Skin Disorders - Cutaneous Markers Of Skin Disease

Question 1

Acanthosis nigricans

Answer 1

• insulin resistance, hyperinsulinemia
• rarely associated with internal tumors
• intetriginous areas
• dark velvety skin
• Histological: hyperkeratosis and epidermal papillomatosus

Question 2

Cafe au lait spots/neurofibromas

Answer 2

• cafe au lait macules: congenital pigmented macules >0.5cm, 6+ associated with neurofibromatosis
• neurofibromas: benign tumors of Schwann cells and fibroblasts, solitary lesions are common, multiple lesions are associated with neurofibromatosis (NF1 - most common, Von Recklinghouse and NF2)

Question 3

Xanthomas

Answer 3

•lipid accumulation in dermal macrophages
*multiple associated with lipid disorders
•skin colored to yellow papules and nodules, may fuse to form plaques
•xanthelasma: on or near eyelids, may or may not be associated with Hyperlipidemia
•differs from lipoma!

Question 4

Tuberous Sclerosis Complex - angiofibromas

Answer 4

• skin colored erythematous papules
• spindle cells around dermal blood vessels form a mass in the superficial dermis
• multiple facial angiofibromas associated with tuberous sclerosis: genetic disease includes benign CNS tumors, seizures, renal cysts
• previously called ajeno a sebaceum (NOT associated with sebaceous glands)

Question 5

Porphyria cutanea tarda

Answer 5

• disorder of heme metabolism involving an enzyme deficiency in the heme synthesis pathway, increased uroporphyrins which are photosensitizing
• cutaneous symptoms include erythema and burning in sun exposed skin; systemic symptoms include acute abdominal pain, diarrhoea, red or brown urine
• Treatment can include phlebotomy to reduce iron load, reducing porphyrin; beta carotene to increase sun tolerance, sun avoidance

Question 6

Necrobiosis Lipoidica Diabeticorum

Answer 6

• an uncommon but distinctive skin condition generally occurring on anterior lower legs
• may be sign of DM

Question 7

Erythema Nodosum

Answer 7

•sign of deep fungal infection or allergic reaction

Question 8

Eruptive Xanthoma

Answer 8

•a profusion of yellowish papules which may be a sign of elevated blood lipids or diabetes

Question 9

Erythema Chronicum Migrans

Answer 9

•circular target like rash of Lyme Disease

Question 10

DRESS

Answer 10

•Drug Reaction with Eosinophils and Systemic Symptoms
•rare, severe, drug induced hypersensitivity reaction
-fever, rash, lymphadenopathy, facial swelling, organ involvement (liver, kidney, lung)