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Dermatology > Skin + Systemic Disease > Flashcards

Skin + Systemic Disease Flashcards

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Dermatology Board Prep flashcards
1
Q

What is carcinoid syndrome

A 
Facial telengiectasis
Flushing
Diarrhoea 
N+V
No sweating
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2
Q

What does carcinoid syndrome indicate

A

GI cancer with liver mets
Bronchial
Ovarian Ca

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3
Q

What does Ectopic ACTH do

A

Release of melanin

Hyperpigmentation of skin, gums and greases

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4
Q

How does Paraneoplastic pemphigus present

A

Erosive stomatitis
Ulceration of mouth and lips
Rash

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5
Q

What is associated with it

A

Non-Hodgkin’s

Castleman’s disease

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6
Q

What is erythema Graytum Repens

A

Parenoplastic erythematous lesion
Look at pics
Associated with malignancy particularly lung

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7
Q

What is acquired hypertrichosis

A

Androgen indedendent hair growth

Acute onset of lanugo hairs at face and body

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8
Q

What causes

A

Colorectal cancer
Lung and breast
Drugs
Anoreixa

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9
Q

What is Bazex syndrom

A

Hyperkeratosis of extremeties

Can look like psoriasis so biopsy

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10
Q

What underlies Bazex syndrome

A

SCC

Gastric / colon / biliary adenocarcinoma

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11
Q

What is Aconthosis Nigrican’s

A

Symmetrical brown, velvet plaques
Often neck, axilla or groin
Hyperkeratosis
Hyperpigmentation

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12
Q

What is associated with aconthosis nigrican’s

A

Insulin resistance = benign

  • Type II DM
  • Obesity
  • PCOS
  • Acromegaly / Cushing / hypothyroid
  • Prader-Willi
  • OCP

Malignancy
- GI adenocarcinoma

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13
Q

What is concerning

A

Lip involvement

Weight loss

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14
Q

What should you look for if dermatomyositis and how

A 
Underlying malignancy in 30% 
Muscle and skin biopsy 
CK
Ab - ANA / ANti-Jo1 
Age / gender cancer screen and follow up 5 years 
- Smear
- PSA
- Colonoscopy
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15
Q

How does it present

A 
Inflammatory myopathy
Shawl sign - photosensitivity / violet discolouration on sun exposed area 
Helitrope Rash - violet around eye 
Telangiectasia
Gottron's papules on knuckles 
Scalp erythema
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16
Q

What is Sweets Syndrome

A

Juicy nodules limited to neck and UL

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17
Q

What can cause

A

Post infection
Medication
Tumour

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18
Q

What is acquired ichthyosis

A

Dry rough skin with scaling

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19
Q

What can cause

A 
Congenital
Lymphoproliferaive disorder 
Autoimmune
Nutritional deficiency 
Tumours
Medication
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20
Q

Genetic tumour syndromes

A

See genetics

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21
Q

What is hereditary haemorrhagic telangiectasia and what system related too

A

AD
GI
Telangiectasia over skin and mucous membrane

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22
Q

What is criteria

A

Epistaxis
Telangiectasis of lips / oral cavity / nose
Visceral lesions
FH

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23
Q

What visceral lesions

A

Hepatic, cerebral or spina AVN
GI telangiectasia with or without bleeding
Risk of haemorrhage

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24
Q

What is needed for Dx

A 
2+ = possible 
3+ = definite
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25
Q

What is erythema nodosum

A

Hypersensitivity reaction leading to inflammation of SC fat
Usually over shins
NOT bruises
Painful, blue red raised nodular lesion

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26
Q

How do you Dx and how long to resolve

A

6 weeks
Rest and analgesia
Steroid to reduce inflammation
Arrange follow up

Dx = clinical 
Depends on cause 
Biopsy 
CRP and ESR
Throat swab for strep
Stool MC+S
Faecal calprotectin
CXR to exclude sarcoid / malignancy / pneumonia
Serum ACE
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27
Q

What causes

A

Granulomatous condition - IBD / Sarcoid / TB / fungal (macrophage around insult)
Drugs - penicillin / COCP / NSAID
Infection - strep / TB / gastroenteritis
Malignancy
Pregnancy

Pneumonic
NO - idiopathic
D - drugs - penicillin / COCP 
O - OCP / pregnancy 
S - sarcoid / TB 
U - UC / Chron's / Bechet's 
M - strep / Mycoplasma / EBV

MOST COMMON SARCOID / IBD IN EXAM

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28
Q

What causes pyoderma gangrenosum

A 
IBD
Autoimmune hepatitis
PBC
Granulomatosis with polyangiitis
Myeloma 
Myeloproliferative
RA / SLE
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29
Q

How does pyoderma gangreonsum present

A 
Initially small red papule
Develop pustular ulcers
Tender red / blue
Overhanging necrotic edge
Purulent surface 
System fever / myalgia
LL
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30
Q

How do you Rx

A

Oral steroid + ciclosporin = 1st line

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31
Q

What kind of skin disease does Chron’s have

A

Orofacial granulmatosis - lip swelling, fissures, ulcers
Erythema nodosum
Pyoderma gangrenous

32
Q

What is another shin lesion relating to Graves’

A

Pretibilal myxoedema
Symmetrical erythematous lesions above lateral malleoli
Oedema
Shiny orange peel skin

33
Q

What skin disease associated with rheumatic fever

A

Erythema marginatum
Pink coalescent rings on trunk
Come and go

34
Q

What is coeliac associated with

A

Dermatitis herpetiform

35
Q

What is dermatitis herpetiform and what leads to this

A

Autoimmune blistering skin condition due to deposition of IgA in dermis
Itchy vesicles on extensor surfaces in clusters
Cal appear like chicken pox
Systemically well

36
Q

How do you Dx

A

Biopsy
Immunoflourescene showing IgA
Coeliac serology - anti-TTG

37
Q

How do you Rx

A

Dapsone = Ax and anti-inflammatory
Emollient
Topical steroid
Gluten free diet

38
Q

What skin manifestations of liver disease

A 
Palmar erythema
Spider naevi
Gynaecomastia
Decreased pubic hair
Bruising
Scratch marks
39
Q

What skin manifestation of malabsorption

A

Dry pigmented skin
Bruising
Hair loss

40
Q

What skin conditions associated with underlying malignancy

A

Acanothosis nigrican
Dermatomyositis
Thrombophlebitis
Mets in skin

41
Q

What can DM cause

A 
Acanthosis nigrican
Diabetic bullae
Eruptive xanthoma due to hyperlipid
Diabetic dermopathy
Carotenemia
Acral erythema
Disseminated granuloma
42
Q

What is disseminated granuloma

A

Papular lesion
Hyperpigemnted
Dorsal surface of hands, feet and extensors of arms and legs

43
Q

Who is at risk of vitamin deficiency

A

Elderly
Alcohol
Eating disorder
Isoniazid therapy - B3

44
Q

What vitamin important for skin and what happens if deficienct

A

Vit A

Hyperkeratosis

45
Q

What are the 5D’s of niacin (B3) deficiency ‘pellagra’ and where does it affect

A 
Neck region + photosensitive areas
Dermatitis
Dementia
Diarrhoea
Depression
Death
46
Q

What is scurvy

A

Lack of vitamin C

47
Q

What can scurvy cause

A 
Bruising
Gum infection
Hair loss
Fatigue 
Weakness 
GI haemorrhage
48
Q

What is alopecia acreata

A

Autoimmune condition causing localised, well demarcated patterns of hair loss
May have small broken exclamation marks at edge of hair loss

49
Q

Can it grow back

A

Yes

50
Q

What are DDX

A 
Scarring alopecia
Androgenic alopecia
PCOS
Stress
Hypothyroid
51
Q

What is scarring

A

Attack of follicle = fibrosis

Will not grow back

52
Q

What is androgenic linked to

A

Autoimmune thyroid

Pernicious anaemia

53
Q

How do you investigate

A

FBC, ferritin, thyroid if generalised hair loss

Ask about menstrual if suspect PCOS

54
Q

How do you Rx

A

Topical steroid
Phototherapy
Immunotherapy
Wigs

55
Q

What is vitiligo

A 
Autoimmune condition resulting in loss of melanocytes and depigmentation 
Causes white patches
Well demarcated
Hyperpigmented
Sunlight = itch
Koebner +Ve
56
Q

What is associated

A 
Type 1 DM
Addison
Autoimmune thyroid
Pernicious anaemia
Alopecia acreata
Premature ovarian failure
57
Q

How do you Rx

A

Suncream
Camoflauge make up
Topical corticosteroids can reverse

58
Q

If patients presents with nail ridging what should you do

A

Routine bloods

Can be a sign of a more serious underlying problem / anaemia

59
Q

What is Peutz Jegher

A

AD
Haemartous polyp
Pigmented macule around lips, face, palms, soles
Can cause obstruction / intusscetpion / GI bleed

60
Q

What can it be a sign of

A

COlon cancer

61
Q

What are Muir Torre

A

Facial bumps

62
Q

What do you do

A

Biopsy to see if sebaceous tumour

63
Q

If lots

A

Risk of GI and breast cancer

64
Q

What is Xeroderma pigmentosum

A

Genetic inability to repair sun damage

65
Q

What can be underlying

A

Sarcoma
Leukaemia
GI
Lung

66
Q

What is Howel exams

A

Palmar keratoderma

67
Q

What is underlying

A

Usually oesophageal cancer

68
Q

What is Kaposi Sarcoma

A

Vascular malignancy driven by HHV-8

69
Q

How does it present

A

Mucosal and cutaneous purple tumour

Can be visceral

70
Q

Who is affected

A

Immunocompromised

71
Q

How do you investigate

A

HIV test for all

Biopsy as could be bacillary angiomatosis (bacteria)

72
Q

How do you Rx

A

ART
Lower dose immunosuppressoin
Direct removal

73
Q

What is migratory thrombophlebitis

A

Palpable nodular cord
Pain and induration along superficial vein
Can have previous episodes

74
Q

What causes

A

Clots leading to inflammation
Often underlying malignancy
Typically pancreatic

75
Q

How do. you investigate

A

USS / CT for pancreatic

Dermatology (12 decks)

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