Skin Manifestations of Systemic Disease Flashcards
Behcet’s disease etiology and related dermatoses
Autoimmune
Painful aphthous ulcers in oral cavity ± genital mucous membranes, erythema nodosum, acneiform papules
Buerger’s disease etiology and related dermatoses
Autoimmune
Superficial migratory thrombophlebitis, pallor, cyanosis, gangrene, ulcerations, digital resorptions
Dermatomyositis etiology and related dermatoses
Autoimmune
Periorbital and extensor violaceous erythema, heliotrope with edema, Gottron’s papules (violaceous flattopped papules with atrophy), periungual erythema, telangiectasia, calcinosis cutis
Polyarteritis nodosa etiology and related dermatoses
Autoimmune
Subcutaneous nodules, stellate purpura, erythema, gangrene, splinter hemorrhages, livedo reticularis, ulceration
Reactive arthritis etiology and related dermatoses
Autoimmune
Keratoderma blennorrhagica (on feet), balanitis circinata (on male penis)
Rheumatic fever etiology and related dermatoses
Petechiae, urticaria, erythema nodosum, rheumatic nodules, evanescent rash
Scleroderma etiology and related dermatoses
Autoimmune
Raynaud’s, nonpitting edema, waxy/shiny/tense atrophic skin (morphea), ulcers, cutaneous calcification, periungual telangiectasia, acrosclerosis, salt-and-pepper pigmentation
SLE etiology and related dermatoses
Autoimmune
Malar erythema, discoid rash (erythematous papules or plaques with keratotic scale, follicular plugging, atrophic scarring on face, hands, and arms), hemorrhagic bullae, palpable purpura, urticarial purpura, patchy/ diffuse alopecia, mucosal ulcers, photosensitivity
Crohn’s disease/UC etiology and related dermatoses
Autoimmune
Pyoderma gangrenosum, erythema nodosum, Sweet’s syndrome
Addison’s disease etiology and related dermatoses
endocrine
Generalized hyperpigmentation or limited to skin folds, buccal mucosa, and scars
Cushing’s syndrome etiology and related dermatoses
endocrine
Moon facies, purple striae, acne, hyperpigmentation, hirsutism, atrophic skin with telangiectasia
Diabetes mellitus etiology and related dermatoses
Endocrine
Infections (e.g. boils, carbuncles, Candidiasis, S. aureus, dermatophytoses, tinea pedis and cruris, infectious eczematoid dermatitis), pruritus, eruptive xanthomas, necrobiosis lipoidica diabeticorum, granuloma annulare, diabetic foot, diabetic bullae, acanthosis nigricans, calciphylaxis
Hyperthyroidism etiology and related dermatoses
Endocrine
Moist, warm skin, seborrhea, acne, nail atrophy, hyperpigmentation, toxic alopecia, pretibial myxedema, acropachy, onycholysis
Hypothyroidism etiology and related dermatoses
Endocrine
Cool, dry, scaly, thickened, hyperpigmented skin; toxic alopecia with dry, coarse hair, brittle nails, myxedema, loss of lateral 1/3 eyebrows
HIV-related Infections related dermatoses
Viral (e.g. HSV, HZV, HPV, CMV, molluscum contagiosum, oral hairy leukoplakia),
bacterial (impetigo, acneiform folliculitis, dental caries, cellulitis, bacillary epithelioid angiomatosis, syphilis),
fungal (candidiasis, histoplasmosis, cryptococcus, blastomycosis)
HIV-related Inflammaotry dermatoses
Seborrhea, psoriasis, pityriasis rosea, vasculitis
HIV-related Malignancies related dermatoses
Kaposi’s sarcoma, lymphoma, BCC, SCC, MM
Adenocarcinoma (GI and cervix/anus/rectum) related dermatoses
GI - Peu z-Jeghers: pigmented macules on lips/oral mucosa
Cervix/anus/rectum - Paget’s disease: eroding scaling plaques of perineum
Carcinoma (Breast, GI, thyroid, breast/lung/ovary) related dermatoses
Breast - Paget’s disease, eczematous and crusting lesions of the skin of the nipple and usually areola of the breast
GI - Palmoplantar keratoderma: thickened skin of palms/soles
Thyroid - Sipple’s syndrome: multiple mucosal neuromas
Breast/lung/ovary - Dermatomyositis: heliotrope erythema of eyelids and violaceous plaques over knuckles
Lymphoma/leukemia (Hodgkin’s, acute leukemia) related dermatoses
Hodgkin’s - Ataxia Telangiectasia: telangiectasia on pinna, bulbar conjunctiva
Acute leukemia - Ichthyosis: generalized scaling especially on extremities, Sweet’s syndrome Bloom’s syndrome: butterfly erythema on face, associated with short stature
Multiple myeloma related dermatoses
Amyloidosis: large, smooth tongue with waxy papules on eyelids, nasolabial folds and lips, as well as facial petechiae
Liver disease related dermatoses
Pruritus, hyperpigmentation, spider nevi, palmar erythema, white nails (Terry’s nails), porphyria cutanea tarda, xanthomas, hair loss, jaundice
Renal disease related dermatoses
Pruritus, pigmentation, half and half nails, perforating dermatosis, calciphylaxis
Pruritic urticarial papules and plaques of pregnancy related dermatoses
Erythematous papules or urticarial plaques in distribution of striae distensae: buttocks, thighs, upper inner arms and lower back
Cryoglobulinemia related dermatoses
Palpable purpura in cold-exposed areas, Raynaud’s, cold urticaria, acral hemorrhagic necrosis, bleeding disorders, associated with hepatitis C infection
Raynaud’s Phenomenon DDx
COLD HAND
Cryoglobulins/Cryofibrinogens
Obstruction/Occupational
Lupus erythematosus, other connective tissue disease
DM/Drugs
Hematologic problems (polycythemia, leukemia, etc) Arterial problems (atherosclerosis) Neurologic problems (vascular tone) Disease of unknown origin (idiopathic)
Acanthosis Nigricans description and associated conditions
An asymptomatic dark thickened velvety hyperpigmentation of flexural skin most commonly around the neck.
Associated with DM, obesity, and other endocrine disorders and malignancy. It is a cutaneous marker of tissue insulin resistance
