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43 Cards in this Set
- Front
- Back
Cancer associated with tripe palms? |
Alone- lung CA
TP + AN- gastric carcinoma |
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Necrolytic migratory erythema is associated with? |
Glucogonoma |
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Acrokeratosis paraneoplastica associated with? |
aerodigestive tract cancer |
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Carcinoid syndrome = flushing and erythema of the H + N, pellagra like dermatitis, can be associated with? |
mid gut tumors, commonly with liver mets
bronchial carcinoid tumors
increased 5-HIAA levels (hydroxyindoleacetic acid), a seratonin metabolite |
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Erythema gyratum repens |
rule out malignancy! |
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Hypertrichosis lanuginosa associated with? |
lung, colon, breast |
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Paraneoplastic pemphigus MC associations? (pic) |
NHL
CLL
CASTLEMANS
SARCOMA
THYMOMA |
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sign of Leser Trelat is kindof whack... when do we actually get worried about it? |
when accompanied by generalized pruritis or AN |
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Patients with shawl sign, heliotroph rash, ragged cuticles need to be worked up for... |
ovarian, lung, colorectal, pancreatic, NHL |
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MC association with Sweet's syndrome? |
AML |
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Primary Amyloidosis is most commonly associated with deposition of what? |
deposition of AL, monoclonal gammopathy (d/t plasma cell dyscrasia), multiple myeloma |
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Juvenile xanthogranuloma MC associated with hematologic disorder? |
paraproteinemia (IgG with kappa light chains) |
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What is Schnitzler's syndrome? |
chronic urticaria with IgM kappa paraproteinemia with lymphoplasmacytic malignancies |
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Necrobiosis lipoidica
Most patients with NLD have diabetes, only very few patients with diabetes have NLD
oval, violaceous patch with red advancing border, can ulcerate, typically on shins
seen earlier in type I, later in type II DM |
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Which subset of GA can be associated with DM? |
disseminated GA |
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where is the split in diabetic bullae? |
subepidermal (BMZ) |
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What pathologies can Acanthosis Nigricans be seen with? |
Carcinomas (stomach esp) Drugs (nicotinic acid, estrogen, corticosteroids) Pineal tumors Endocrine d/o PCOS, acromegaly, Cushing's, hypothyroidism) Obesity |
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Eruptive xanthomas are typically seen where? Indicative of what? |
yellow-red papules on extensor surfaces
high TG |
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What is the most common cutaneous manifestation of diabetes? |
Diabetic Dermopathy- asx crops of red brown patches on shins |
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Cutaneous insulin treatment reactions can include? What is the most common treatment to cause reactions? |
allergy, lipoatrophy, lipohypertrophy (inject)
First Generation Sulfonylureas (chlorpropamide, tolbutamide) are the most common to cause reactions, usually maculopapular eruptions --> treat through these |
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Skin in hyperthyroidism? |
warm and moist facial flushing palmar erythema hyperpigmentation fine hair/hair loss/early graying |
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Pretibial myxedema vs generalized myxedema? |
Pretibial more common in hyperthyroid
Generalized more common in hypothyroid |
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Cutaneous manifestations of hypothyroidism? |
skin is cool, dry, pale
hypohydrosis
carotenemia
hair is dry, brittle, loss of hair from lateral 1/3 eyebrow
easy bruising, purpura, impaired wound healing |
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Deposits in generalized myxedema? |
hyaluronic acid and chondroitin sulfate |
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Patient at 30 weeks presents with generalized, pruritic, urticarial papule on the trunk with several vesicles and bullae (involves the umbilicus). What do we work her up for? |
Herpes Gestationis
increased incidence in hydatidiform moles, choriocarcinoma, thyroid disease |
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Skin manifestations of adrenal insufficiency? |
ADDISONS disease
hyperpigmentation, loss of sex hair in women |
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Skin manifestations of Cushing's syndrome? Work up? |
truncal obesity, buffalo hump, mood facies, slender limbs, atrophy, telangietasias, purpura, poor wound healing, hirsuitism
work up with overnight dexamthasone suppression test or a 24 hour urine free cortisol determination can be used as a screen for Cushing syndrome d/t endogenous cortisol production
Elevated ACTH levels are found in Cushing's disease (pitutary over production of ACTH) and ectopic ACTH syndrome
Suppressed levels of ACTH arefound in adrenal tumors |
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MCC internal organ associated with generalized pruritis? |
renal (d/t retention of pruritogeneic factors, hyperparathyroidism, hypercalcemia, hyperphosphatemia, elevated histamine) |
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MC skin manifestation in chronic renal failure? |
xerosis |
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Treatment? |
sodium thiosulfate |
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acquired perforating dermatosis- a/w diabetes
primary perforating dermatosis: kyrle's disease, elastosis perofrans serpingosa, perforating folliculitis, preactive perforating collagenosis |
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What is nephrogenic systemic fibrosis? |
occurs in individuals with impaired renal function, most commonly dialysis dependent
Presents on extremities with symmetrically distributed, ill defined, thick, indurated, erythematous to hyperpigmented plaques, see a peau d'orange appearance
a/w exposure to GAD *** |
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Most common primary cancers to metastasize to the skin? |
Breast and lungs |
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Pyoderma gangrenosum is associated with which types of malignancies and disease? |
hematologic malignancy, crohns > UC, RA, HIV, hepatitis |
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Read this: manifestations of end stage renal disease |
pruritis (MC cause) uremic frost (BUN > 250) calciphylaxis acquired perforating disorder nephrogenic systemic fibrosis bullous disease of dialysis lindsays nails (aka half and half) jaundice (bili >2.5)
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Read this: manifestations of liver disease |
Cirrhosis- spider angiomas (increased estrogen), dupytrens contracture, gynecomastia, palmar erythema, pruritis, xanthoma striatum palmare, caput medusae, terrys nails, meuhrckes nails (transverse white bands parallel to the lunula- hypoalbuminemia), clubbing, brittleness |
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Necrolytic acral erythema? |
hepatitis C |
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Sweets syndrome can be associated with.... |
AML most commonly, IBD, GCSF, carbamazapine, bactrim |
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gene defect? complications? |
Hereditary Hemorrhagic Telangiectasias
AD defect in ENG (endoglein), ACVRL1
telangiectasias on facial, acral skin, oral mucosa --> GI hemorrhage, pulmonary and hepatic AVM, recurrent epistaxis |
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Blue rubber bleb nevus syndrome... |
AD/sporatic, muation in TIE2 gene
multiple tender cutaneous blue nevi with increased risk of GI malformations (esp in colon)
TIE a rubber band around that GI bleed! |
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Read this:
Cardiac manifestations on skin |
cyanosis (Hb decrease of 5g/dl) Clubbing (increase in Lovibond's angle) Flushing (severe mitral stenosis) Xanthomas Infective endocarditis (splinter hemorrhages, petechiae, oslers nodes, janeway lesions) Rheumatic fever (subcutaneous nodules, erythema marginatum) |
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Acquired icthyosis is associated with what malignancy? |
hodgkins lymphoma |
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Acquired icthyosis is associated with which medications? |
nicotinic acid, hydroxyurea, EGFR, protein kinase inhibitors, vemurafenib |