Skin and Systemic Disease Flashcards
List 5 types of systemic disease which can cause skin changes.
Endocrine disease Internal malignancy Nutritional deficiency Systemic infection Systemic inflammatory disease
List the 4 main endocrine problems which can cause skin changes.
Thyroid problems
Diabetes mellitus
Steroid imbalance
Sex hormone imbalance
List common skin changes in thyroid disorders. Consider:
a) Hypothyroidism (2)
b) Grave’s disease (2)
HYPOTHYROIDISM:
Dry skin
Pretibial myxoedema
GRAVE’S DISEASE:
Thyroid dermopathy
Thyroid acropachy
List 5 types of skin changes seen in diabetes mellitus.
Necrobiosis lipoidica Diabetic dermopathy Scleredema diabeticorum Leg ulcers Granuloma annulare
List 4 clinical features of necrobiosis lipoidica.
Waxy appearance
Yellow discolouration
Ulceration
Scarring
List 4 clinical features of scleredema diabeticorum.
Spongy, thickened skin
Warm, red, inflamed skin
Non-pitting oedema
Shawl distribution
List 3 clinical features of granuloma annulare.
Circular red lesions
Raised lesions
Widespread
List 6 skin changes often seen in Cushing’s syndrome.
What is Cushing’s syndrome?
Steroid excess
Erythema Gynaecomastia Acne Striae Purpura with minor trauma (easy bruising) Global skin atrophy (skin thinning)
List 2 skin changes seen in Addison’s disease.
What is Addison’s disease?
Steroid insufficiency
Hyperpigmentation
Acanthosis nigracans
List some common skin changes caused by sex hormone imbalance. Consider:
a) Testosterone excess (2)
b) Progesterone excess (2)
TESTOSTERONE:
Acne
Hirsutism
PROGESTERONE:
Acne
Dermatitis
List 6 skin changes which can be seen with internal malignancies.
Necrolytic migratory erythema Erythema gyratum repens Acanthosis nigracans Erythema annulare Sweet's syndrome Sister Mary Joseph nodule
List 4 clinical features of necrolytic migratory erythema.
What type of cancer is it most strongly associated with?
Ring-shaped red, scaly plaques
Itching
Pain
Progression of plaques through blistering, erosion and crusting
Islet cell tumours in pancreas
List 4 clinical features associated with erythema gyratum repens.
Which type of cancer is most strongly associated with it?
Red, concentric bands
Whorled woodgrain pattern
Severe itching
Peripheral eosinphilia
Lung cancer
List 2 clinical features of acanthosis nigracans.
Which type of cancer is most strongly associated with it?
Pigmented skin
Velvety feel
GI adenocarcinomas (60% gastric)
List 4 clinical features associated with Sweet’s syndrome.
Increased WCC
Sudden onset fever
Pain
Red, well-defined plaques and papules
Define a “Sister Mary Joseph nodule”.
Metastasis of cancer to the umbilicus, usually spreading from advanced peritoneal adenocarcinoma
Which 3 types of nutritional insufficiencies are most commonly associated with skin changes?
Vitamin B deficiencies
Zinc deficiency
Vitamin C deficiency
Which 3 types of skin change are associated with vit B deficiency?
State the specific vitamin B which causes it.
Dermatitis (B6)
Angular chelitis (B12)
Pellagra (B3)
Which 1 type of skin change is associated with zinc deficiency?
Acrodermatitis enterpathica
List 7 clinical features associated with vitamin C deficiency.
Punctate purpura Corkscrew curly hairs Patchy hyperpigmentation Dry skin Dry hair Poor wound healing Inflamed gums
List 6 causes of erythema nodosum.
IBD Infection (esp. streptococcus) Pregnancy OCP Sarcoidosis Drug induced
What is erythema nodosum?
Bruise-like swellings on the shins
List 3 causes of pyoderma gangrenosum.
Inflammatory bowel disease, e.g.
Crohn’s disease
Ulcerative colitis
Rheumatoid arthritis
Myeloma
