Managing Skin Disorders in Systemic Disease

Question 1

x

Answer 1

x

Question 2

x

Answer 2

x

Question 3

Case 1 - 38F
New onset (weeks) of: photodistributed rash, fever, arthritis, fatigue

PMH = No new medications

Which investigation should be conducted next?
Urinalysis
Vit C
Liquid panel
HbA1c

Answer 3

Correct answer = Urinalysis -
Her symptoms are indicative of Systemic Lupus Erythematous - FBC, U&E, ANA, anti-dsDNA, complement, urinalysis

Not Vit C - used for suspected scurvy
Not Lipid panel - used for
Not HbA1c - used for suspected diabetes

x

Question 4

Case 2 - Newborn
Characteristic rash - annular rash

Which investigation should be conducted next?
Genetic testing
Syphilis
ECG
Skin biopsy

Answer 4

Correct answer = ECG
Annular rash chacracteris of neonatal lupus - 50% risk of complete heart black and consequent heart failure
These are associated with Ro and La antibodies

None of the other tests are indicated to check for heart failure

Question 5

Case 3 - 50F
New rash - face, chest, upper back and dorsal hands
HPC = difficult getting up stairs and carrying her shopping

Which of the following conditions are NOT associated with the condition illustrated?
Diabetes Mellitus (DM)
Digital ischaemia
Malignancy
Interstitial Lung Disease

Answer 5

Her symptoms show Gottron’s papules (dorsal hands)); Heliotrope rash (eyes), Shawl sign (upper back)

x

Question 6

Case 4 -
Which of the following signs are associated with CKD (chronic kidney disease)?

Corkscrew hairs and perifollicular purpura
x

Answer 6

Correct answer = Calciphylaxis - characterised by ulcers - calcium gets deposited in the arteries due to lack of calcium metabolism by kidneys?
x

Question 7

Case 5 - 23M
PMH = epilepsy
Flu-like illness, sore eyes, oral ulceration - followed by extensive painfil rash
Recently started on new anti-epileptic

Which of the following statements about this condition is incorrect?

Answer 7

Lymphadenopathy is not a characterist feature of SJS / TEN, but is mong the diagnostic criteria for DRESS

Question 8

Case 6 -

Which of the following is true regarding itch in the absence of a rash?

Answer 8

Chronic rubbing and scarthing may cause the appear of nodules

Question 9

Case 7 - Which of the following is true regarding Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)?

Answer 9

Correct answer = Fulminant live failure may occur

Cause of most fatalities in this condition

Question 10

Case 8 -

Which of the following is a manifestation of sarcoidosis?

Answer 10

Lupus pernio

Question 11

Case 9 -

Which of the ail changes is not associaed with chronic liver disease?

Answer 11

hald and half nails

Question 12

SBAQ - 10

Which of the following conditions is not associated with IBD (inflammatory bowel disease)?

Answer 12

Dermatotis herpetiformis - associated with coeliac disease (gluten hypersensitivity) due to similarities in the antigen between gluten and one on the skin

PG = associated with IBD and cancer, not cancer though
HS = associated with IBD, smoking and being overweight
OG = associated with Crohn's disease (CD)

Question 13

SBAQ - 11

Which of the following are not a manifestation of malignancy?

Answer 13

Lues maligna - secondary syphilis where you get necrosis of the skin = infectious but not cancerous

Question 14

SBAQ - 12

HIV seroconversion may manifest in which of the following ways?

Answer 14

All of the above -

EM = can get it in infections., drug allergies, randomly

Question 15

SBAQ - 13

Which of the following conditions may be a manifestation of underlying acromegaly?

Answer 15

Cutis gyrata verticis

Question 16

SBAQ - 14

Which of the following statements are true regarding the skin in systemic disease?

Answer 16

Managemennt of multi-systemic diseases can be undertaken by…

Question 17

When should a HIV test be done?

Answer 17

Any non-specific rash

Question 18

SBAQ - 15
Which of the following features randens a cutaneous graft VS host disease (cGVHD) a more likely a drug as the cause of this rash?

Answer 18

D - all of the above