Skin and Systemic Disease Flashcards

1
Q

What are the skin changes seen in thyroid diseases

A

Hypothyroidism - Dry skin.
Hyperthyroidism/Graves - Pretibial myxoedema (puffy swollen legs) and thyroid acropachy.

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2
Q

What are potential skin changes seen in diabetes mellitus?

A
  • Necrobiosis lipoidica,
  • Diabetic dermopathy,
  • Scleredema,
  • Leg ulcers,
  • Granuloma annulare
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3
Q

What does the following image show

A

Necrobiosis Lipoidica. Often occurs on the shins, it appears as a waxy, yellow discolouration. It can offten ulcerate and scar

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4
Q

What does the following image show?

A

Diabetic dermopathy. Inflammatory papules which heals with hyperpigmentation

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5
Q

What does the following image show?

A

Scleredema. Makes it very difficult to pinch the skin

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6
Q

What does the following image show?

A

Granuloma annulare. Single patch not for concern but concerning if there are multiple

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7
Q

What are the skin changes seen with steroid excess (cushing’s disease)

A
  • Acne,
  • Striae,
  • Erythema,
  • Gynaecomastia
  • Non dermatological presentation - increased central obesity, moon faces and buffalo hump
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8
Q

What are the skin changes seen with steroid insufficiency (Addison’s disease)

A

Hyperpigmentation
Acanthosis nigracans

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9
Q

What are the skin changes seen with testosterone excess and what conditions may cause this?

A

It can cause acne and hirsutism. This can be seen in PCOS, testicular tumours, testosterone drug therapy

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10
Q

What skin changes can be seen with progesterone excess and what conditions may cause this?

A

Acne and dermatitis. It can be seen with OCP use or in congenital adrenal hyperplasia

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11
Q

What skin changes can be seen with internal malignancies

A
  • 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)
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12
Q

What does the following image show?

A

Necrolytic migratory erythema. It causes erythematous scaly plaques which are associated with islet cell tumour of the pancreas

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13
Q

What does the following image show?

A

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.

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14
Q

What are the 3 types of acanthosis nigricans?

A

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)

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15
Q

What are the dermatological appearence of vitamin B6, B12 and B3 deficiency

A

B6 - Dermatitis,
B12 - Angular chelitis,
B3 - Pellagra which is associated with 3 D’s: dementia, dermatitis and diarrhoea (and death)

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16
Q

What is the dermatological appearence of zinc deficiencies

A

Pustules, bullae and scalling

17
Q

What are the different causes of a zinc deficiency?

A
  • Inherited: Mutations in SLC39A which encodes for intestinal zinc transporter.
  • Nutritional deficiency (in children it can occur if milk has low levels of zinc. In adults in occurs with diseases that affect absorption eg, alcoholism, IBD)
18
Q

What is the dermatological presentation of a vitamin C deficiency?

A
  • Punctate purpura/bruising,
  • Corkscrew spiral curly hairs,
  • Patchy hyperpigmentation,
  • Dry skin,
  • Dry hair,
  • Non healing wounds,
  • Inflamed gums
19
Q

What does the following image show and what are some causes

A

Erythema nodosum. It can be caused by a streptococcal infection, pregnancy/OCP, sarcoidosis, drug induced, bacterial/viral infections

20
Q

What does the following image show and what are some causes?

A

Pyoderma Grangrenosum. It can be caused by inflammatory bowel diseases, rheumatoid arthritis, and myeloma

21
Q

What are some nail and hair diseases

A
  • Alopecia areata hair loss (autoimmune)
  • Hair thinning which can be caused by B12, iron deficiency, lupus or hypothyroidism.
  • Male pattern balding with androgen excess,
  • Nail clubbing,
  • Nail fold telangectasia