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Dermatology > Skin and Systemic Disease > Flashcards

Skin and Systemic Disease Flashcards

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Dermatology Board Prep flashcards
1
Q

Name two cutaneous manifestation of GI genetic diseases

A
  • Hereditary haemorrhagic telangiectasia

* Blue rubber bleb naevus -> GI haemorrhage

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2
Q

What is hereditary haemorrhage telangiectasia?

A

Autosomal dominant genetic disorder that leads to abnormal blood vessel formation in the skin and mucous membranes

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3
Q

Name two cutaneous manifestation of GI inflammatory / autoimmune diseases

A
  • Erythema nodosum

* Pyoderma gangrenosum (causes tissue to become necrotic, causing deep ulcers that usually occur on the legs)

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4
Q

Name a cutaneous manifestation of vitamin deficiency

A

Vitamin deficiency
• Gingival hypertrophy
• Bleeding gums

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5
Q

What are cutaneous manifestations of diabetes?

A
  • Acanthosis nigricans
  • Diabetic bullae
  • Diabetic dermopathy
  • Eruptive xanthomas
  • Necrobiosis lipoidica
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6
Q

What is diabetic dermopathy?

A

Lots of small papules which join to form almost plaque-like lesions

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7
Q

What is acanthosis nigricans?

A

Hyperprigmentation of skin folds (commonly around neck) - can be benign or malignant

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8
Q

Describe Necrobiosis lipoidica

A

Tender yellowish brown patches develop slowly on the lower legs over several months

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9
Q

What are cutaneous manifestations of thyroid disorders?

A
  • Hyperthyroid -> thyroid acropachy

* Hypothyroid -> pre-tibial myxoedema

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10
Q

What skin conditions are caused by autoimmunity?

A
  • Cutaneous lupus
  • Cutaneous vasculitis
  • Alopecia
  • Vitiligo
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11
Q

What are the features of cutaneous lupus?

A 
Butterfly rash 
• Plaques with clear margins 
• Photosensitivity 
• Negative antibodies 
• Disc-like lesions and raised on the outside
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12
Q

What are the features of cutaneous vasculitis?

A

Small vessel vasculitis (small haemorrhages)

• Lacey pattern - no change with temperature if pathological

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13
Q

What are the features of alopecia?

A

• Alopecia areata
• T-lymphocyte, cytokine rejection of hair
- Totalis
- Universalis

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14
Q

What are the differential diagnoses of alopecia?

A
  • Scarring alopecia (hair doesn’t grow back)

* Androgenic alopecia

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15
Q

What are the features of vitiligo?

A
  • Segmental
  • Generalised
  • Destruction of melanocytes
  • Associated with other autoimmune conditions
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16
Q

Give examples of common malignancies which cause cutaneous manifestation

A 
Carcinoid Syndrome
Ectopic ACTH
Pagets disease
Paraneoplastic pemphigus
Acquired hypertrichosis
Erythema Gyratum Repens
Bazex Syndrome
Leser Trelat
17
Q

Describe the cutaneous manifestation of carcinoid syndrome (malignancy)

A

• Episodic flushing, mins-hours
- No sweating (unlike menopause)
• Facial telangiectasia

  • GI carcinoid = liver mets
  • Bronchial, ovarian = can occur with no liver mets
18
Q

Describe the cutaneous manifestation of ectopic ACTH syndrome (malignancy)

A
  • Tumour production of ACTH leads to generalised hyperpigmentation
  • ACTH -> Inc. MSH -> release of melanin from melanocytes
19
Q

Describe the cutaneous manifestation of pagets + extra-mammary pagets (malignancy)

A

Paget’s disease
• Eczematous plaque (nipple/areolar)
• Extension of underlying ductal

Extra-mammary pagets
• Usually axilla or ano-genital areas
• Intraepitheial adenoma

20
Q

Describe the cutaneous manifestation of paraneoplastic pemphigus (malignancy)

A
  • Erosive stomatitis, rash
  • Auto-antibodies driven
  • Non-hogkins, castleman’s disease
  • Blisters which had ruptured -> erosions or ulcers
  • Often mucosal involvement
21
Q

Describe the cutaneous manifestation of acquired hypertrichosis lanuginosa (malignancy)

A
  • Acute onset of lanugo* hairs all across face & body
  • Colorectal ca > lung > breast - usually advanced

*baby hairs (very fine)

22
Q

Describe the cutaneous manifestation of Erythema Gyratum Repens (malignancy)

A
  • Concentric erythematous lesions
  • Associated with Lung ca > Oesophageal, Breast
  • Very rarely with -Mycobacteial infection, Pregnancy
23
Q

Describe the cutaneous manifestation of Bazex Syndrome (malignancy)

A
  • Symmetrical hyperkeratosis of extremities – acrokeratosis neoplastica
  • Resembles psoriasis, non-specific fx on skin biopsy
  • SCC: Bronchial, oropharyngeal, Gastric, colon, biliary adenocarcinomas
24
Q

Describe the cutaneous manifestation of Leser-Trelat (malignancy)

A
  • Eruptive seborrhoeic keratosis (brown warty nodules)

* GI adenocarcinomas

25
Q

What are two skin conditions associated with cancer?

A
  • Acanthosis Nigricans

* Dermatomyositis

26
Q

Describe the clinical features of Acanthosis Nigricans

A

Brown to black, poorly defined, velvety hyperpigmentation of the skin. It is usually found in body folds.

27
Q

When can Acanthosis Nigricans occur?

A

Can preceed malignancy (gastric adenocarcinoma).
Concern if:

  • Older patient, rapid onset
  • Involves lips
  • Weight loss
28
Q

Describe the clinical features of Dermatomyositis

A 
Inflammatory myopathy + rash
• Periorbital heliotrope rash
• Gottrons papules: red maculo-papular lesions over bony prominences (i.e. back of fingers)
• Shawl sign
• Photosensitive 
• Asso with -Ovarian, breast, lung ca
29
Q

What is the shawl sign?

A

Widespread, flat, reddened area that appears on the upper back, shoulders and back of neck

30
Q

What signs may be associated with malignancy?

A
  • Bullous pemphgoid
  • Sweets Syndrome
  • Pyoderma gangrenosum
  • Acquired ichthyosis
  • Cryoglobulinaemia
31
Q

What is sweets syndrome?

A

Sudden onset of fever, an elevated white blood cell count, and tender, red, well-demarcated papules and plaques

32
Q

What is Pyoderma gangrenosum?

A

Causes tissue to become necrotic, causing deep ulcers that usually occur on the legs

33
Q

What Is acquired ichthyosis?

A

Non-hereditary skin condition characterised by dry and rough skin with scaling

34
Q

What are the features of Peutz-Jeghers?

A

Melanosis, colon hamartomas, colon Ca

35
Q

What are the features of Muir-Torre?

A

Sebaceous tumours, keratoacanthomas, GI, breast, GU

36
Q

What are the clinical manifestations of MEN syndromes?

A

Angiofibromas, neuromas, lichen or macular amyloid (MEN2)

37
Q

What are the clinical features of hotel-evans syndrome?

A

Palmoplantar keratoderma (thickening of the skin on the palms and soles)

Dermatology (8 decks)

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