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Year 4: Dermatology > Systemic Disease > Flashcards

Systemic Disease Flashcards

1
Q

what is necrobiosis nigricans

A

shiny atrophic plaques on legs seen in type 1 diabetes

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2
Q

what are xanthomas due to

A

hyperlipidaemia - lipid laden macrophage ‘foam cells’ in the skin

  • seen in diabetes
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3
Q

velvety hyperpigmented patches commonly found in skin folds e.g. axillae

A

acanthosis nigricans

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4
Q

what metabolic condition causes acanthosis nigricans

A

diabets

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5
Q

what malignancy causes acanthosis nigricans

A

GI adenocarcinoma

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6
Q

red spot that blances on pressure + fills from centre

A

spider naevi

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7
Q

difference between spider naevi and telangectasia

A

spider naevi fill from centre

telangectasia fill from edge

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8
Q

what causes spider naevi

A

liver disease

oral contraceptive pill

pregnancy

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9
Q

what is addisons disease

A

autoimmune antibodies against adrenal cortex causing deficiency of glucocorticoids and mineralocorticoids

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10
Q

skin manifestations of addisons disease

A

skin hyperpigmentation

  • especiialy in sun exposed areas/skin creases/mucosa

palmar crease pigmentation

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11
Q

why is hyperpigmentation seen in addisons disease

A

reduced negative feedback of pituitary hormones – increased ACTH production

ACTH made from same precursor as melanocyte stimulating hormone

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12
Q

symmeytrical erythematous lesions on legs, shiny orange peel skin

A

Pretibial myoxedema

  • Grave’s disease
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13
Q

pathophysiolgy of pretibial myoxedema

A

hyaluronic acid deposition in dermis – pink colouration + thickening

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14
Q

skin manifestations of Grave’s disease

A

pretibial myoxedema

warm, flushed skin

Grave’s eye disease - driven by lymphocyte infiltration of connective tissue, hyaluronic acid deposition + lipogenesis

hair thinning

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15
Q

skin manifestations of hypothyroidism

A

brittle, course hair

dry skin

periorbital odema

facial puffiness

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16
Q

what is pellagra

A

Vitamin B3 deficiency

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17
Q

features of pellagra

A

3 D’s

  • Weeping Dermatitis
  • Dementia
  • Diarrhoea
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18
Q

what is scurvy

A

vitamin C deficiency

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19
Q

features of scurvy

A

bleeding gums

perifollicular haemorrhages

corkscrew hairs

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20
Q

itially red pustules/papules that coalesce to progress to necrotic ulcers with violaceous borders

characteristic of?

A

pyogerma gangrenosum

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21
Q

causes of pyogerma gangrenosum

A

IBD - UC/crohn’s

Myeloma

Acute myeloid leukaemia

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22
Q

treatment pyoderma gangrenosum

A

oral steroids

23
Q

acutely unwell + tender papules/plaques but no ulcers

characteristic of?

A

febrile neutrophilic dermatosis

(also known as sweet syndrome)

24
Q

what caues febrile neutrophilic dermatosis

A

IBD

pregnancy

URTI

gastroenteritis

25
Q

raised, red, tender nodules on shins

A

erythema nodosum

26
Q

where is the inflammation in erythema nodosum

A

panniculitis - inflammation of subcutaneous fat

27
Q

causes of erythema nodosum

A

SITS On legS

Strep infection

IBD

TB

Sarcoidosis

Oral contraceptive

Sulphonamides

28
Q

what is lupus erythematosus

A

autoimmune type 3 hypersensitivity disease that can have multi-system involvement

29
Q

what are the clinical varients of lupus

A
  1. chronic discoid lupus (CDLE)
  2. subacute cutaneous
  3. Systemic lupus (SLE)
29
Q

features of chronic discoid lupus (CDLE)

A

Fixed, erythematous, scaly, plaques with telangectasia often found on face/sun exposed sites – heal with scarring

photosensitivity

scarring alopecia

30
Q

antibodies found in lupus

A

ANA

anti-dsDNA

anti-smith

31
Q

treatment of CDLE

A

potent topical steroids

oral hydroxychloroquine

32
Q

features of subacute cutaneous lupus

A

widespread annular erythematous scaly plaques

symmetrical distribution

upper back/shoulders/arms most common sites

33
Q

treatment of subacute lupus

A

hydroxychloroquine

34
Q

cutaneous features of systemic lupus (SLE)

A

butterfly rash

photosensitive

prominent nail fold cappillaries

35
Q

blood results in lupus

A

FBC: low Hb, Low lymphocytes, low platelets

Increased ESR

CRP normal

increased urea

increased creatinine

36
Q

what is systemic sclerosis

A

multi system autoimmune disease characterised by inflammation damage + fibrosis of skin and internal organs

37
Q

pathophysiology of skin changes in systemic sclerosis

A

thicking of connective tissue due to over production of collagen + fibrilin

38
Q

what is scleroderma

A

thickened, firm, tight skin

  • commonly affects the fingers – sclerodactyly
39
Q

what are the two types of systemic sclerosis

A
  1. limited
    - fibrosis restricted to hands, distal arms, face + neck
  2. diffuse
    - fibrosis affects chest, abdomen, upper arms.
    - internal organ disease common
40
Q

antibody associated with systemic sclerosis

A

anti-centromere

41
Q

features of systemic sclerosis

A

CREST

Calcinosis

Raynauds

Esophageal dysmotility

Sclerodactyly

Telangectasia

42
Q

treatment of scleroderma

A

cyclophosphamide / methotrexate

43
Q

treatment of reynauds

A

calcium channel blockers e.g. amlodipine

44
Q

heliotrope rash

gottons papules

characteristic of?

A

dermatomyositis

45
Q

features of dermatomyositis

A

heliotrope rash

gottrons papules - back of hands

proximal muscle weakneass

myositis - raised CK

may be due to underlying malignancy

46
Q

features of vasculitis

A

raised + palpable painful purpuric rash

often localised to shins

can blister + ulcerate

47
Q

what is mycosis fungoides

A

cutaneous T cell lymphoma

48
Q

presentation of mycosis fungiodes

A

itchy, patchy rash slowing progressing to plaque stage and eventual tumour stage

often on trunk

lymphadenopathy

49
Q

treatment mycosis fungoides

A

topical steroids

50
Q

unilateral nipple eczema may be suggestive of what disease?

A

pagets disease of the nipple

51
Q

presentation of kaposi’s sarcoma

A

purple papules / plaques which may ulcerate

52
Q

what causes kaposi’s sarcoma

A

human herpes virus 8 (HHV-8)

  • affects people with HIV

Year 4: Dermatology (17 decks)

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