The Skin in Systemic Disease

Question 1

What is the condition and what systemic illness is it associated with?

Answer 1

Ecthyma

Diabetes Meilltus

Question 2

What is the condition and what systemic illness is it associated with?

Answer 2

Pretibial Myxoedema

Hyperthyroidism - Graves disease

(can also occur with hypothyroidism)

Question 3

What is the condition and what systemic illness is it associated with?

Answer 3

Diabetic Dermopathy

Question 4

What is the condition and what systemic illness is it associated with?

Answer 4

Necrobiosis Lipodica

DM

Question 5

What is the condition and what systemic illness is it associated with?

Answer 5

Tinea pedis

DM

Question 6

What is the condition and what systemic illness is it associated with?

Answer 6

Necrobiosis Lipodica

DM

Question 7

What is the condition and what systemic illness is it associated with?

Answer 7

Thyroid Acropathy

Question 8

What is the condition and what systemic illness is it associated with?

Answer 8

Neuropathic Ulcer

Question 9

What conditions are associated with thyroid?

Answer 9

Xerosis (dry skin)

Pruritis

Diffuse hair loss

Periorbital and facial oedema, pretibial myxoedema

Thyroid acropathy

Question 10

What skin changes do you get addisons and cushings?

Answer 10

Addisons: hyperpigmentation

Cushings: Striae

Question 11

What is the condition and what systemic illness is it associated with?

Answer 11

Eruptive Xanthoma

Hyperlipidaemia

Question 12

What is the condition and what systemic illness is it associated with?

Answer 12

Tuberous Xanthoma

Hyperlipidaemia

Question 13

What is the condition and what systemic illness is it associated with?

Answer 13

Tendinous Xanthoma

Hyperlipidaemia

Question 14

What is the condition and what systemic illness is it associated with?

Answer 14

Xanthelasma

Hyperlipidaemia

Question 15

What is the condition and what systemic illness is it associated with?

Answer 15

Dermatitis Herpetiformis

Question 16

What are the skin conditions associated with hepatic illness?

Answer 16

Jaundice

Pruritis

Spider naevi

Palmar erythema

Question 17

What is the skin condition and the system it is related to?

Answer 17

Hereditary Haemorrhagic Telangiectasia

Gatroenterology

Question 18

What group of conditions are these?

Answer 18

Vasculitis

Question 19

What are the causes of vasculitis?

(5)

Answer 19

Connective Tissue Disease:​

• SLE
• Rheumatoid
• Wenger’s Granulomatosis

Infective Causes:

• Meningococcal sepsis
• Post Strep infection
• Hepatitis C

Drugs

Auto antigens

Malignancy

Question 20

Describe the rash and name the condition?

Answer 20

D: localised to the face in photosensitive areas

C: butterfly configuration

M: erythematous macules

Systemic Lupus Erythematosus

Question 21

What is the diagnosis and what are the causes?

Answer 21

Erythema Nodosum

IBD

Sarcoidosis

Inf: strep. TB

Drugs: Sulphonamides, OCP

Idiopathic

Question 22

What is the following condition and what illnesses is associated with?

Answer 22

Pyoderma gangrenosum: note purpley tinge to the border

IBD

Myeloid diseases

Rheumatoid Artiritis

Diabetes

Question 23

A patient comes in with proximal muscle weakness, teangiectasia in the nail folds and the following skin rashes/lesions, what is the diagnosis and what should be investigated for?

Answer 23

Dermatomyositis

25% of those will have an underlying malignancy,

• Ovarian
• Lung
• Colorectal
• Pancreatic
• Hodgkin’s lymphoma

Note: rash on the upper eyelid is known as a heliotrope rash

Erythematous papules on the hand are known as Gottron;s papules

Question 24

What is the follwoing condition, which regions does it commonly occur and what diseases is it related to?

Answer 24

Acanthosis Nigricans

Armpit, groin and neck

Gastric Adenocarcinoma

Diabetes

Obesity

Question 25

The following condition is caused by a drug reaction, what is the condition, and which medications is it associated with?

Answer 25

Toxic Erythema

Antibiotics and sulphonamides

Question 26

The following condition is caused by a drug reaction, what is the condition, and which medications is it associated with?

Answer 26

Uticaria

Salicylate and transiently after certain vaccines

Question 27

What sort of reaction does the following image show?

Answer 27

A phototoxic reaction

Question 28

Which medications can cause photosensitivity?

Answer 28

Tetracyclines

Sulphonamides

Amiadarone

Furosemide

Thiazide like diuretics

Retinoids

Nalidixic acid

Question 29

What is the following condition and what other dematological conditions is it associated with?

Answer 29

Erythema Multiforme

Associated with Steven Johnsons Syndrome and Toxic Endodermal Necrolysis

Question 30

What is the following condition and where does it usually occur?

Answer 30

Steven Johnson Syndrome

Mucosal sites

May be severe eye and oral involvement

Includes prodome of fever and respiratory symptoms

Question 31

What is the following condition, what other symptoms will the patient have, what is the potential causative drug and what is the associated mortality?

Answer 31

Toxic Epidermal Necolysis

Fever, Pain, Blistering and skin loss covering >30% body surface area

Mortality about 35%

Causative drugs: NSAIDs, antibiotics, anticonvulsants

Question 32

Which medications are the usual suspects in terms of skin eruptions?

Answer 32

Antibiotics (usually sulphonamides)

Anticonvulsants

NSAIDs

Allopurinol

Question 33

How would you manage a patient in skin failure e.g. Toxic epidermal necrolysis?

Answer 33

Stop causative agent.

Refer to ITU and burns (high sepsis risk)

Fluids

Emollients and bandaging

ENT and opthalmology review as there can be scarringh of mucosal sites.

Question 34

What is the following condition and what conditions is it associated with?

Answer 34

Acquired Ichthyosis

Asociated with malignancy