Skin Signs Of Systemic Disease

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Back 1

café au lait spots

Neurofibromatosis: autosomal dominant

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Diabetes Melitus skin signs?

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Candida stomatitis

Candida vulvitis - note characteristic satellite lesions

Candida balanitis- erythema, scaling, papules and pustules affecting foreskin and glans penis

Granuloma Annulare

Nercobiosis lipoidica

Diabetic shin spots (diabetic dermopathy)

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Back 3

Granuloma annulare, seen on the dorsal aspects of the hands.

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Back 4

Necrobiosis lipoidica. Yellowish–red atrophic areas are seen onthe shins of a diabetic patient.

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What are diabetic shin spots?

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(small healed infarcts on shin which can indicate the presence of microangiopathy)

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If the diabetes has an associated hyperlipidaemia how can this present?

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Eruptive xanthoma

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Back 7

Porphyria cutanea tarda

blisters and erosions on sun exposed sites

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what is and causes porphyria cutanea tarda?

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Enzyme deficiency leads to build up of porphyrin precursors which are activated by sunlight and leads to skin fragility and blistering.

Can be precipitated by alcohol excess.

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Xanthelasma?

Back 9

deposition of fat in the eyelids.

Only 50% of cases have raised circulating lipids.

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Addisons?

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Generalised hyperpigmentation due to pituitary reduction of ACTH and FSH which stimulate pigment production in the skin

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Back 11

Pre-tibial myxoedema

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Causes and associations of pre-tibial myxoedema?

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pre-tibial skin deposits of mucopolysaccharides

Associated with exophthalmic Graves’disease

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Systemic sclerosis skin manifestations?

Back 13

scerodactyly

microstomia

telangiectasia

splinter haemorrhages

proximal nauilflds

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Dermatomyosis skin manifestations?

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violaceous, erythematous rash over knuckles, proximal nail fold swelling

May also see violaceous, erythema and swelling around the eyes – heliotrope sign

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Erythema Multiforme (EM

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Erythema Multiforme (EM)
presents as ?

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Symmetrical, discoid, inflammed plaque eruption plus blistering plaques.

peripheries - hands feet occasionally face

lasts for 2-3 weeks

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What does Steven-johnson syndrome involve?

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mucous membranes of the mouth and eyes leading to severe blistering

settles in 2-3 weeks

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Presentation of Pyoderma gangrenosum

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Dusky blue red edge

dermal infiltration with polymorphs and necrosis of underlying epidermis but no evidence of vasculitis

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disease associations of pyoderma?

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IBD

RA

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Superficial thrombophlebitis?

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Linear appearance as follows the vein

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Superficial thrombophlebitis may suggest?

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lung or pancreatic cancer

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what internal malignancy is Acanthosis nigricans associated with?

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bladder cancer

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Erythema gyratum repens?

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Wood grain patterning

internal tumour

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Polymorphic Light Eruption (PLE)

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‘prickly heat’. Reaction to ultraviolet not heat

Intensely itchy, erythematous rash after going out in the sun that takes a few days to settle after coming out of the sun.