Skin and Systemic Disease Flashcards
What classes of systemic diseases can cause changes in the skin?
Endocrine disease Internal malignancy Nutritional deficiency Systemic infection Systemic inflammatory disease
What changes in the skin can result from hypothyroidism?
Dry skin
What changes in the skin can result from grave’s disease?
Thyroid dermopathy
Thyroid acropachy
Pretibial myxoedema
What skin changes can result from diabetes?
Necrobiosis lipoidica Diabetic dermopathy Sclerodema Leg ulcers Granuloma annular
Describe the appearance of necrobiosis lipoidica.
Waxy appearance
Usually yellow discolouration
Can ulcerate and scar
Often seen on the shins
On which area of the body is necrobiosis lipoidica usually seen?
Shins
What changes in the skin can result from steroid excess?
Acne
Striae
Erythema
Gynaecomastia
What changes in the skin can result from steroid insufficiency?
Hyperpigmentation
Acanthosis nigracans
What changes in the skin can be seen in Cushing’s disease?
Increase in central adiposity
Moon faces
Buffalo hump
Global skin atrophy (epidermal and dermal components)
Striae on abdominal flanks, arms and thighs
Purpura with minor trauma
An excess of testosterone can cause acne and hirsutism. What can cause such an excess?
PCOS
Testicular tumours
Testosterone drug therapy
What are the effects of excess testosterone on the skin?
Acne
Hirsutism
What are the effects of excess progesterone on the skin?
Acne
Dermatitis
Excess progesterone causes acne and dermatitis. What can cause an excess of progesterone?
Congenital adrenal hyperplasia
Contraceptive treatments
What skin changes can result from internal malignancy?
Necrolytic migratory erythema Erythema gyratum repens Acanthoses nigricans Erythema annulare Sweet's syndrome Sister Mary Joseph Nodules
What is the other name for necrolytic migratory erythema?
Glucagonoma syndrome
What type of malignancy is necrolytic migratory erythema associated with?
Islet cell tumour of the pancreas
Other than necrolytic migratory erythema, what are the signs of islet cell tumours of the pancreas?
Hyperglycaemia
Diarrhoea
Weight loss
Glossitis
How is necrolytic migratory erythema treated?
Removal of the tumour
Describe the appearance of necrolytic migratory erythema?
Erythematous, scaly plaques on aural, intertriginous and periorificial areas
Describe the appearance of erythema gyratum repens.
Reddened, concentric bands with a whorled woodgrain pattern.
Which cancers is erythema gyratum repens associated with?
Strong association with lung cancer
Weak association with breast, cervical and GI cancers
Describe the appearance of acanthosis nigricans?
Smooth, velvet-like hyperkeratotic plaque in intertriginous areas such as the groin, axillae and neck
Describe type one acanthoses nigricans?
Associated with malignancy (especially adenocarcinoma of the GI tract)
Sudden onset
More expensive
Describe type two acanthoses nigricans?
Familial type Autosomal dominant Very rare Appears at birth No association with malignancy
Describe type three acanthoses nigricans?
Associated with obesity and insulin resistance
Most common type
Which nutritional deficiencies can cause skin changes?
Vitamin B
Vitamin C
Zinc
What skin changes can be caused by vitamin B12 deficiency?
Angular stomatitis
What skin changes can be caused by vitamin B6 deficiency?
Dermatitis
What skin changes can be caused by vitamin B3 deficiency?
Pellagra
Pellagra is caused by a vitamin B3 deficiency. What is this condition marked by?
Diarrhoea
Dementia
Dermatitis
What skin changes result from zinc deficiency?
Acrodermatitis enteropathica
What is acrodermatitis enteropathica?
An autosomal recessive inherited condition which affects the uptake of zinc and causes diarrhoea, hair loss and an inflammatory reaction around the mouth and anus.
A zinc deficiency can follow breast feeding. T/F?
True
When might total parenteral nutrition without zinc supplementation occur in adults?
Alcoholism
Malabsorption states
Inflammatory bowel disease
Bowel surgery
How is acrodermatitis enteropathica treated?
Zinc supplementation
What skin changes occur in vitamin C deficiency?
Punctate purpura Bruising Corkscrew spiral curly hairs Patchy hyperpigmentation Dry skin and hair Non-healing wounds Inflamed gums
What are the causes of erythema nodosum?
Streptococcal infection
Sarcoidosis
Bacterial/viral infection
Drug induced
What diseases are associated with pyoderma gangrenosum?
Inflammatory bowel disease (churn’s disease, ulcerative colitis)
Rheumatoid arthritis
Myeloma
What are the possible systemic causes of hair thinning?
Vitamin B12 deficiency
Iron deficiency
Lupus
Hypothyroidism
What effect does androgen excess have on the hair?
Male pattern balding
