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Dermatology > Skin and Systemic Disease > Flashcards

Skin and Systemic Disease Flashcards

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1
Q

what are some dermatological manifestations of diabetes

A 
Necrobiosis lipoidica
rubeosis 
diabetic dermopathy
granuloma annulare
vitiligo 
acanthosis nigricans 
lipodystrophy
vascular changes 
xanthomata 
yellow skin
dry and wet gangrene
candidiasis 
necrotising fasciitis 
foot ulcers
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2
Q

what is necrobiosis lipoidica

A

brown/red/yellow raised shiny patch usually above tibia

with telangeictasia

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3
Q

what is diabetic dermopathy

A

atrophic hyperpigmented lesions on lower legs

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4
Q

what is granuloma annulare

A

pink raised annular lesions - usually on knuckles

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5
Q

what proportion of people with diabetes develop necrobiosis lipoidica

A

<1% of diabetics

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6
Q

what sex is more likely to get necrobiosis lipoidica and by how much

A

Females, 3:1

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7
Q

what are some dermatological manifestations of thyroid dysfunction

A 
pretibial myxedema (hyperthyroidism)
dry skin (hypothyroidism)
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8
Q

what is pretibial myxedema

A

pink/flesh coloured mucoid plaques seen on lower shins, marked exophthalmos may also be seen

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9
Q

what are some dermatological manifestations of SLE

A

acute malar rash in a butterfly distribution

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10
Q

what are some cutaneous manifestations of systemic cancers

A 
acanthosis nigricans 
acquired ichthosis
pyoderma gangrenosum 
dermatomyositis 
dermatitis herpetiformis 
generalised pruitis
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11
Q

what is acanthosis nigricans

A

velvety thickened hyperpigmented papillomatous ‘dirty’ looking skin - usually in flexors

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12
Q

in what conditions is acanthosis nigricans seen and when would you be suspicious of malignancy

A

insulin resistance and metabolic syndromes as well as GI malignancy

hyperacute onset + severe symptoms, usually on mucous membranes and palms

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13
Q

what kinds of cancers is acanthosis nigricans associated with

A

GI cancers - specifically gastric carcinomas

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14
Q

what is acquired ichthyosis

A

dry rough skin with scaling

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15
Q

what cancer is particularly associated with acquired ichythosis

A

Hodgkins lymphoma

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16
Q

what is pyoderma gangrenosum

A

ulcerative skin disease causing an acute onset painful pustule/nodule arising after minor trauma

presents with a rapidly enlarging ragged border and a necrotic center

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17
Q

what systemic diseases is pyoderma gangrenosum associated with

A 
RA
crohns 
diverticulitis 
chronic active hepatitis 
behcets diseae 
malignancy
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18
Q

what malignancies is pyoderma gangrenosum associated with

A

haemotological maligancies

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19
Q

how do you treat pyoderma gangrenosum

A

find/treat underlying disease

topical/oral steroids may be helpful + emmolients

ciclosporin may be used as final option

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20
Q

what is dermatomyositis

A

subset of polymyosistis with distincitive skin change where it changes to a lilac discolouration around eyes, malar erythema, some also get slightly atrophic lilac papules over the knuckles, streaks of erythema over extensor tendons, ragged cuticles + periungal telangiectasia

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21
Q

what causes dermatomyositis

A

autoantibodies to striated muscle

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22
Q

what are some symptoms of dermatomyositis

A

skin changes

progressive proximal muscle weakness

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23
Q

what indicates a good prognosis for dermatomyositis

A

calcinosis

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24
Q

what proportion of patients with dermatomyositis have an underlying malignancy

A

30%

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25
what are some biochemical markers for dermatomyositis
elevated Creatine phosphokinase
26
what test detects muscular abnormalities for suspected dermatomyositis
electromyography | muscular biopsy
27
what is shown on muscle biopsy in dermatomyositis
inflammation/destruction
28
what is the treatment for dermatomyositis
high dose systemic steroids needed for several years immunosuppressive agents (azathioprine) used to rpevent seteroids treat until there is a biochemical improvement
29
what is dermatitis herpetiformis
chronic recurrent intensely pruritic eruptions occurring symmetrically on extensor surfaces of trunk and extremities - typically grouped vesicles
30
what is dermatitis herpetiformis associated with
coeliacs
31
how do you diagnose dermatitis herpetiformis
immunoflourescent skin biopsy
32
whats the treatment for dermatitis herpetiformis
dapsone (Antibiotic) | treat coeliacs
33
what are the differentials for generalised pruitis
metabolic - thyroid, renal failure malignancy - lymphoma. leukaemia, myeloma most common drugs = alcohol, aspirin, codeine, morphine haematological - polycythamiea RV, ID hepatic disease - obstructive jaundice, cholestasis pregnancy dry skin
34
what is erythema gyratum repens
shifting wave of erythema covering the skins surface looking like the grain of wood
35
what is acquired hypertrichosis lanuginosa
malignant down - excessive/widespread growth of laguno hair
36
what is necrolytic migratory erythema + what is it seen in
crusting edge that moves | anaemia/WL/diabetes/Stomatitis
37
what does necrolytic migratory erythema indicate
glucagon secreting tumour
38
what is bazex syndrome
papulosquamous eruption on finger, toes, ears nose
39
what causes bazex syndrome
URT tumours
40
what is acute febrile neutrophillic dermatosis
red odematous plaque presenting with a classic triad of increased ESR, fever and raised neutrophils
41
what is associated with neutrophillic dermatosis
myeloproliferative disorders
42
what is pachydermoperiostasis
coarsening/thickening of the skin seen with severe clubbing occuring on face/fingers commonly
43
what causes pachydermoperiostasis
autosomal dominant disease or due to systemic disease
44
what is erythema nodosum
immunological inflammation of subcutaneous fat presenting as tender bruise like nodules on the lower legs with associated fever, malaise and lethargy
45
what is the demographics of a typical patient with erythema nodosum
F>M 3:1, 15-30 years old
46
what is erythema nodosum associated with
infection - TB drugs - OCP, sulfonamides disease - IBD, sarcoid, behets
47
how do you treat erythema nodosum
rest NSAIDS prednisolone if refractory
48
what's the prognosis for erythema nodosum
usually resolves in around 6 weeks
49
what are some skin manifestations for cutaneous small vessel vasculitis
palpable purpura <1cm
50
what is polyarteritis nodosa
necrosing vasculitis of large arteries caused by immune complexes, causing tender subcutaneous nodules along lines of arteries, ulcerations/stellate patches of purpura covering the skin, splinter haemorrhages and net like vascular patterns
51
what happens if polyarteritis nodosa is left untreated
chronic oragn failure and death - usually from CKD
52
what is the treatment for polyarteritis nodosa
systemic steroids and cyclophosphamides (chemo) low dose steroids only if disease is purely cutaneous
53
what is the mechanism of non allergic drug eruptions
intrinsic pharmacological mechanisms (disclolouration + amiodarone) predictable may be exacerbation of existing skin disease idiosyncratic
54
what is the mechanism of allergic drug eruptions
unpredictable eruptions commonly occuring on 2nd exposure, most commonly morbilliform rashes with a central distribution
55
what is the most serious form of an allergic drug eruptions
toxic epidermal necrolysis
56
what causes toxic epidermal necrolysis
barbiturates, anticonvulsants, antibiotics
57
what drugs commonly cause rashes
``` penicillins/sulphonamides anticonvulsants NSAIDS Thiazides Allopurinol Gold + penicillinamine ```
58
whats the treatment for toxic epidermal necrolysis
``` stop drugs consider measures to decrease drug in system symptomatic oral steroids controversial avoid drug in future label medical records ```
59
what is toxic erythema
most common drug related rash marbiform erythematous macules most often occurs 7-14 dats after into of drug
60
what is erythema multiforme
rreaction pattern of blood vessels in skin with secondary epidermal changes = classically red and a bullseye lesions occur over a 10 days and are often symmetrically extensor skin mostly
61
what is the age distribution of erythema multiforme
<20 years olf in 50% of patients
62
what causes erythema multiforme
infection (HSV, mycoplasma) | drugs - penicillin, sulphonamide, phenytoin, allopurinol
63
what are some differentials for erythema multiforme
non-EM eruption secondary syphilis urticarial
64
what does a true target lesion have
at least 3 colours in it
65
what is steven johnsons syndrome
severe drug eruptions associated with a prodrome of URTIs and fevers, followed by symmetrical red macular eruption with blistering, ALWAYS involving the oral mucosa less severe than TEN
66
what causes steven-johnson syndrome
infections - mycoplasma + HSV idiopathic Drugs - NSAIDS, sulphonamides, penicillin, anti-convulsants, allopurinol

Dermatology (12 decks)

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