The Skin in Systemic Disease Flashcards

1
Q

Are rashes limited to the surface of the skin?

A

No, they may be more than skin deep

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2
Q

Why can rashes damage internal organs?

A

They are more than skin deep

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3
Q

How may the skin be involved in systemic disease?

A

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

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4
Q

If you suspect a skin condition is neoplastic what investigations could you do?

A

Skin biopsy and imaging

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5
Q

If you suspect a skin condition is infectious what investigations could you do?

A

Mincrobiology

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6
Q

If you suspect a skin condition is autoimmune what investigations could you do?

A

Blood tests (especially inflammatory markers)

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7
Q

What are the 2 types if lupus erythematosus?

A

Systemic and cutaneous

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8
Q

What are the manifestations of systemic lupus erythematosus?

A
Photodistributed rash 
Cutaneous vasculitis
Chilblains 
Alopecia
Livedo reticularis
Cutaneous vasculitis 
Subacute cutaneous lupus (SCLE)
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9
Q

What are the mucocutaneous diagnostic criteria of lupus?

A

Cutaneous lupus

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10
Q

What are the haematological diagnostic criteria of lupus?

A

Haemolytic anaemia
Thrombocytopenia
Leukopenia

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11
Q

What are the immunological diagnostic criteria of lupus?

A

ANA
Anti-dsDNA
Antiphospholipid syndrome
Direct Coomb’s test

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12
Q

What are some visible features of lupus?

A
Chilblains
Photo-distributed (sun-exposed areas) erythematous rash
Livedo reticularis
Palpable purpura
Subacute cutaneous lupus
Discoid lupus 
Subacute lupus erythematosus
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13
Q

What must be done if neonatal lupus is suspected and why?

A

ECG

Because theres a 50% risk of heart block

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14
Q

What type of disease is dermatomyositis?

A

An autoimmune connective tissue disease

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15
Q

What is seen in dermatomyositis?

A

Proximal extensor inflammatory myopathy

Photo-distributed pink-violet rash favouring scalp, periocular regional and extensor surfaces

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16
Q

What are features of dermatomyositis?

A

Grotton’s papules
Ragged cuticles
Shawl sign
Heliotrope rash

17
Q

What effect do different antibodies have in dermatomyositis?

A

They cause different pathologies

18
Q

What do manifestations of vasculitis depend on?

A

The size of the blood vessels involved

19
Q

What are small vessel manifestations of vasculitis?

A

Purpura (macular/palpable)

20
Q

What are medium vessel manifestations of vasculitis?

A

Digital necrosis
Retiform purpura ulcers
Subcutaneous nodules along blood vessels
Retiform purpura ulcers

21
Q

Why is IgA vasculitis different to other forms?

A

It causes renal failure so it requires follow up

22
Q

What does granulomatosis with polyangitis present with?

A

Cough, dyspnoea, chest pain