Skin signs of systemic disease Flashcards
Bacterial endocarditis
What part of the heart is infected?
What is an Osler node? Where are they typically found?
What is a Janeyway lesion? Where do they occur
- An infection of the inner lining of your heart (endocardium)
- Occurs when bacteria spreads through your bloodstream and attach to areas in your heart
Findings:
Osler nodes
Red-purple, slightly raised, tender papules, often with a pale center.
Pain often precedes the development of the visible lesion by up to 24 hours.
They are typically found on the fingers and/or toes.
Janeway lesions
Non-tender, often hemorrhagic and occur mostly on the palms and soles including the thenar and hypothenar eminences (at the base of the thumb and little finger respectively).
Last days to weeks before healing totally.
Seen in acute endocarditis.
Bacterial endocarditis
What can you see in the nails?
Cutaneous Sarcoidosis
Is this a local or systemic disease?
A characteristic sign is Eryhema nodosum, what is it and where is it mostly present?
Lupus pernio? Present in where?
- A multisystem granulomatous disease
- This means there are scattered collections of mixed inflammatory cells (granulomas) affecting many different parts of the body.
Most common organs affected include the lungs, lymph nodes, eyes and skin.
–>Erythema nodosum (EN): tender, 1-2 cm nodules mostly on the shins;
–>Lupus pernio: Deep red and purple infiltrated smooth plaques on nose, cheeks, and ears.
Digital clubbing
It is associated with diseases of the _____ and ______. It can be acquired or congenital.
What causes it?
What are some examples of respiratory diseases that clubbing is associated with?
A deformity of the finger or toe nails associated with a number of diseases, mostly of the heart and lungs.
- Clubbing can be acquired or congenital.
- Clubbing is caused by enlargement of the soft tissue of the distal digit. The nail plate is enlarged and excessively curved, with a greater than 180° widening of the angle between the proximal nail fold and the nail plate. Pressure on the tissue proximal to the cuticle gives a spongy feeling in a clubbed finger.
Digital clubbing is often associated with respiratory diseases: —Bronchiectasis (destruction and widening of the large airways); chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis; pulmonary fibrosis (scarring of the lungs), Cystic Fibrosis, and lung cancer.
What is lupus erythematous?
Lupus erythematosus is a chronic inflammatory disease that occurs when your body’s immune system attacks your own tissues and organs. Lupus erythematosus commonly attacks the skin.
Cutaneous Lupus Erythematosus
The most common presentation is ________ and results in red scalling plaques on light-exposed areas specially the _____ and _____.
What is subacute cutaenous LE?
Characterized by what?
It can occur in?
What are the complications of neonatal LE?
Discoid LE is the most common presentation and results in red scaling plaques on light-exposed areas especially the face and scalp.
-The plaques heal with scarring**.
Subacute cutaneous LE is characterized by *more widespread photosensitive annular scaly plaques. This type of LE may occur in the mothers of babies with neonatal LE (or they may appear healthy).
–They resolve without scarring.
Neonatal lupus can have heart block 50% of the time, even in asymptomatic mothers. You can save a life if you note erythematous annular lesions, note maternal history and order an EKG.
Examples of discoid LE:
Examples of discoid LE:
In systemic lupus Erithematosus:
What 4 criteria can be diagnosed with skin exam?
Malar rash
Discoid rash
Oral ulcers
photosensitivity
Dermatomyositis
What causes?
What is amyophatic dermatomyositis? How is it different that dermatomyositis itself?
Dermatomyositis causes chronic muscle inflammation accompanied by muscle weakness.
Symptoms typically include a skin rash and worsening muscle weakness over time.
Can be associated with malignancy, especially in those over 55 years of age
It often presents with muscle weakness, elevated muscle enzymes and a rash affecting the face, chest, arms and hands.
There is a skin only variant called amyopathic dermatomyositis. In this case, there is a skin rash without muscle inflammation or weakness.
Heliotrope rash in dermatomyositis
It is a violaceous patches of the eyelids, often associated with edema (swelling).
Gottron’s papules in dermatomyositis
Gottron’s papules: violaceous plaques over the knuckles
Skin erythematous to violaces patches and plaques on upper torso are called______ sign, and in lateral thighs is calles _____ sign.
Skin findings also include erythematous to violaceous patches and plaques on upper torso (shawl sign) and lateral thighs (holster sign), erythema/dryness/fissuring of palms, ragged cuticles
Important because can be associated with pulmonary fibrosis and genitourinary cancer, especially in women with rapid onset of severe symptoms
