The Skin in Systemic Disease Flashcards
Are rashes limited to the surface of the skin?
No, they may be more than skin deep
Why can rashes damage internal organs?
They are more than skin deep
How may the skin be involved in systemic disease?
The disease might target the skin
The systemic disease might cause skin signs
Some skin conditions indicate the presence of other systemic disease
Systemic disease may be secondary to a skin disorder
If you suspect a skin condition is neoplastic what investigations could you do?
Skin biopsy and imaging
If you suspect a skin condition is infectious what investigations could you do?
Mincrobiology
If you suspect a skin condition is autoimmune what investigations could you do?
Blood tests (especially inflammatory markers)
What are the 2 types if lupus erythematosus?
Systemic and cutaneous
What are the manifestations of systemic lupus erythematosus?
Photodistributed rash Cutaneous vasculitis Chilblains Alopecia Livedo reticularis Cutaneous vasculitis Subacute cutaneous lupus (SCLE)
What are the mucocutaneous diagnostic criteria of lupus?
Cutaneous lupus
What are the haematological diagnostic criteria of lupus?
Haemolytic anaemia
Thrombocytopenia
Leukopenia
What are the immunological diagnostic criteria of lupus?
ANA
Anti-dsDNA
Antiphospholipid syndrome
Direct Coomb’s test
What are some visible features of lupus?
Chilblains Photo-distributed (sun-exposed areas) erythematous rash Livedo reticularis Palpable purpura Subacute cutaneous lupus Discoid lupus Subacute lupus erythematosus
What must be done if neonatal lupus is suspected and why?
ECG
Because theres a 50% risk of heart block
What type of disease is dermatomyositis?
An autoimmune connective tissue disease
What is seen in dermatomyositis?
Proximal extensor inflammatory myopathy
Photo-distributed pink-violet rash favouring scalp, periocular regional and extensor surfaces
What are features of dermatomyositis?
Grotton’s papules
Ragged cuticles
Shawl sign
Heliotrope rash
What effect do different antibodies have in dermatomyositis?
They cause different pathologies
What do manifestations of vasculitis depend on?
The size of the blood vessels involved
What are small vessel manifestations of vasculitis?
Purpura (macular/palpable)
What are medium vessel manifestations of vasculitis?
Digital necrosis
Retiform purpura ulcers
Subcutaneous nodules along blood vessels
Retiform purpura ulcers
Why is IgA vasculitis different to other forms?
It causes renal failure so it requires follow up
What does granulomatosis with polyangitis present with?
Cough, dyspnoea, chest pain
