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BRS YR2 > Skin in Systemic Disease > Flashcards

Skin in Systemic Disease Flashcards

1
Q

How are dermatological diagnostic skills useful?

A
  • Prevent or reduce internal organ damage by early diagnosis
  • Allow detection of internal malignancy
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2
Q

What are the two main types of lupus erythamtosus?

A
  • systemic lupus
  • cutaneous (discoid) lupus
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3
Q

What are the skin features of systemic lupus erythmatosus?

A
  • chilblains
  • photodistributed erythematous rash
  • livedo reticularis
  • palpable purpura
  • subacute cutaneous lupus
  • alopecia
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4
Q

What are the skin features of discoid lupus erythmatosus?

A

Scarring

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5
Q

What is dermatomyositis?

A
  • autoimmune connective tissue disease
  • proximal extensor inflammatory myopathy
  • subtypes with different clinical features can be predicted by antibody profile
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6
Q

What are the skin features of dermatomyositis?

A
  • photodistributed pink-violet rash on scalp, periocular region and extensor surfaces
  • Gottron’s papules
  • ragged cuticles
  • Shawl sign
  • Heliotrope rash
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7
Q

What is vasculitis?

A

Inflammation or swelling of blood vessels

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8
Q

What are the skin features of vasculitis?

A
  • depends on the size of the blood vessel
  • small vessel = purpura
  • medium vessel = digital necrosis, retiform purpura ulcers, subcutaneous nodules along blood vessels
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9
Q

What is sarcoidosis?

A
  • systmeic granulomatous disorder of unknown origin
  • can affect multiple organs, lungs most common
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10
Q

What are the skin features of sarcoidosis?

A
  • highly variable
  • red-brown or violet papules on face, lips, upper back, neck and extremities
  • lupus pernio (unrelated to LE)
  • ulcers
  • scars
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11
Q

What is DRESS?

A
  • drug reaction with eosinophilia and systemic symptoms
  • rash and systemic upset incorporating hameotological and solid-organ disturbances
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12
Q

What is the scoring criteria for DRESS?

A
  • fever
  • lymphodenopathy
  • atypical lymphocytes
  • peripheral hypereosinophilia
  • interanal organs involved
  • negative ANA, hepatitis, mycoplasma and chlamydia
  • skin involvement
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13
Q

What are the skin features of DRESS?

A
  • widespread papules
  • maculopapullar eruption
  • erythroderma
  • head/neck oedema
  • multiform erythma
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14
Q

What is graft vs host disease?

A
  • T-lymphocyte response from the graft’s immune cells against host cells
  • affects people with stem cell transplants
  • mainly affects skin, liver and GI tract
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15
Q

Which symptoms indicate GvHD rather than DRESS?

A
  • face involvement
  • acral involvement
  • diarrhoea
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16
Q

What is pruritis?

A
  • itching with no rash
  • suggests internal cause
17
Q

What can chronic skin scratching from pruritis lead to?

A

Nodular prurigo

18
Q

What is carcinoid syndrome?

A

signifies metastasis of a malignant carcinoid tumour

19
Q

What are the symptoms of carcinoid syndrome?

A
  • seretonin secretion
  • flushing (25% of cases)
  • diarrhoea
  • bronchospasm
  • hypotension
20
Q

What is SJS/TEN?

A
  • Stevens-Johnson syndrome/ toxic epidermal necrolysis
  • dermatological emergency
21
Q

What differentiates SJS and TEN?

A
  • SJS = < 10% epidermal detachment
  • TEN = > 30% epidermal detachment
  • SJS/TEN = 10-30% epidermal detachment
22
Q

What causes SJS/TEN?

A
  • cell-mediated cytotoxic reaction against epidermal cells
  • mostly caused by drugs (antibiotics and anti-epileptics)
23
Q

What is the disease progression of SJS/TEN?

A
  1. flu-like symptoms
  2. abrupt onset of lesion on trunk, then face and limbs
  3. macules, blisters and erythma
  4. blisters merge causing sheets of skin detachment
  5. extensive full thickness epidermal necrosis in less than 2-3 days
24
Q

What is erythroderma?

A

generalised erythma affecting > 90% of the body surface area

25
Q

What are the causes of erythroderma?

A
  • drug reactions
  • cutaneous T cell lymphoma
  • psoriasis
  • atopic eczema
  • idiopathic
26
Q

What are the systemic manifestations of erythroderma?

A
  • peripheral edema
  • tachycardia
  • loss of fluids and proteins
  • disturbed thermoregulation
  • sepsis

BRS YR2 (67 decks)

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