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MSCT > MSCT Week 6: Cutaneous Signs of Systemic Disease > Flashcards

MSCT Week 6: Cutaneous Signs of Systemic Disease Flashcards

1
Q

Skin findings and systemic disease

A
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2
Q

Question 1

A

Acanthosis Nigricans

Screen for Diabetes

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3
Q

Acanthosis Nigricans Clinical Features

A
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4
Q

Acanthosis Nigricans most commonly found where on the body?

A
  • Posterior neck fold
  • axillae most common
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5
Q

Acanthosis Nigricans is a sign of

A

Insulin Resistance

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6
Q

Identify features of histology

A

acanthosis

IDGF-1 causes thickening and overdevelopment of the epidermis

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7
Q

Acanthosis Nigricans should screen for diabetes mellitus by?

A

glucose tolerance test

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8
Q

Malignant Acanthosis Nigricans Clinical Features

A
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9
Q

“Tripe Palms”

A

Think Malignant Acanthosis Nigricans

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10
Q

Strange manifestations of Malignant Acanthosis Nigricans

A

thickened velvety plaques

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11
Q

Diabetes and Skin

A
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12
Q

Diabetes and Skin: Diabetic Dermopathy Clinical Features

A

deposition of glycosylated proteins in the skin

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13
Q

Identify

A

Acanthosis Nigricans

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14
Q

Associations with Acanthosis Nigricans

A

no collagen vascular disease

some hereditary some syndromic

some insulin resistance

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15
Q

Why does this occur?

A

Diabetic Neuropathy

don’t realize that they are damaging their feet because they have lost sensation

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16
Q

What is this?

A
  • Scleroderma from poorly controlled diabetes or from other disorders but diabetes is most common
  • typically asymptomatic, infiltration of the skin (usually in the back) with mucin
  • thickened hardened, can be pruritic
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17
Q

What is this?

A

Bullosis Diabeticorum

  • non-infectious
  • not-inflammed
  • sterile blisters filled with water on the lower limbs and feet
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18
Q

What is this?

A

Necrobiosis Lipoidica

  • typically occurs on the anterior shins
  • the atrophic skin where vessels can be seen underneath
  • yellowish hue
  • if ulcerate are difficult to treat
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19
Q

What is this

A

Acquired Perforating Disorder

  • common for diabetics on renal dialysis
  • build up of abnormal collagen and elastin in the skin and the body tries to eliminate it
  • epidermis tries to envelope abnormal collagen
  • transepidermal elimination
  • associated with renal failure
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20
Q

Acquired Perforating Disorder is associated with?

A

Renal failure

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21
Q

What is this?

A

Eruptive Xanthomas

  • grouped yellow tender papules
  • firm
  • extensor surfaces and buttocks
  • happen when cholesterol and triglycerides are very high
  • This is an emergency
  • as cholesterol is brought down they resolve
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22
Q

Question

A

Malignancy

This is called the sign of leser-Trelat

a large number of seborrheic keratoses suddenly appearing responding to same growth factor as does the malignancy

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23
Q

Sign of Leser-Trelat

A
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24
Q

Identify Histological Features

A

Pseudocysts

thickened epidermis

well defined basal layer

comedo blackhead like openings

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25
Question
* Abdominal cramping, bloating, especially after consuming bread * and fatigue from malabsorption * Gluten-sensitive enteropathy or celiac disease ## Footnote **Dermatitis Herpetiformis**
26
Dermatitis Herpetiformis Clinical Features
27
Dermatitis Herpetiformis Etiology
IgA Autoantibodies mucosal antibodies are spilling out targeting epidermal * Tissue transglutaminase * Epidermal Transglutaminase * Gliadin
28
Identify Histological Features
neutrophilic infiltrate in the dermal papillae with some vesiculation separating the dermal papillae from the epidermis ## Footnote **Dermatitis Herpetiformis**
29
Dermatitis Herpetiformis HLA Association
HLA DQ2 and HLA DQ8
30
Dermatitis Herpetiformis Immunofluorescence Features
31
Dermatitis Herpetiformis Treatment 5 listed
32
Question
Autoimmune Disease (Graves Disease, Lupus, Rheumatoid Arthritis)
33
Dermatitis Herpetiformis Risks for
* Hypothyroidism * Intestinal lymphoma from chronic intestinal inflammation
34
Vitiligo Clinical Features
35
Vitiligo appears where on the body?
in areas that favor trauma symmetric depigmented macules and patches
36
identify Histological Features
Normal skin
37
Identify Histological Features
* No melanocytes in the basal layer * when stained for melanin nothing shows up
38
Koebnerization
when some lesions more likely to occur in areas of trauma
39
Vitiligo Treatment 4 listed
40
Question
Systemic Lupus Erythematosus
41
Systemic Lupus Erythematosus Clinical Features
42
Why is lupus named?
wolf mask
43
Identify Histological Features
SLE * Perivascular infiltrate (lymphocytes and a few histiocytes * peradnexal (around hair follicles and eccrine ducts * vacuolization of the basal layer * destruction of basal keratinocytes * thickening of basement membrane * mucus deposition
44
Identify Histological Features
SLE * destruction of keratinocytes * keratinocytes undergoing apoptosis * basal layer cuboidal * vacular dermatitis * think about erythema multiforme and drug reactions they would look very similar * do immunofluorescence for antibody deposition to distinguish
45
Identify Histologic Features
SLE stained for mucin thickened basement membrane
46
Subacute Cutaneous Lupus Erythematosus Clinical Features
10-20% have systemic symptoms as well
47
Subacute Cutaneous Lupus Erythematosus flares with?
Sun exposure
48
Discoid Lupus Erythematosus Clinical Features
49
Question
Muscle Weakness
50
Dermatomyositis Clinical Features
51
"Heliotrope Rash" think?
Dermatomyositis
52
"Shawl Sign" think?
Dermatomyositis
53
Dermatomyositis Lesion
Erythematous to dusky lilac patch-plaques usually w/ minimal scale
54
Dermatomyositis Associations
proximal muscle weakness muscle fatigue muscle tenderness fever malaise
55
Dermatomyositis Treatment
56
57
Question
Breast Cancer worry about malignancy with Dermatomyositis
58
Dermatomyositis & Malignancy
59
Question
Erythema Nodosum
60
Erythema Nodosum Clinical Features
can be mistaken with cellulitis
61
Identify Histological Features
inflammation primarily in the fat lymphocytes and histiocytes **Erythema Nodosum**
62
Identify Histological Features
Erythema Nodosum can have giant cells
63
Erythema Nodosum Associations
64
Other Erythemas 4 listed
65
Question
Pyoderma Gangrenosum
66
Pyoderma Gangrenosum Clinical Features
67
Identify Histological Features
Pyoderma Gangrenosum can look like folliculitis (pustular ingflammation around the hair follicle in any ulcer see inflammation of blood vessels biopsy on the edge
68
Question
Inflammatory Bowel Disease
69
70
Pyoderma Gangrenosum Associations
71
Pyoderma Gangrenosum Associations continued
72
Question
Cutaneous T-Cell Lymphoma
73
Identify Histologic Features
atypical epidermotropic lymphoid infiltrate Cutaneous T-cell Lymphoma
74
Identify Histologic Features
75
Cutaneous T-cell Lymphoma Clinical Features
76
Cutaneous T-cell Lymphoma AKA
Mycosis Fungoides
77
Pruritus
78
Mediators of Pruritus
79
Common skin conditions with pruritus
80
Systemic Disease that cause Pruritus
81
signs of chronic pruritus
82
Skin signs of chronic pruritus & workup
83
Laboratory studies for systemic diseases
84
Physical Exam for systemic diseases
85
Hx for systemic diseases
86
Diagnoses for systemic diseases

MSCT (30 decks)

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