Skin and systemic disease Flashcards
manifestations of DM in the skin
infection - erysipelas, cellulitis, candidiasis ulcers necribiosis lipoidica xanthomata acanthosis nigricans diabetic dermopathy (brown atrophic lesions) bullar granuloma annulare angiopathy sensory loss
what is necrobiosis lipoidica
collagen becomes inflamed and you get a granulomatous inflammatory reaction anterior shins shiny waxy yellow indurated appearance telangiectasias can ulcerate difficult to heal does not correlate with diabetic control
what is acanthosis nigricans
darkened thickened velvety skin in flexural areas
hyperpigmentation
type 1 - paraneoplastic
type 2 - insulin resistance, metabolic syndrome
causes of acanthosis nigricans
DM GI malignancy PCOS obesity insulin resistance
manifestations of hyperthyroidism in the skin
warm moist smooth skin facial flushing palmar erythema diffuse alopecia hyperhidrosis pruritis chronic urticaria pretibial myoedema in Graves disease
what is pretibial myxoedema
purple / brown indurated waxy thicker nodules/plaques on anterior shins
sluggish circulation in the legs, antibodies accumulate there
manifestations of hypothyroidism in the skin
cold, dry rough skin xerosis dry course brittle hair loss of lateral 1/3rd of eyebrow facial puffiness periorbital oedema generalised myxoedema
cutaneous features of SLE
malar rash photosensitivity alopecia ulcers nail fold capillaries
cutaneous features of dermatomyositis
eyelid oedema heliotrope rash around the eyes Gottrons papules over knuckles shawl sign dilated nail fold capillaries photosensitivity
investigations for dermatomyositis
CK
malignancy screen - paraneoplastic
breast, GI, colon, lung
cutaneous features of systemic sclerosis
sclerodactyly telangiectasia periunual telangiectasia Raynauds phenomenon beaked nose furrowing of the mouth calcinosis
list skin manifestations of malignancy
Cutaneous t cell lymphoma - mycosis fungoides
Paget’s disease of the nipple
cutaneous metastatic deposits
Kaposi sarcoma
appearance of CTCL
patch --> plaque --> tumour dry may resemble atypical eczema then psoriasis unresponsive to emollients and steroids can cause erythroderma
appearance of Paget’s disease of the nipple
eczematous eruption around the nipple
unilateral
skin manifestations of HIV
infections - HSV, molluscum, fungal, staph, candidiasis seborrhoeic dermatitis new/worsening psoriasis dry skin / pruritis Kaposi's sarcoma
appearance of vasculitis in the skin
non blanching purpuric rash usually on lower limbs
+- bullae, necrosis
painful palpable purpura
appearance of livedo reticularis
mottled cyanotic network exacerbated by the cold
anything that causes sluggish blood flow
causes of livedo reticularis
prolonged heat e.g. hot water bottle APLS cardiac failure vascular emboli drugs arteritis infections
what is erythema nodosum
painful erythematous subcutaneous nodules on shins panniculitis no scaling or epidermal involvement need to go deep for a biopsy usually bilateral
commonest cause of erythema nodosum
COCP
other causes of erythema nodosum
IBD TB sarcoidosis drugs - OCP infections - URTI idiopathic
what are xanthomata
indicative of underlying lipid metabolism disorders
can be seen around the eyes or on the arms
management of cellulitis/erysipelas
PO or IV antibiotics
management of necrobiosis lipoidica
optimising diabetic control topical steroids - potential for skin thinning tacrolimus - steroid sparing
