Skin disorders associated with systemic disease

Question 1

Skin disorders assoc. with diabetes

Answer 1

Necrobiosis lipoidica
Skin Infection (candida/ staph)
Neuropathic ulcers
Vitiligo
Lipoatrophy
Granuloma annulare

Question 2

Features of Necrobiosis lipoidica

Answer 2

• shiny, painless yellow/red/brown skin
• shin
• surrounding telangiectasia

Question 3

Features of granuloma annulare

Answer 3

• slightly hyperpigmented papules
• depressed centrally

Question 4

Gastric Cancer

Answer 4

Acanthosis nigricans

Question 5

Lymphoma

Answer 5

Acquired ichthyosis
Erythroderma

Question 6

Gastrointestinal and lung cancer

Answer 6

Acquired hypertrichosis lanuginosa

Question 7

Dermatomyositis

Answer 7

Ovarian and Lung cancer

Question 8

Erythema gyratum repens

Answer 8

Lung cancer

Question 8

Erythema gyratum repens

Answer 8

Lung cancer

Question 9

Migratory thrombophlebitis

Answer 9

Pancreatic cancer

Question 10

Necrolytic migratory erythema

Answer 10

Glucagonoma

Question 11

Myeloproliferative disorders

Answer 11

Pyoderma gangrenosum (bullous and non-bullous forms)

Question 12

Sweet’s syndrome

Answer 12

Haematological malignancy e.g. Myelodysplasia - tender, purple plaques

Question 13

Tylosis

Answer 13

Oesophageal cancer

Question 14

What skin conditions can be caused by pregnancy?

Answer 14

atopic eruption
polymorphic eruption
pemphogoid gestationis

Question 15

Features of atopic eruption of pregnancy

Answer 15

• eczematous, itchy red rash
• no specific treatment is needed

Question 16

Features of polymorphic eruption of pregnancy
and what trimester does this occur in?

Answer 16

• last trimester
• lesions first appear in abdominal striae
• pruritic

Question 17

Management of polymorphic eruptiojn of pregnancy

Answer 17

emollients
mild potency topical steroids oral steroids

Question 18

Features of pemphigoid gestationis

Answer 18

• pruritic blistering lesions
• peri-umbilical region first then spread to trunk, back, buttocks and arms

Question 19

Management of pemphigoid gestationis

Answer 19

oral corticosteroids are usually required

Question 20

When does pemphigoid gestationis usually present during pregnancy?

Answer 20

• 2nd or 3rd trimester
• rarely seen in the first pregnancy

Question 21

Skin disorders associated with TB

Answer 21

• Lupus vulgaris
• erythema nodosum
• scarring alopecia
• scrofuloderma: skin breakdown overlying a TB focus
• verrucosa cutis
• gumma

Question 22

Features of lupus vulgaris

Answer 22

• most common cutaneous TB in Indian subcontinent
• affects face, particularly nose and mouth
• initial lesion = erythematous flat plaque which gradually becomes elevated and may ulcerate