissection of the ascending aorta,
mitral valve prolapse and regurgitation
dislocation of lens of eye
thickened skin over fingers/hands, skin tightening around mouth, Raynaud’s, salt & pepper skin changes, vasculitis
Systemic Scleroderma
Concerns: pulmonary hypertension, pericarditis (poor prognosis)
Erythema nodosum, discoid eczema (nummular dermatitis), erythema multiforme, calcinosis cutis, lupus pernio, pruritis
granulomas on histology
Sarcoidosis
Concerns: affects multiple organ systems.
Purple, polygonal, pruritic papules; mucosal lesions; Wickham striae
Lichen Planus
Associated with Hepatitis C
fragile, easily sun-damaged skin on the back of hand and forearm (blistering lesions); hypertrichosis
Porphyria cutanea tarda
Associated with hepatitis
Spontaneous recurrent epitaxis,
multiple telangiectases on skin and mucous membranes
Osler-Rendu-Weber (hereditary hemorrhagic telangiectasia)
Punched-out, rapidly enlarging ulcer, underlying IBD or rheumatoid arthritis
Pyoderma Gangrenosum
NEVER DEBRIDE
(AI where neutrophils attack skin)
Grey Turner’s Sign
retroperitoneal bleed
Cullen’s sign
abdominal bleeding/trauma, acute pancreatitis
Koilonychia
Iron Deficiency
Lindsay’s nails: nail half white, half red
Chronic Kidney Disease
Terry’s nails: mostly white
liver failure, congestive heart failure
child (esp. blonde girl) who’s never had a haircut
loose anagen hair syndrome
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
Systemic Lupus Erythematosus
a number of concentric and erythematous whirling rings
Erythema gyratum repens
Concern: Cancer
rapid growth of long, fine, lanugo-type (i.e.: fetal) hair particularly around the eyebrows, forehead, ears and nose
Hypertrichosis lanuginosa acquisita
Concern: Cancer
thickened velvety palms that have the appearance of the stomach lining of beef, pork, or sheep
Tripe Palms
Concern: Cancer, particularly lung or gastrointestinal carcinoma.
explosive onset of multiple seborrheic keratoses
Lesser-Trelat Sign
Concern: Cancer
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)
Dermatomyositis
Concerns: pulmonary fibrosis and genitourinary cancer (esp. with rapid onset)
red papular lesions in the umbilicus
Sister Mary Joseph Node
Typically metastasis of advanced peritoneal adenocarcinoma
Typically metastasizes to skin
renal, lung, breast cancer
