skin signs of systemic disease

Question 1

in chronic renal failure the muddy hue i due to the

Answer 1

accumulation of the
carotenoid and nitrogenous pigments (urochromes)
in the dermis

Question 2

occurs in states that produce low

arterial oxygen saturation

Answer 2

central cyanosis

Question 3

develops when there is
normal arterial oxygen saturation but reduced blood
flow,

Answer 3

peripheral cyanosis

Question 4

in secondary polycythemia there may be presence of

Answer 4

nail clubbing

Question 5

melanosis is primarily seen n

Answer 5

primary biliary cirrhosis

Question 6

Metallic gray or bronze-brown discoloration
Accentuated in sun exposed and traumatized skin,
occasionally there is buccal and conjunctival
pigmentation

Answer 6

Hemochromatosis

Question 7

Vitamin B3 deficiency

Answer 7

pellagra

Question 8

4Ds in pellagra

Answer 8

dermatitis, dementia, diarrhea, death

Question 9

Casal’s necklace is a feature of

Answer 9

pellagra (niacin deficiency)

Question 10

jaundic is most prominent in

Answer 10

xtra-hepatic

biliary obstruction and PBC

Question 11

cholestatic pruritus is due to

Answer 11

retained cutaneous bile acids

Question 12

management of cholestatic pruritus

Answer 12

oral nalmefene/

IV or oral naloxone for short term efficacy

Question 13

Hyperpigmentation of the skin (brown-black) seen
usually on skin folds such as neck, axilla and groins
 Manifested by diabetic and obese patient

Answer 13

acanthosis nigricans

Question 14

Metastases at the umbilicus

Answer 14

Sister mary joseph nodule

Question 15

cancer associated with MIGRATORY SUPERFICIAL THROMBOPHLEBITIS

Answer 15

pancreatic cancer

Question 16

Nails are normal in their distal 50% (red/pink/brown) and

white in the proximal 50%, with sharp demarcations

Answer 16

LINDSEY OR HALF-AND-HALF NAILS

Question 17

Are characteristic of cirrhosis
• The so-called watch-glass deformity may accompany
white nails.

Answer 17

TERRY’S WHITE NAILS

Question 18

In hepatolenticular degeneration (Wilson’s disease)

• bluish discoloration of the lunular portion of nails

Answer 18

AZURE LUNULE

Question 19

Clubbing is common in all forms of cirrhosis, especially

Answer 19

PBC and chronic active hepa

Question 20

most
representative and classic vascular lesion of chronic
liver disease

Answer 20

SPIDER NEVUS

Question 21

lipid deposits localized on the eyes

Answer 21

Xanthelasma

Question 22

most common manifestation of subacute bacterial endocarditis

Answer 22

petechiae

Question 23

conjunctival petechiae

Answer 23

Roth’s spots-

Question 24

Erythematous or hemorrhagic papules, macules or
nodules
Painful, tender and located distally on the digital
units

Answer 24

Osler’s nodes:

Question 25

non-tender, located proximally on the palms and

soles

Answer 25

Janeway lesions

Question 26

Hyperkeratotic papules with central, crust-filled crater on

the trunk and extensor surface often in linear pattern

Answer 26

ACQUIRED PERFORATING DERMATOSES

Question 27

Tightness and thickening of the skin and periarticular
connective tissue of the fingers, resulting in a painless
loss of joint mobility

Answer 27

DIABETIC LIMITED JOINT MOBILITY

CHEIROARTHROPATHY

Question 28

Painless, symmetric induration and thickening of the

skin on the upper back and neck

Answer 28

SCLERODERMA DIABETICORUM

Question 29

pathogenesis of scleredema diabeticorum

Answer 29

unregulated production of ECM mol by fibroblasts w/c leads to thick collagen bundles and deposition of GAGS

Question 30

1- to 4-mm, reddish-yellow papules on the buttocks and
extensor surfaces of the extremities
• There is often underlying severe hypertriglyceridemia

Answer 30

ERUPTIVE XANTHOMAS

Question 31

Sharply demarcated yellow-brown plaques on the

anterior pretibial area

Answer 31

NECROBIOSIS LIPOIDICA

Question 32

Small (<1cm), atrophic, pink to brown, scar-like macules

on the pretibial areas

Answer 32

DIABETIC DERMOPATHY

Question 33

Pruritic, keratotic papules on the extensor surfaces of

the extremities

Answer 33

ACQUIRED PERFORATING DISORDERS

Question 34

Abrupt, spontaneous blisters on the lower extremities

• painless and non-pruritic

Answer 34

BULLOSIS DIABETICORUM

Question 35

classic manifestation of hyperthyroidism and

Grave’s disease

Answer 35

pretibial myxedema/ pretibial thyroid dermopathy

Question 36

Concave shape with distal onycholysis

Answer 36

• Plummer’s nails

Question 37

Digital clubbing, soft-tissue of the hands and feet,

presence of characteristic periosteal reactions

Answer 37

Thyroid acropachy

Question 38

cutaneous manifestations of hypothyroidism

Answer 38

myxedema

carotenemia

Question 39

most classic finding associated with hypothyroidism

Answer 39

Myxedema

Question 40

myxedema is due to

Answer 40

dermal accumulation of
mucopolysaccharides, namely, hyaluronic acid and
chondroitin sulfate.

Question 41

Excessive production of endogenous cortisol

Answer 41

cushing’s syndrom

Question 42

in cushing’s the pituitary secretes what in excess

Answer 42

corticotropin or excess production of cortisol

Question 43

moon facies is associated with

Answer 43

cushing’s

Question 44

Destruction of the adrenal glands and the resulting lifethreatening
deficiency of glucocorticoids,
mineralocorticoids, and adrenal androgens

Answer 44

addison’s disease

Question 45

why is there longitudinal pigmented bands in the nails of a person with addison’s

Answer 45

it is a consewuence of low cortisol levels and the resulting loss of negative feedback on the hypothalamus and pituitary

Question 46

why is there decreased axillary and pubic hair in women and not in men

Answer 46

it is due to the loss of adrenal androgens it doesn’t occur in men because adequate androgen levels
are maintained by the testes

Question 47

addison’s disease presentation in men

Answer 47

Calcification of auricular cartilages