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Week A10 - Dermatology > Skin & Systemic Diseases > Flashcards

Skin & Systemic Diseases Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the typical skin changes that occur in thyroid disease? [3]

A
  1. Dry skin (hypothyroidism)
  2. Thyroid dermopathy/Pretibial myxedema (Grave’s disease)
  3. Thyroid acropachy (Grave’s disease)
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2
Q

What are the typical skin changes that occur in diabetes? [8]

A
  1. Necrobiosis lipoidica
    • Usually yellow discolouration
    • Often shins
    • Occasionally ulcerates and scars
  2. Diabetic dermopathy
  3. Scleredema (not scleroderma)
  4. Leg ulcers
  5. Granuloma annulare
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3
Q

What are the typical skin changes that occur with excess steroids? [4]

A

(steroid excess = Cushing’s disease)

  1. Acne
  2. Striae
  3. Erythema
  4. Gynecomastia
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4
Q

What are the typical skin changes associated with steroid insufficiency? [2]

A
  1. Hyperpigmentation
  2. Acanthosis nigricans
    • brown to black, poorly defined, velvety hyperpigmentation of the skin
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5
Q

What are the typical skin changes associated with Cushing’s Syndrome? [5]

A

Excessive production of cortisol in the body leads to:

  1. Increased central adiposity
  2. Moon facies and buffalo hump
  3. Global skin atrophy, epidermal and dermal components
  4. Striae on abdominal flanks, arms, thighs
  5. Purpura with minor trauma - reduced connective tissue
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6
Q

What are the complications/typical skin changes of excess sex hormones?

  1. excess testosterone? [4]
  2. excess progesterone? [3]
A
  • Excess Testosterone
    1. Polycystic Ovarian Syndrome
    2. Testicular tumours
    3. Acne
    4. Hirsutism
  • Excess Progesterone
    1. Congenital adrenal hyperplasia
    2. Acne
    3. Dermatitis
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7
Q

Name the cutaneous signs that may indicate internal malignancy [6]

A
  1. Necrolytic migratory erythema
  2. Erythema gyratum repens
  3. Acanthosis nigricans
  4. Erythema annulare
  5. Sweet’s Syndrome
  6. Sister Mary Joseph Nodule
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8
Q

Describe the features of necrolytic migratory erythema under the following headings:

  1. also known as? [1]
  2. clinical presentation? [1]
  3. associated malignancy? [1]
  4. other signs? [4]
  5. treatment? [1]
A
  1. Rare disease, also known as glucagonoma syndrome
  2. Clinical presentation:
    • erythematous, scaly plaques on acral, intertriginous, and periorificial areas
  3. association with an islet cell tumour of the pancreas
  4. other signs:
    • hyperglycemia,
    • diarrhoea,
    • weight loss,
    • glossitis
  5. Treatment is removal of the tumour
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9
Q

Describe the features of erythema gyratum repens under the following headings:

  1. clinical presentation? [3]
  2. associated malignancies? [4]
  3. treatment? [1]
A
  1. Clinical Presentation?
    • reddened concentric bands whorled woodgrain pattern
    • severe pruritus
    • peripheral eosinophilia
  2. Associated malignancies:
    • Strong association with lung cancer
    • Association with breast, cervical, GI cancers less strong
  3. Treatment of the underlying malignancy treats skin disease
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10
Q

Describe the features of acanthosis nigricans under the following headings:

  1. what is it? [1]
  2. describe the 3 types: Type I [4]
  3. describe the 3 types: Type II [5]
  4. describe the 3 types: Type III [3]
A
  1. Smooth, velvet-like, hyperkeratotic plaques in intertriginous areas (e.g. groin, axillae, neck)
  2. Type I associated with malignancy
    • adenocarcinoma, especially of the gastrointestinal tract (60% gastric)
    • sudden onset and more extensive
  3. Type II familial type, autosomal dominant
    • very rare,
    • appears at birth,
    • no malignancy
  4. Type III associated with obesity and insulin resistance
    • most common type
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11
Q

What are the typical cutaneous changes associated with vitamin B deficiencies?

  1. B6? [1]
  2. B12? [1]
  3. B3? [4]
A
  1. B6 (i.e. pyridoxine) → dermatitis
  2. B12 (i.e. cobalamin) → angular cheilitis
  3. B3 (i.e. niacin) → pellagra → 3 D’s = dementia/dermatitis/diarrhoea
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12
Q

Describe the clinical features of zinc deficiency under the following headings:

  1. condition that causes zinc deficiency? [1]
  2. presentation? [3]
  3. causative mutation? [1]
  4. cause in infants? [1]
  5. causes in adults? [6]
  6. differential diagnosis? [2]
  7. treatment? [1]
A
  1. Acrodermatitis Enteropathica
  2. Presentation:
    • pustules,
    • bullae,
    • scaling (acral and perioral distribution)
  3. Mutation in SLC39A, which encodes an intestinal zinc transporter
  4. In infants:
    • deficiency can follow breast-feeding, when breast milk contains low levels of zinc
  5. In adults:
    • disease can occur after total parenteral nutrition without zinc
    • supplementation;
    • alcoholism
    • malabsorption states
    • inflammatory bowel disease
    • bowel surgery
  6. Differential diagnosis:
    • nutritional deficiencies,
    • necrolytic migratory erythema
  7. Treatment:
    • zinc supplementation
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13
Q

What are the typical cutaneous changes associated with scurvy, i.e. vitamin C deficiency? [7]

A
  1. Punctate purpura / bruising
  2. “Corkscrew” spiral curly hairs
  3. Patchy hyperpigmentation
  4. Dry skin
  5. Dry hair
  6. Non-healing wounds
  7. Inflamed gums
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14
Q

What are the typical cutaneous changes of erythema nodosum? [3]

A
  1. bilateral skin redness
  2. so painful nothing can touch it
  3. very tight and swollen skin
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15
Q

What are the causes of erythema nodosum? [7]

A
  1. Streptococcal infection
  2. Pregnancy/oral contraceptive pill
  3. Sarcoidosis
  4. Drug induced
  5. Bacterial/Viral infection
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16
Q

What are the typical cutaneous changes associated with pyoderma gangrenosum? [6]

A
  1. ulcerative lesion
  2. usually affecting the shins
  3. purple rim
  4. raised “cliff edge” - deep
  5. overhanging edge
  6. central area of ulceration
17
Q

What are the causes of pyoderma gangrenosum? [5]

A
  1. Inflammatory Bowel Disease
    • Crohn’s disease
    • Ulcerative colitis
  2. Rheumatoid arthritis
  3. Myeloma
18
Q

Describe the hair & nail changes associated with systemic disease [4]

A
  1. Alopecia areata hair loss (autoimmune)
  2. Hair thinning
  3. Male pattern balding → androgen excess
  4. Nail clubbing, nail fold telangiectasia
19
Q

What are the typical systemic causes of hair thinning? [4]

A
  1. B12 deficiency
  2. iron deficiency
  3. lupus
  4. hypothyroidism

Week A10 - Dermatology (9 decks)

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