Dermatologic Manifestations of Systemic Diseases Flashcards
Diabetic Manifestations:
- Diabetic Dermopathy
- Acanthosis Nigricans
- Necrobiosis Lipoidica Diabeticorum
- Bullous Dibeticorum
- Diabetic Ulcer
- Skin Tags
Diabetic Dermopathy:
- Most Common Skin finding in patients with diabetes
- Positive correlation with number of diabetic microangiopathic complications
- Macule, papule, patch, plaques on lower anterior legs
- Looks like bruises on shins
Acanthosis Nigricans:
- Hyperpigmented velvety plaques
- Treating DM will make them RESOLVE
- Areas where the skin folds
- Many other associations not just DM
Necorbiosis Lipoidica Diabeticorum:
- Collagen degradation with granuloma formation and fat deposition
- Type 1 DM more prominent
- Red shiny asymptomatic patches on shins
Bullous diabeticorum:
- Painless, rapid spontaneous development
- Not common
- Absence of trauma appear overnight
- Negative immunofluorescent
- Blistering on acral areas
Diabetic ulcers:
- Neurogenic/neuropathic ulcer
- Often feet
- Difficult to treat and may cause loss of function and limb loss
Skin Tags:
-Associated with Acanthosis Nigricans
Xanthoma Manifestations:
- Eruptive
- Tuberous/Tuberoeruptive
- Tendinous
- Plane
- Xanthelasma
What is a xanthoma in general:
- Due to intracellular and dermal lipid deposition
- Lipid disorder or paraproteinemia
Eruptive Xanthoma:
- Red-yellow papules
- Extremities hands buttocks
- KOEBNER Phenomenon
- Hypertriglyceridemia
- Treating TGs will cause them to go away
Tuberous/Tuberoeruptive Xanthoma:
- Yellow nodules on EXTENSOR surfaces -> ELBOW And KNEES
- High Cholesterol States
Tendinous Xanthomas:
- Nodular lipid deposition affecting Achilles, Extensors of hand knees or elbows
- Always clue to underlying lipid metabolism
Plane Xanthoma:
- Yellow to orange macule papule patch plaque
- Site is a clue to the underlying disease
Xanthelasma:
- Papable xanthomas of the eyelids
- Hyperlipidemia
Renal Manifestations:
- Perforating Disorders
- Calciphylaxis
- Nephrogenic Fibrosing Dermopathy
- Pruritis
Acquired Perforating Disorders:
- Perforating Folliculitis: dermal material eliminated through follicles
- Elastosis perforans serpiginosa: Transepidermal elimination of elastic fibers
- Reactive perforating collagenosis: transepithelial elimination of altered collagen (Lesions regress)
- Kyrle’s disease
Elastosis perforans Serpiginosa:
- Associated with Down syndrome
- Cryotherapy helps
- May be due to D-penicillamine
Kyrle’s Disease:
- Keratin predominantly extruded but elastic fibers and collagen may be present
- Always on lower extremity
Calciphylaxis:
- Depoisition of calcium salts in skin due to dysregulation of calcium metabolism
- Most severe form of metastatic calcification
- Associated with chronic renal failure, hemodialysis, secondary hyperparathyroidism
- Violaceous painful patches with necrosis and ulcers
- High mortality rate
Nephrogenic fibrosing dermopathy:
-Due to exposure to Gadolinium-containing contrast agent used with MRI in patients with advanced renal disease
Skin thickened and hard leading to dismobility
Pulmonary Causes:
-Sarcoidosis
Sarcoidosis:
- 25% pts have skin manifestations
- Asymptomatic red brown dermal papules and or plaques
- Neck face upper extremities and upper trunk
- Enlarged Lacrimal Glands
- Atrophy in lesion
- Yellow brown apple jelly color with diascopy
- Elevated ACE level
- Erythema Nodosum: sometimes in sarcoidosis; tender bruise like nodules on lower extremity -> Bruise on skin
Rheumatologic Manifestations:
- Pyoderma gangrenosum
- Reiter’s syndrome
Pyoderma Gangrenosum:
- Inflammatory, NONINFECTIOUS, ulcerative neutrophilic skin disease
- Pustules turn to ulcers and become necrotic
- Ulcerative colitis and Crohn Association
- Pathergy: DAMAGE/SURGERY MAKES IT WORSE DO NOT DO SURGERY
Reactive Arthritis:
- SA after a GI GU infection
- Chlamdia trachomatis major cause
- Arthritis, Enthesitis, Dactylitis Back pain
- Sausage fingers
- Keratoderma blennorrhagica, Oral Ulcers, Anterior Uveitis
- NSAIDs
