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22 Cards in this Set
- Front
- Back
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Name a cutaneous manifestation of neuropsychiatric disease and describe how it presents.
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Delusions of parasitosis. Patient thinks they have a parasite in their skin (sensation of biting, crawling, or stinging) and often presents with 'matchbox' or 'ziploc bag' sign.
Important to exclude/distinguish from substance abuse |
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How do you treat delusions of parasitosis?
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Antipsychotic
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What are the cutaneous manifestations of endocarditis? (5)
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Petechiae
Splinter hemorrhages (red linear lesions in the nailbeds) Osler nodes (PAINFUL subcutaneous nodules, typically at the distal pads of fingers and toes) Janeway lesions (PAINLESS red macules on the palms and soles) Roth spots (retinal hemorrhages) |
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How does lupus pernio present?
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It has papulonodules and plaques on areas affected by cold temperature and often presents with a beaded appearance of papules along the nasal rim.
Strong association with chronic pulmonary and upper respiratory tract sarcoidosis |
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What diseases is pyoderma gangrenosum associated with?
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Lymphoreticular malignancies and IBD. It seems to be a neutrophilic problem
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How does pyoderma gangrenosum present?
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Super nasty. Inflammatory process with rapidly expanding, painful ulcerations with purple borders. Often affects legs and new lesions often occur at sites of trauma (wounds, needlesticks/IV lines)
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What bacteria is pyoderma gangrenosum associated with?
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None, it's aseptic, although it can be secondarily infected
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What is Sweet's syndrome associated with?
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Infection, treatment with granulocyte colony-stimulating factor (G-CSF), IBD, and acute myelogenous leukemia
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How does Sweet's syndrome present?
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Brightly erythematous papulo-nodular lesions with pseudovesiculation (neutrophils fill the dermis) along with episodic fevers, and elevated WBC and ESR. Lesions often occur at sites of trauma. Skin looks tight and shiny
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How do you treat Sweet's syndrome?
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Responds very well to prednisone
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How does nephrogenic systemic fibrosis present?
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Debilitating progressive skin and joint fibrosis with secondary impairment of functioning and mobility. The fibrosis may affect the diaphragm, heart, lungs, and kidneys.
This is only seen in patients with renal failure |
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What is nephrogenic systemic fibrosis associated with?
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Renal failure, but also STRONGLY associated with gadolinium-containing MRI contrast agents
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What causes acrodermatitis enteropathica?
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Zinc deficiency (can be acquired or genetic)
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How does acrodermatitis present?
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Dry, scaly eczematous patches and plaques with vesiculobullous or erosive lesions at periorificial and acral sites. Might also have alopecia and diarrhea
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What are the lab findings of acrodermatitis enteropathica?
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Low serum zinc, anemia, and low alkaline phosphatase
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What is Kaposi's sarcoma associated with and what causes it?
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Human Herpes Virus (HHV) 8
Associated STRONGLY with AIDS - treat with anti-retrovirals |
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What causes disseminated intravascular coagulation?
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Consumptive coagulopathy (clotting factors are consumed)
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How does disseminated intravascular coagulation present?
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Diffuse petechia and purpura; tissue necrosis with possible bulla formation; bleeding from wound sites, lines, mucosal surfaces
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How do cutaneous metastases present?
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Firm papules/nodules +/- ulceration
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What is hypertrichosis lanuginosa acquisita and what is it associated with?
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Fine, downy hair that is overgrown/all over the body. Associated with LUNG, breast, uterine, colorectal, lymphoma, and bladder malignancies
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What is erythema gyratum repens and what is it associated with?
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Concentric erythematous plaques, often with polycyclic arrangement that gives a 'wood-grain' appearance. Classically associated with lung cancer (also esophageal and breast cancer)
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What is paraneoplastic pemphigus and what is it associated with?
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Severe mucosal erosions and ulcerations (KNOW) mediated by autoantibodies against epidermal proteins. Associated with non-hodgkin's lymphoma.
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