Systemic Disease Flashcards
What is erythema multiforme? Features?
Hypersensitivity reaction which is most commonly triggered by infections. (mostly herpes simplex)
Target lesions
Initially seen on back of hands and feet before spreading to the those
Minimal mucosal involvement in mild disease
Pruritus is mild
What can cause erythema multiforme?
HSV IDiopathic Bacteria: mycoplasma Drugs: penicillin, sulphonamides, allopurinol, carbamazepine CT disease - SLE Sarcoidosis Malignancy
What is erythema multiforme major?
More severe form with mucosa involvement and systemic upset, fever.
What is management of erythema multiforme?
No treatment in most
Potent topical steroid may relieve rash discomfort
Emolient
If needed treat the cause
What are erythema nodosum features?
Inflammation of subcutaneous fat Tender, eryhematous, nodular lesions Over shins usually Usually resolves within 6 weeks Lesions heal without scarring
What are causes of erythema nodosum?
Infection: streptococci, TB, brucellosis Sarcoidosis IBD, Behcet's Malignancy, lymphoma Penicillin Sulphonamides COCP Pregnancy
What is pyoderma gangrenosum?
Typically on lower limbs
Initially small red papule
Later deep, red, necrotic ulcers with a purple border
May be accompanied by systemic symptoms
What are causes of pyoderma gangrenosum?
Idiopathic IBD - UC/Crohn's RA SLE Myeloproliferative disorders Lymphoma Myeloid leukaemias PBC
What is management for pyoderma gangrenosum?
Oral steroids first line
Ciclorpoin or other immunosuppressants
What is dermatitis herpetiformis? Features, Dx, Mx? Which antibody is positive?
Rash that presents with Coeliacs disease
Very itchy/burning blisters on the elbows, scalp, shoulder, ankle, buttocks
IgA deposition in the dermis
Skin biopsy
Mx:
Gluten free diet
Dapsone
Anti-tissue transglutaminase antibody positive test
What is acanthuses nigricans? Causes?
Symmetrical brown, velvety, plaques that often found on the neck, axilla and groin
Gastrointestinal adenocarcinoma DM Obesity Polycystic Ovary syndorme Acromegaly Cushing's disease Hypothyroidism Familial Prader-Willi OCP Nicotinic acid
What skin signs are seen in lupus?
Facial butterfly rash
Photosensitvity of the face, dorsal, hands, V of neck
Diffuse allopecia
Cutaneous lupus erythematosus
What are spider naevi? How can they be differentiated from telangiectasia? What are they associated with?
Central red papule with surrounding capillaries
Blanch upon pressure
Usually upper body
Spider naevi fill from the centre when blanched
Telangiectasia fill from the edge
Liver disease
Pregnancy
COCP
Why is erythema migraines?
Papule becomes a spreading red ring lasting weeks to months
Lyme disease - tick bite
Doxycycline
What are signs of cutaneous vasculitis? Causes?
Palpable purpua e.g. on legs
Nodules
Painful ulcers
Livedo reticularis
Idiopathic
Systemic vasculitis e.g. polyarteritis nodosa, HSP, granulomatosis with polyangitis
