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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

Presentation of carcinoid syndrome

A

Episodic flushing mins - hours
No sweating
Facial telagiectasia

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2
Q

What is paraneoplastic pemphigus?

A

Blistering skin condition caused by weakness in certain areas of the skin

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3
Q

Presentation of paraneoplastic pemphigus

A

Blisters
Erosive stomatitis
Rash
Very dry and painful mouth

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4
Q

What causes carcinoid syndrome?

A

GI carcinoid
Bronchial carcinoid
Ovarian carcinoid

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5
Q

What can cause paraneoplastic pemphigus?

A

Non hodgkins lymphoma

Castlemans disease

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6
Q

What is erythema gyratum repens?

A

Concentric erythematous lesions

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7
Q

What is acquired hypertrichosis lanuginose?

A

Acute onset of lanugo hairs at face and body

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8
Q

Who normally have lanugo hairs?

A

Neonates

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9
Q

Causes of acquired hypertrichosis lanuginose

A

Severe eating disorders
Colorectal cancer >
Lung cancer >
Breast cancer

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10
Q

What is bazex syndrome?

A

Hyperkeratosis of extremities
Resembles psoriasis
Non specific diagnosis on skin biopsy

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11
Q

Causes of bzex syndrome

A

SCC; bronchial, oropharyngeal, GI

Gastric, colon, biliary tumours, adenocarcinomas

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12
Q

What is ectopic ACTH syndrome?

A

Tumour production of ACTH leads to generalised hyperpigmentation

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13
Q

Why does ectopic ACTH syndrome lead to hyperpigmentation?

A

ACTH -> increased MSH -> Release of melanin from melanocytes

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14
Q

Pathology of pagets disease

A

Extension of underlying ductal adenocarcinoma

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15
Q

Presentation of Pagets disease

A

Eczematous plaque at nipple / areola

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16
Q

Causes of extra mammary pagets

A

Primary intraepithelial adenocarcinoma (>75%)
Secondary to underlying visceral tumour
- bladder
- colon

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17
Q

What skin conditions are strongly associated with cancer?

A

Acanthosis nigricans

Dermatomyositis

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18
Q

How is acanthosis nigricans related to cancer?

A

Can preceed malignancy (particularly a gastric adenocarcinoma)

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19
Q

Concerns arise with acanthosis nigricans if;

A 
Older patient
Rapid onset
Other skin signs 
Involves lips
Weight loss
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20
Q

What is dermatomyositis?

A

Inflammatory myopathy + rash

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21
Q

Presentation of dermatomyositis

A 
Periorbital heliotrope rash 
Gottrons papules 
- red maculo popular lesions over bony prominences 
Shawl sign 
Photosensitive poilkiloderma 
Scalp erythema
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22
Q

Skin conditions that may be associated with malignancy

A 
Bullous pemphgoid 
Sweets syndrome
Pyoderma gangrenosum 
Acquired ichthyosis 
Acquired angioedema 
Primary systemic amyloid 
Cryoglobulinaemia
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23
Q

Presentation of sweets syndrome

A

Juicy nodules which tend to be in upper back, upper limbs and neck

24
Q

3 examples of genetic tumour syndromes

A

MEN syndromes
Xeroderma pigmentosum
Peutz-Jeghers

25
Q

What is xeroderma pigmentosum?

A

Inability to repair sun damage

26
Q

Diabetes skin signs

A 
Acanthosis nigricans 
Acral erythema 
Carotenemia 
Diabetic bullae 
Diabetic dermopathy 
Disseminated granuloma annulare 
Eruptive xanthomas 
Necrobiosis lipoidica 
Rubeosis 
Scleroderma
27
Q

What is alopecia?

A

Patchy loss of hair

28
Q

What is the medical condition of alopecia called?

A

Alopecia areata

29
Q

Pathology of alopecia

A

T lymphocyte, cytokine rejection of hair

  • totalis
  • universalis
30
Q

Differential diagnosis of alopecia areata

A

Scarring alopecia

Androgenic alopecia

31
Q

What is scarring alopecia?

A

Attack of the follicles
Leading to fibrosis
Hair will never grow back

32
Q

What is vitiligo?

A

Segmental patches of different coloured skin

33
Q

What type of condition is alopecia?

A

Autoimmune

34
Q

Presentation of alopecia areata

A

Localised, well demarcated patches of hair loss

At edge of hair loss, may be small broken “exclamation mark” hairs

35
Q

What % of people regrow their hair in alopecia areata?

A

50% by 1 year

80 - 90% eventually

36
Q

Treatment options of alopecia

A 
Hair regrowth naturally 
Topical or intralesional corticosteriods
Topical minoxidil
Phototherapy
Dithranol 
Contact immunotherapy 
Wigs
37
Q

What is bullous pemphigoid?

A

Autoimmune condition causing sub epidermal blistering of the skin

38
Q

Pathology of bullous pemphigoid

A

Secondary to the development of antibodies against hemidesmosomal proteins BP180 and BP230

39
Q

Diagnosis of bullous pemphigoid

A

Immunofluroescence

- IgG and C3 at the dermoepidermal junction

40
Q

Management of bullous pemphigoid

A

Oral corticoids MAINSTAY
Topical corticosteriods
Immunosuppressants
Antibiotics

41
Q

What is dermatitis herpetiformis?

A

Autoimmune blistering skin disorder

42
Q

What condition is dermatitis herpetiformis associated with?

A

Coeliac disease

43
Q

Pathology of dermatitis herpetiformis

A

IgA deposition in the dermis

44
Q

Presentation of dermatitis herpetiformis

A

Itchy, vesicular skin lesions on the EXTENSOR surfaces (elbows, knees, buttocks)

45
Q

Diagnosis of dermatitis herpetiformis

A

Skin biopsy

- direct immunofluorescence shows deposition of IgA in a granular pattern in the upper dermis

46
Q

Management of dermatitis herpetiformis

A

Gluten free diet

Dapsone

47
Q

Presentation of lichen planus

A

Itchy, popular rash most common on palms, soles, genitalia and flexor surfaces of the arms
Rash often polyglonal in shape - white lines pattern on the surface
Koebener phenomenon may be seen (new skin lesions appearing at the site of trauma)
Oral involvement in 50%
- white lace pattern on buccal mucosa
Nails
- thinning of nail plate
- longitudinal ridging

48
Q

Causes of lichenoid drug eruptions

A

Gold
Quinine
Thiazides

49
Q

Management of lichen planus

A

Topical steroids mainstay of treatment
Benzydamine mouthwash if oral
Extensive may require oral steroids or immunosuppression

50
Q

What skin manifestations can be associated with SLE?

A

Photosensitive “butterfly rash”
Discoid lupus
Alopecia
Livedo reticularis (net like rash)

51
Q

What is vitiligo?

A

Autoimmune condition which results in loss of melanocytes and consequent depigmentation of the skin

52
Q

When do symptoms of vitiligo typically develop?

A

20 - 30 y/o

53
Q

Where tends to be most affected in vitiligo?

A

Peripheries

54
Q

What may precipitate new lesions in vitiligo and what is this called?

A

Trauma - koebner phenomenon

55
Q

Assosiated conditions of vitligo

A 
T1DM
Addisons 
Autoimmune thyroid disease 
Pernicious anaemia 
Alopecia areata
56
Q

Management of vitiligo

A 
Suncream on affected areas
Camoflague make up 
Topical steroids may reverse changes if applied early 
Topical tacrolimus maybe
Phototherapy maybe
57
Q

First line treatment for hyperhidrosis

A

Aluminium chloride

Dermatology (11 decks)

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