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Derm Manifestations of Systemic Disease
n/a
50
Medical
Graduate
08/21/2012

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Term
How does Acanthosis Nigricans manifest?
Definition
Thickened, velvety, hyperpigmented lesions
Term
Acanthosis Nigricans is most often associated with what other conditions?
Definition
Diabetes and obesity, less commonly associated with endocrine disorders, pineal tumors, and occult malignancy
Term
How is Acanthosis Nigricans treated?
Definition
Ammonium lactate cream (Lac-Hydrin 12%), only mildly effective
Term
How does Granuloma Anulare manifest?
Definition
Ring of small, firm, flesh-colored or violaceous papules, associated with diabetes
Term
Granuloma Anulares must be distinguished from what similar disease?
Definition
Tinea Corporis
Term
How is Granuloma Annulare treated?
Definition
Topical and/or intralesional corticosteroids
Term
What kind of skin changes do you see as a result of diabetes milletus?
Definition
Foot ulcers, acanthosis nigricans, gas gangrene, granuloma annulare, insulin lipidystrophy, necrobiosis lipoidica, yellow nails, perforating disorders, eruptive xanthomas, candida infections, carotenodermia, diabetic bullae, diabetic dermopathy, diabetic thick skin, erythema, external otitis, finger pebbles
Term
What is Kaposi's Sarcoma?
Definition
Malignant tumor of epithelial tissue
Term
Describe the epidemiology of Kaposi's sarcoma
Definition
Classic form seen in elderly men of Jewish, Greek, or Italian descent, linked to herpes virust type 8, typically found on feet or lower legs
Term
What are indications of a case of Kaposi's sarcoma being sporadic?
Definition
Azthioprine, cyclophosphamide, cyclosporin, and prednisone
Term
Describe AIDS-related kaposi's sarcoma
Definition
Multi-focal, occurs on trunk, head, neck, and oral mucosa
Term
How is Kaposi's sarcoma diagnosed and treated?
Definition
Diagnosed via biopsy and treated with radiation or chemotherapy
Term
How does oral hairy leukoplakia manifest?
Definition
White vertical corrugations, typically on lateral aspect of tongue, may spread to cover the entire dorsal surface or spread onto the ventral surface of tongue, unable to scrape lesion with tongue blade
Term
What causes oral hairy leukoplakia?
Definition
Epstein-Barr virus, usually found in HIV or immunocompromised patients
Term
How is oral hairy leukoplakia treated?
Definition
Topical retinoids, topical podophyllin resin, high dose acyclovir or ganciclovir
Term
How does lichen planus usually manifest?
Definition
Polygonal purplish flat topped papules, occurs on extremities, trunk, and orally, is associated with hepatitis C
Term
How is lichen planus diagnosed and treated?
Definition
Confirmed with biopsy, treated with topical and intralesional corticosteroids
Term
How does adenoma sebaceum manifest?
Definition
Fibrous, flesh0colored, discrete pabules, can be associated with tuberous sclerosis
Term
What is recommended for neonates or children who present with adenoma sebaceum?
Definition
Renal ultrasound and echocardiogram for neonates, neurologic evaluation and/or opthalmologic evaluation may be needed for children, neurosurgery may be required for CNS involvement
Term
How does erythema multiforme manifest?
Definition
Relatively common inflammatory disease, presents with dusky red target lesions, round maculopapules, and/or urticarial plaques, associated with Herpes Simplex infection, Mycoplasma pneumoniae infection, and acute URI
Term
How is Erythema Multiforme treated?
Definition
Topical staroids and oral antihistamines for most cases, systemic corticosteroids in widespread cases
Term
How does alopecia areata manifest?
Definition
Sudden appearance of non-scarring diffuse or patchy hair loss, typically sharply defined round or oval areas, hair regrows spontaneously and may be accompanied by nail pitting
Term
How is alopecia areata treated?
Definition
Intralesional and topical steroids, Minoxidil and Anthralin may be used, be sure to screen for thyroid disease and pernicious anemia
Term
How does Telogen Effluvium manifest?
Definition
Non-scarring, non-inflammatory alopecia usually occurring 3-5 months following systemic stress, caused by predominance of telogen phase of hair growth
Term
What kind of systemic stress is associated with Telogen Effluvium?
Definition
Pregnancy, crash dieting, physical or emotional stress
Term
How is Telogen Effluvium treated?
Definition
Minoxidil may be helpful in chronic cases
Term
How does Pretibial Myxedema manifest?
Definition
Localized infiltrative dermopathy, scaly thickening and induration of the skin, lesions may be slightly pigmented papule sor nodules and often have an orange peal texture, is a manifestation of Grave's disease (hyperthyroidism)
Term
How is pretibial myxedema treated?
Definition
By treating underlying disease. Topical potent fluorinated steroids may also be recommended
Term
What type of skin changes do you see as a result of hyperthyroidism?
Definition
Thickening of the epidermis, fast nail growth, soft velvety dry skin, increased pigmentation, increased skin temp, thinned scalp hair, red palms, pruritus and hives (rare), flushed face, pretibial myxedema, increased sweating palms/soles, acropathy (thick fingers and toes)
Term
What type of skin changes do you see as a result of hypothyroidism?
Definition
Cold, scaly, wrinkled skin, dry scalp and hair, anhydrosis, hair loss, skin color change, puffy edema in hands face, eyelids, brittle thick nails, eczema craquele, bruising, poor wound healing
Term
How does Pyoderma Gangrenosum manifest?
Definition
Initial lesion described as pustule or inflamed red nodule that ulcerates, most common sites are lower extremities and abdomen, associated with inflammatory bowel disease and RA
Term
How is Pyoderma Gangrenosum treated?
Definition
Topical corticosteroids
Term
How does digital clubbing manifest?
Definition
Softening and periungual erythema of the nail beds, decreased or loss of the normal 15 degree angle that the nail makes with its cuticle, enlargement or bulging of the distal phalanx and curvature of the nails themselves, associated with interstitial lung disease and congenital heart disease
Term
How does cutaneous sarcoidosis manifest?
Definition
Granulomatous disease of uncertain etiology, tpyically red-brown papules or small plaques common around the mouth, nose, and eyes, most patients have respiratory tract involvement
Term
How is cutaneous sarcoidosis confirmed and treated?
Definition
Confirmed with biopsy, treated with topical or intralesional corticosteroids & systemic corticosteroids
Term
What are the dermatological manifestations of pulmonary disease?
Definition
Clubbing, cyanosis, papular sarcoidosis, lupus pernio, subcutaneous nodules, palpable purpura, urticarial rashes, livedo reticularis, ulcerative panniculitis, petechial eruptions, yellow nails
Term
What is the most common cutaneous T cell lymphoma?
Definition
Mycosis Fungoides, caused by clonal proliferation of T lymphocytes and confirmed by skin biopsy
Term
How is Mycosis Fungoides treated?
Definition
4 stages - 1: Emollients, topical corticosteroids, PUVA or UVB, topical chemotherapy, 2: above + local radiotherapy and interferon alpha-2a, 3: above + low does methotrexate and extracorporeal photophoresis, 4: above + combination chemotherapy and radiotherapy to lymph nodes
Term
How does Dermatitis Herpetiformis manifest?
Definition
Chronic skin disorder characterized by intensely burning pruritic vesicular rash, may evolve to burning urticarial papules, vesicles, and bullae, associated with gluten sensitive enteropathy and autoimmune disorders (Hashimoto's thyroiditis, lymphoma, and IDDM)
Term
How is Dermatitis Herpetiformis treated?
Definition
Topical corticosteroids in mild cases
Term
How doe pruritic urticarial papules and plagues of pregnancy (PUPPP) present?
Definition
Common intensely pruritic dermatosis usually beginning in 3rd trimester, associated with severe striae more common in first pregnancy, no associated complications during pregnancy or delivery and recurrences are rare
Term
How are pruritic urticarial papules and plaques of pregnancy treated?
Definition
Topical corticosteroids and antihistamines
Term
How does porphyria cutanea tarda manifest?
Definition
Erythema, edema, and vesicles with blisters occuring in sun-exposed areas, results from a deficiency of hepatic uroporphyrinogen decarboxylase activity, both acquired and familial forms exist
Term
How is the acquired form of porphyria cutanea tarda contracted?
Definition
Associated with liver disease typically secondary to ethanol abuse, hepatotoxic drugs, and hep B and C infections
Term
How is porphyria cutanea tarda treated?
Definition
Avoid hepatotoxins, sun exposure, treated with serial plebotomies and chloroquine or hydroxychloroquine
Term
How does erythema nodosum manifest?
Definition
Panniculitis characterized by pink to dusky red firm nodules with indistinct edges most commonly on the peritibial surfaces, may be due to infection, drugs, malignancies, and inflammatory conditions
Term
How is Erythema Nodosum treated?
Definition
By treating underlying causes, NSAIDS, and potassium iodide
Term
How does dermatomyositis manifest?
Definition
Idiopathic connective tissue disease characterized by proximal muscle weakness and violaceous skin rash prominent on the eyelids, scalp, metacarpophalangeal joints, and bony prominences, associate dwith underlying malignancy
Term
How is dermatomyositis diagnosed and treated?
Definition
Diagnosed by an EMG, muscle biopsy, and blood tests, treated with sun protection, hydroxychloroquine, systemic corticosteroids, and antihistamines
Term
What are the primary lesions of pruritis (itching)?
Definition
Urticaria, scabies, atopic dermatitis, psoriasis, contact dermatitis, insect bites, milaria, dry skin, chicken pox
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