Skin and Systematic Disease Flashcards
skin signs of GI disease
what are GI genetic conditions causing skin manifestations?
Hereditary haemorrhagic telangiectasia
Ehlers danlos (collagen) – poor collagen in blood vessel = likely to burst and bleed
Pseudo xanthoma elasticum (elastic)
Blue rubber bleb naevus
-> GI haemorrhage
What GI Inflammatory/Autoimmune cause skin manifestions?
Malignant atrophic papulosis (degos disease) – GI haemorrhage
Erythema nodosum
Pyoderma gangrenosum
> IBD
what vitamin deficiencies cause skin manifestations?
Scurvy/Beriberi
Skin signs of endocrine disease
what skin manifestations does diabetes cause?
- Acanthosis nigricans
- Diabetic bullae
- Diabetic dermopathy
- Eruptive xanthomas
- Necrobiosis lipoidica
what skin manifestations does thyroid disorders cause?
- Hyperthyroid - Thyroid acropachy
- Hypothyroid - Pre-tibial Myxoedema
what are autoimmune conditions cause skin manifestations?
Cutaneous lupus
Cutaneous vasculitis
Alopecia
Vitiligo
how does cutaneous lupus present?
Lupus has different types of presentations
Cutaneous – Butterfly rash
- Plaques with clear margins
- Photosensitivity
- Negative antibodies
may be drug related
what causes Vasculitic rashes?
Small vessel vasculitis (commonest)
what is alopecia and what are some differnetial diagnosis?
Alopecia areata
T-lymphocyte, cytokine rejection of hair
Totalis - total hair loss
Universalis
Differential dx:
- Scarring alopecia
- Androgenic alopecia
what is Vitiligo?
Segmental
Generalised
Destruction of melanocytes
Associated with other autoimmune conditions
do skin conditions have an association with an underlying malignancy?
Some skin conditions have stronger associations with underlying malignancy, while others have less strong association
there may be an underlying malignancy in most cases in what diseases?
Carcinoid Syndrome
Ectopic ACTH
Pagets disease
Paraneoplastic pemphigus
Acquired hypertrichosis
Erythema Gyratum Repens
Bazex Syndrome
Leser Trelat
what is Carcinoid Syndrome?
- Episodic flushing, mins -hours - No sweating (unlike menopause)
- Facial telangiectasia
- GI carcinoid = liver mets
- Bronchial, ovarian = can occur with no liver mets
what is Ectopic ACTH syndrome?
- Tumour production of ACTH leads to generalised hyperpigmentation
- ACTH -> Inc. MSH -> release of melanin from melanocytes
what is Pagets & Extra-Mammary Pagets
Paget’s Disease
- Eczematous Plaque (nipple/Areola)
- Extension of underlying ductal adenocarcinoma
Extra-Mammary Pagets
- Usually axilla or ano-genital areas
- Intraepithelial adenoca in ¾ cases
what is Paraneoplastic Pemphigus?
Erosive stomatitis, rash
Auto-antibodies driven
Non-hodgkins, Castlemans disease
Pemphigus – autoimmune blistering condition
Haemorrhagic erosions on lips and inside the mouth
what is Acquired hypertrichosis lanuginosa?
Acute onset of lanugo hairs at face & body
Colorectal ca > lung > breast, usually advanced
very rare
what is Erythema Gyratum Repens?
Concentric erythematous lesions
Associated with Lung ca > Oesophageal,Breast
Very rarely with -Mycobacteial infection, Pregnancy
what is Bazex Syndrome?
- Symmetrical hyperkeratosis of extremities - Acrokeratosis neoplastica
- Resembles psoriasis, non-specific fx on skin biopsy
- SCC: Bronchial, oropharyngeal, Gastric, colon, biliary adenocarcinomas
what is Leser-Trelat?
Eruptive seborrhoeic keratosis
GI adenocarcinomas
what are conditions associated with cancer?
Acanthosis Nigricans
Dermatomyositis
what is Acanthosis Nigricans?
Can preceed malignancy (gastric adenocarcinoma). ?related to by-products. Concern if:
Older patient, rapid onset
Involves lips
Weight loss
what is Dermatomyositis?
• Inflammatory myopathy + rash:
- Periorbital heliotrope rash
- Gottrons papules: red maculo-papular lesions over bony prominences
- Shawl sign
- Photosensitive
- Asso with -Ovarian, breast, lung ca
what are ocnditions that may be associated with a malignancy?
Bullous pemphgoid
Sweets Syndrome
Pyoderma gangrenosum
Acquired ichthyosis
Cryoglobulinaemia
pictures showing
- Bullous pemphigoid
- Sweets syndrome (esp AML)
pictures showing:
- Pyoderma gangrenosum
- Acquired ichthyosis
Genetic tumour syndromes
Peutz-Jeghers (d/d- HHT): melanosis, colon hamartomas, colon ca
Muir-Torre: sebaceous tumours, keratoacanthomas, GI, breast, GU
Neurofibromatosis: Café au lait, Ax freckles, Neurofibromas, nerve sheath, phaeoCCyT, carcinoid
MEN syndromes: angiofibromas, neuromas, lichen or macular amyloid (MEN2), endocrine, P’s
Howel-Evans: palmoplantar keratoderma, oesophageal, Thickening of the skin of the palms and soles
