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Disease and Defense III > Skin Signs of Systemic disease :) > Flashcards

Skin Signs of Systemic disease :) Flashcards

1
Q

Rash / fever / headache… think?

A

Ticks

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2
Q

Seborrheic dermatitis (in adults)

A

a more severe form of common dandruff that can affect the scalp, face, and upper torso

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3
Q

seborrheic dermatitis is seen in

A 
mainly neurological conditions
parkinson's
after head trauma
HIV 
PTSD
chronic neurological conditions such as cerebral palsy
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4
Q

Acanthosis Nigricans

A

Velvety neck

Soft dark areas in skin folds, hands, and neck

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5
Q

When you see acanthosis nigricans, what should you be thinking?

A

Obesity
diabetes mellitus
metabolic syndrome

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6
Q

Acanthosis Nigricans frequently is associated wtih endocrinopathies (3)

A

Cushing’s (Excess cortisol)
PCOS
total lipodystrophy

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7
Q

Acanthosis Nigricans is rarely associated with drugs, but can be associated with –> (2)

A

Nicotinic acid

systemic steroids

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8
Q

Acanthosis nigricans and cancer?

A

Not the majority

- But may precede 18%, accompany (60%) or follow (22%) the onset of internal cancer

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9
Q

Acanthosis nigricans associated cancer?

A

adenocarcinoma of the stomach (60%), lung and breast cancer, and less often other types of cancer

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10
Q

Acanthosis nigricans and cancer red flag?

A

rapid onset of an associated weight loss

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11
Q

Diabetes and skin

What do we frequently see?

A

Rash on shins - Necrobiosis lipoidica
Disseminated granuloma anular
Ulcerations

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12
Q

Infective endocarditis dermatologic findings?

A

Splineter hemorrhages in hails
Janeway lesions
Osler nodes
Roth spots - in eyes

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13
Q

what are janeway lesions

A

non-tender, small erythematous or haemorrhagic macular or nodular lesions on the palms or soles only a few millimeters in diameter - acute endocarditis due to septic emboli

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14
Q

what are osler nodes

A

Osler nodes are red-purple, slightly raised, tender lumps, often with a pale centre. Pain often precedes the development of the visible lesion by up to 24 hours. They are typically found on the fingers and/or toes. They can occur at any time during the course of endocarditis (usually subacute) and last from hours to several day

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15
Q

Roth spots

A

retinal hemorrhages with white or pale centers.

sign of endocarditis

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16
Q

Strep viridians from teeth can cause?

A

If they are introduced into the bloodstream, they have the potential of causing endocarditis, in particular in individuals with damaged heart valves. They are the most common causes of subacute bacterial endocarditis.

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17
Q

Ehlers Danlos and CV?

A

Skin findings include increased joint and skin elasticity - poor wound healing and incrased ecchymoses - some types are at risk for aortic valve disease

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18
Q

Phaces syndrome derm finding?

worry about?

A

Large hemangioma on face and neck

Worry about cardiac findings such as aortic coarctation, atrial and ventricular septal defects and abnormal cervical and vertebral arteries

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19
Q

Systemic scleroderma skin findings

A

thickened skin over finger and hands
skin tightening around mouth
Raynauds
Esophageal and GI dysmotility and strictures

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20
Q

Systemic scleroderma internal concerns/

A

commonly develop pulmonary hypertension with bad prognosis

pericarditis has poorest prognosis

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21
Q

Systemic scleroderma and ANA?

A

Autoimmune: ANA + 80-90% anticentromere ab in limited, anti-scl70 in systemic

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22
Q

What is sarcoidosis

A

disease involving abnormal collections of inflammatory cells (granulomas) that can form as nodules in multiple organs.[1] The granulomas are most often located in the lungs or its associated lymph nodes, but any organ can be affected.

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23
Q

Sarcoidosis skin findings

A

Walled of granulomas that look like infection response but are not

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24
Q

What is lichen planus?

A

disease of the skin and/or mucous membranes that resembles lichen. The cause is unknown, but it is thought to be the result of an autoimmune process with an unknown initial trigger

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25
Q

How does lichen planus present?

A

purple, polygonal, pruritic papules
Wickman’s striae - an overlying lace pattern of white lines on the surface
mucosal findings may occur without skin findings in 15-25%
nail involvement occurs in 10% and may be the only site of involvement

26
Q

What systemic disease is associated wtih lichen planus?

A

HepCV

27
Q

What is porhyria Cutanea Tarda?

A

Little white blisters - usually on the hand // face

28
Q

What is porhyria cutanea tarda associated with?

A

hepatitis

29
Q

What causes porhyria cutanea tarda?

A

deficiency in uroporhyrinogen decarboxylase

30
Q

How do we treat prohyria cutanea tarda?

A

serial phlebotomy to decrease iron load

31
Q

Osler-weber rendu

A

Osler-Weber-Rendu disease (OWRD) is a rare autosomal dominant disorder that affects blood vessels throughout the body (causing vascular dysplasia) and results in a tendency for bleeding. (The condition is also known as hereditary hemorrhagic telangiectasia [HHT]; the two terms are used interchangeably in this article.) The prognosis varies, depending on the severity of symptoms; generally, it is good, as long as bleeding is promptly recognized and adequately controlled

WORRY ABOUT INTERNAL VASCULATURE TOO - LUNGS

32
Q

Pyoderma Gangranosum -

A

neutrophils attack skin - initial lesion is often a pustule on an erythematous base or an erythematous nodule - often begins in sites of minor trauma

33
Q

Pyoderma Gangranosum - characteristic lesion?

A

ulcer with a necrotic, undermined border

34
Q

Pyoderma Gangranosum location?

A

usually lower extremities

35
Q

Pyoderma Gangranosum assoicated underlying conditions?

A

IBD
UC / Crohns

Arthritis
- RA (seronegative)

Monoclonal gammopathy (IgA)

Other hematologic disorders
- Leukemia?

36
Q

What do you want to avoid in pyoderma gangranosum?

A

surgery and debridement - only makes worse :(

37
Q

Cullen’s sign?

A

is superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus.
This sign takes 24–48 hours to appear and can predict acute pancreatitis, with mortality rising from 8–10% to 40%. It may be accompanied by Grey Turner’s sign[3] (bruising of the flank), which may then be indicative of pancreatic necrosis with retroperitoneal or intraabdominal bleeding.

38
Q

Grey Turner sign

A

refers to bruising of the flanks, the part of the body between the last rib and the top of the hip. The bruising appears as a blue discoloration,[1] and is a sign of retroperitoneal hemorrhage, or bleeding behind the peritoneum, which is a lining of the abdominal cavity. Grey Turner’s sign takes 24–48 hours to develop, and can predict a severe attack of acute pancreatitis.[2]

39
Q

Koilonychia

A

spoon nails–is a nail disease that can be a sign of hypochromic anemia, especially iron-deficiency anemia

40
Q

Hair loss is often due to ?

A

Iron deficiency can be one of top reasons for alopecia (hair loss) in pre-menopausal woman

41
Q

Lindsay nails

A

proximal portion of the nail white and the distal half red, pink, or brown, with a sharp line of demarcation between the two halves
May indicate renal issues

42
Q

Terry’s nails

A

fingernails or toenails appear white with a characteristic “ground glass” appearance, with no lunula.
sign of cirrhosis / CHF

43
Q

4 skin/surface findings of lupus?

A

malar rash (butterfly)
discoid rash
oral ulcers
photosensitivity

44
Q

3 skin signs of malignancy

A

erythema gyratum repens
hypertichosis lanuginosa acquisita
tripe palms

45
Q

erythema gyratum repens

A

figurate erythema that is believed to be a paraneoplastic process.[1, 2, 3, 4] In addition to other features, characteristic concentric erythematous bands forming a wood-grain appearance help distinguish erythema gyratum repens from other figurate erythemas, such as erythema annulare centrifugum, erythema migrans, and erythema marginatum.[5]

46
Q

Hypertrichosis lanuginosa acquisita

A

characterised by the rapid growth of long, fine, lanugo-type (i.e.: fetal) hair particularly around the eyebrows, forehead, ears and nose. It is similar to congenital hypertrichosis lanuginosa (see hypertrichosis) except that it appears later on in adulthood and in most cases associated with an underlying cancer.

47
Q

Tripe palms

A

Tripe palms are characterised by thickened velvety palms that have the appearance of tripe, the stomach lining of beef, pork, or sheep. Approximately 90% of cases of tripe palms are associated with internal malignancy

48
Q

Lesser Trellat sign

A

explosive onset of multiple seborrheic keratoses[1] (many pigmented skin lesions),[2][3] often with an inflammatory base. This can be an ominous sign of internal malignancy as part of a paraneoplastic syndrome.

49
Q

Dematomyositis

A

Many cases of dermatomyositis are a paraneoplastic phenomenon, indicating the presence of cancer
inflammation of the skin and underlying muscle tissue, involving degeneration of collagen, discoloration, and swelling, typically occurring as an autoimmune condition or associated with internal cancer.

50
Q

Sister mary joseph node

A

palpable nodule bulging into the umbilicus as a result of metastasis of a malignant cancer in the pelvis or abdomen.

51
Q

Cancers that like to fuck (mets) with the face?

A

renal
lung
breast

52
Q

You can get big shiny plum looking thing on head/legs or big juicy pustules on hand / face accompanied with fever (Sweet syndrome)?

A

Underlying heme malignancy

53
Q

Blistering lesions with skin coming off - you can create autoantibodies in malignancy as well?

A

leukemia and lymphoma most common

54
Q

In general drug rashes should manifest on ….

A

the trunk - if it is not on the trunk it is likely not a generalized drug rash

55
Q

targetoid lesions - erythema multiforme –> often due to

A

herpes

drugs

56
Q

most hives are less than 6 weeks / after a cold - (urticaria) how long should you wait to work up hives?
how should you treat

A

6 weeks

antihistamines

57
Q

big painful nodules on shins/ lower legs?

A

erythema nodosum? - can be infection - sometime see with TB and pregnancy

58
Q

Red -

A

inflammation infection

59
Q

yeloow

A

liver

60
Q

blue / grey

A

silver ingestion

61
Q

sallow - not pale or jaundice but antique white

A

usually renal

62
Q

geometric usually due to

A

foreign body

Disease and Defense III (11 decks)

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