systemic disorder skin signs

Question 1

Henoch- schonlein purpura (HSP)

• presentation
• describe rash
• diagnosis
• treatment

Answer 1

• mostly children <10yrs,, vasculitic rash, joint pain and abdominal pain
• red spots which change to purple spots within 24hrs and involve lower legs/buttocks usually symmetrical
• skin biopsy to confirm IgA- check kidney function
• self-limiting rash, use NSAIDs for joint pain

Question 2

Polyarteritis Nodosum

• clinical features
• investigations
• treatment

Answer 2

• livedo reticularis, vasculitic lesions on pressure points, palpable purpura
• skin biopsy for IgM
• treatment: oral corticosteroids and warfarin

Question 3

Diagnostic criteria for Kawasaki Disease

Answer 3

unexplained fever for 5 days plus two of

1. polymorphous rash (2/52)
2. mucosal changes- strawberry tongue
3. conjunctivitis (non-exudative)
4. extremity changes (d4-d10)
5. lymphadenopathy (d5-14)

Question 4

Management of kawasaki disease

Answer 4

• need ECG and echo

- iv Ig and aspirin

Question 5

describe lesions in discoid lupus

Answer 5

• dry red annular lesions with scale
• can become hyperpigmented
• scarring results in skin atrophy

Question 6

clinical features of dermatomyositis

Answer 6

• weakness/malaise/fever/wt loss
• photosensitivity
• eczema like rashes (extensors)- heliotrope rash on face
• nail bed changes

Question 7

name 3 potential skin manifestations of diabetes

Answer 7

• necrobiosis lipodica
• acanthosis nigricans
• granuloma annulare