Skin and Systemic Disease Flashcards
What are the skin changes seen in thyroid diseases
Hypothyroidism - Dry skin.
Hyperthyroidism/Graves - Pretibial myxoedema (puffy swollen legs) and thyroid acropachy.
What are potential skin changes seen in diabetes mellitus?
- Necrobiosis lipoidica,
- Diabetic dermopathy,
- Scleredema,
- Leg ulcers,
- Granuloma annulare
What does the following image show
Necrobiosis Lipoidica. Often occurs on the shins, it appears as a waxy, yellow discolouration. It can offten ulcerate and scar
What does the following image show?
Diabetic dermopathy. Inflammatory papules which heals with hyperpigmentation
What does the following image show?
Scleredema. Makes it very difficult to pinch the skin
What does the following image show?
Granuloma annulare. Single patch not for concern but concerning if there are multiple
What are the skin changes seen with steroid excess (cushing’s disease)
- Acne,
- Striae,
- Erythema,
- Gynaecomastia
- Non dermatological presentation - increased central obesity, moon faces and buffalo hump
What are the skin changes seen with steroid insufficiency (Addison’s disease)
Hyperpigmentation
Acanthosis nigracans
What are the skin changes seen with testosterone excess and what conditions may cause this?
It can cause acne and hirsutism. This can be seen in PCOS, testicular tumours, testosterone drug therapy
What skin changes can be seen with progesterone excess and what conditions may cause this?
Acne and dermatitis. It can be seen with OCP use or in congenital adrenal hyperplasia
What skin changes can be seen with internal malignancies
- Necrolytic migratory erythema,
- Erythema gyratum repens,
- Acanthosis nigricans,
- Erythema annulare,
- Sweet syndrome (inflammatory plaques associated with haematological)
- Sister Mary Joseph nodule (umbilical tumour suggesting GU malignancy)
What does the following image show?
Necrolytic migratory erythema. It causes erythematous scaly plaques which are associated with islet cell tumour of the pancreas
What does the following image show?
Erythema gyratum repens. It has reddened concentric bands whorled woodgrain pattern. It has severe pruritus and peripheral eosinophilia. Strong association with lung cancer and less strong association with breast, cervical and GI ca.
What are the 3 types of acanthosis nigricans?
Type 1 - associated with malignancy. Especially adenocarcinoma of GI tract.
Type 2 - Familial type which is autosomal dominant.
Type 3 - Associated with obesity and insulin resistance.
It is a smooth, velvet like hyperkeratotic plaque’s in skin folds (usually darker in colour)
What are the dermatological appearence of vitamin B6, B12 and B3 deficiency
B6 - Dermatitis,
B12 - Angular chelitis,
B3 - Pellagra which is associated with 3 D’s: dementia, dermatitis and diarrhoea (and death)
What does the following image show and what are some causes
Erythema nodosum. It can be caused by a streptococcal infection, pregnancy/OCP, sarcoidosis, drug induced, bacterial/viral infections
What does the following image show and what are some causes?
Pyoderma Grangrenosum. It can be caused by inflammatory bowel diseases, rheumatoid arthritis, and myeloma
