systemic skin basics Flashcards
distrib of dermatomyositis
extensor surfaces (both muscle weakness and rashes)
skin systemic disorders
SLE dermatomyositits vasculitis granulomatosis with polyangiitis sarcoidosis systemic amyloidosis graft vs host
types of lupus erythmatous
neonatal
systemic
cutaneous/discoid
what does SLE affect
liver kidney skin joints brain
what does discoid lupus look like
coin shaped lesions
scaly, thick, red
dont hurt or itch
signs of SLE
photodistrubuted rash - butterfly subacute cutaneous lupus livedo reticularis chillblains palpable purpura
neonatal lupus risks
ECG needs to be done as they have risk of heart block
presentation of dermatomyositis
photodistrubuted pink violet extensor surfaces and periocular upper trunk redness (shawl and V sign) gouttrons papules on fingers
presentation of vasculitis
purpura
digital necrosis
retiform purpura ulcers & subcutaneous nodules following blood vessel
presentation of granulomatosis with polyangiitis
cough chest pain stuffy nose nosebleeds
palpable purpura
retiform purpura and subcutaneous nodules
sarcoidosis presentation
lupus pernio (bluish red) over nose cheeks ears very variable - great mimicker
sarcoidosis
diagnosis of exclusion
causes granulomas to form in organs particularly lungs and skin
systemic amyloidosis
amyloid deposits in tissue
can cause organ failure
presentation of systemic amyloidosis
wt loss, fatigue
dyspnoea + syncope
periorbital purpura/racoon sign
graft vs host disease
donor T cells attack antigens in recipient who is immunosuppressed
acute or chronic
stem cell transplants
graft vs host presentation
alloimmune
skin, liver, gi tract
face/ acral involvement and diarrhoea
GvH vs drug reaction
GvH face and acral (extremities) involved
diarrhoea
DRESS
drug reaction with eosinophilia and systemic symptoms
2-6wk after exposure
presentation of DRESS
fever rash - widespread, face, upper trunk+extrems lymphadenopathy peripheral eosinophilia 2-6wk after drugs facial oedema
treatment of DRESS
withdraw drug
corticosteroids
steven johnson syndrome
full thickness mucocutaneous necrosis
steven johnson syndrome presentation
history of flu sympt
acute onset
macules blisters and erythema
sheets of skin detachment
steven johnson syndrome vs toxic epidermal necrolysis
more than 30% skin detachment of steven johnson = TEN
erythroderma
generalised eythema over 90% body surface
can be idiopathic, drug induced, T cell lymphoma (sezary snd) psoriasis, eczema
management of erythrodema
underlying cause
fluids etc
emollients
steroids / ABs
how can gi conditions present on skin
IBD - pyoderma gangrenosum and panniculitis
coeliac - dermatitis herpetiformis
skin manifestation of nutritional deficiencies
scurvy - bleedin of gums, petechiae, corkscrew hairs, follicular hyperkeratosis
zinc - dermatitis diarrhoea depression
niacin/B3 - dermatitis diarrhoea dementia death
CKD skin symptoms
pallor
excoriations
calciphylaxis - clots ulcers necrosis etc
half half nails
liver disease skin signs
jaundice terrys nails and muehrckes nails clubbing spider naevi palmar erythema excoriations
immunodeficiency skin signs
opportunistic infections - viral warts
HIV - kaposis sarcoma
DM skin signs
acanthosis nigricans xerosis skin infections feet ulcers necrobiosis lipoidica granuloma annulare
hyperlipidaemia skin signs
xanthomas
xanthelasma
