The Skin and Systemic Disease Flashcards
What is acanthuses nigerians a sign of?
abdominal malignancy
What is dermatomyositis a sign of?
several malignancies
What is generalised pruritis a sign of?
lymphoma
What is superficial thrombophlebitis a sign of?
pancreas probs
What are the skin manifestations of liver disease?
pruritis spider nave palmar erythema jaundice white nails
What are the skin manifestations of diabetes?
lipoidicagranuloma annulare diabetic dermopathyskin infections leg and foot ulcers
What is Erythema Nodosum?What causes it?
Immunological reaction patternMay be idiopathic caused by infection - streptococcal, primary TB, drugs, UC, etc
How does Erythema Nodosum appear?
tender nodules on shins
What is Erythema Multiforme?What causes it?
Skin reaction patternMay be idiopathicMild forms Drugs - sulphonamides, anticonvulsants, penicillinSevere form often drug relate - Steven Johnson’s syndrome
How does Erythema Multiforme present?
target lesions at acral sites
What is Pyoderma Gangrenosum?
skin reaction pattern purplish nodule or ulcer with undermined edge
What causes Pyoderma Gangrenosum?
may be precipitated by trauma (surgery), can be idiopathic may be underlying bowel disease, inflammatory arthritis, paraproteinaemia, myeloma, Bechets disease
What is erythroderma?
Skin failure
What are the systemic problems caused by erythroderma?
temperature regulation increased fluid loss this can result in cardiac failure, tachycardia, anaemia, dehydration, electrolyte and protein loss, hypothermia and death from sepsis
What are the non-allergic drug reactions?Give exmaples
Intrinsic action of drug on the skin due to pharmacological properties (predictable and dose related) e.g. steroids and stretch marks exacerbation of pre existing condition e.g lithium and psoriasis Idiosyncratic - e.g. fixed drug eruption from phenolpthalein
What are some more examples of intrinsic drug action causing a reaction on the skin?
stretch marks with systemic steroidscracked lips from retinoids photosensitivity from tetracycline candidiasis from antibiotics infections from immunosuppressants discolouration from amiodarone
Describe allergic drug reactions
unpredictable and occur in minority of patients occur in the latent period internal organs may be involved and they can be life threatening may be IgE, cytotoxic, immune complex mediated or cell mediated
What are the other non specific drug eruptions?
Uticaria and angioedema (salicylate, ACE inhibitors) Vaculitis (sulphonamides, indomethacin) Erythema multiforme (sulphonamides, barbiturates)
Which drugs commonly cause rashes?
penicillins/sulphonamides Anticonvulsants NSAIDS Thiazide diuretics Allopurinol Gold and penicillamine
How should drug rashes be treated?
stop drug Consider measures to reduce drug in the system symptomatic oral steroids are controversial avoid drug in future label medical records
