Systemic Disease Derm Manifestations Flashcards
What is Systemic Lupus Erythematosus (SLE)?
Who is m/c affected?
- Chronic inflammatory autoimmune condition that attacks multiple organ systems
- F > M, AA > caucasian
S&S of SLE?
- Malar rash (“butterfly” erythema)
- Livedo reticularis (lacy)
- Hives
- Photosensitivity
- Oral ulcers
- Hairloss
- Raynauds
What are the forms of Cutaneous Lupus Erythematous?
Acute: butterfly rash, morbilliform eruption, erythema & edema of hands sparing the joints
Subacute: annular scaly “psoriasiform” patches in photodistribution
Chronic
Discoid: erythematous/violaceous scaly plaques with follicular plugging –> scarring & atrophy
Tumid: juicy papules/plaques, no scarring
Panniculitis (ex. Erythema Nodosum): involves SQ tissue, painiful nodules
Who is m/c affected by Discoid Lupus Erythematosus?
Where is it m/c located?
- Young-middle aged women
- Face, scalp, ears (neck up)
What skin manifestations do you see with Discoid Lupus Erythematosus?
- Well circummscribed erythematous scaly plaques (ITCHY)
- Follicular plugging (little scale w/i follicle)
- Telangiectasias
- Atrophy
- Dyspigmmentation
How is Discoid Lupus Erythematosus dx?
Skin Biopsy +/- DIF
How is Discoid Lupus Erythematosus treated?
- Topical/IL/Oral steroids
- Cyclosporine
- Hydroxychloroquine
What is Erythema Nodosum?
What does it look like?
Where is it m/c located?
Who is m/c affected?
- M/C inflammatory panniculitis, Delayed hypersensitivity reaction
- Deep tender dusky erythematous nodules
- M/C on Lower extremities (shins), Bilateral/symmetrical
- F > M, 20-40 y/o
What are causes of Erythema Nodosum?
What’s S&S is it associated with?
- Causes: Idiopathic, Infections (Strep, TB), Drugs, Sarcoid, IBD
- Associations: Malaise, Leg edema, Arthralgia, Fever, H/A, Conjunctivitis, GI issues
How is Erythema Nodosum diagnosed?
Clinically, Biopsy (deep fat)
How is Erythema Nodosum treated?
- Bed rest
- Salicylates
- NSAIDs
- Potassium Iodide
What is Dermatomyositis?
Idiopathic inflammatory condition with characteristic myositis & cutaneous findings
What are the S&S of Dermatomyositis?
Cutaneous:
- Erythema/edema of face & eyelids
- Scaly patches on extensor surfaces of extremities
- Dilated vessels at proximal nail folds
- Heliotrope rash: pink/violet patches on eyelids, erythema around eyes
- Gottrons papules: flat-topped polygonal papule over knuckles
- Shawl sign
- V-sign: violaceous/poikiloderma upper chest
- Mottled hyper/hypopigmentation
Systemic:
- Intermittent fever
- Malaise
- Anorexia
- Arthralgias
- Weight loss
- Dysphagia
- Proximal muscle weakness
How is Dermatomyositis definitively diagnosed?
Muscle Biopsy or Skin Biopsy
What labs and imaging are ordered for Dermatomyositis?
Labs:
- Creatinine Kinase
- Aldolase
- LDH
- Transaminases
- ANA (positive in 60-80%)
Imaging:
- EMG
- MRI
- Xray (Barium Swallow)
