Term
| What systemic diseases should you suspect in someone with generalized pruritis without a rash? |
|
Definition
| lymphoma (hodgkin's), endocrinopathy (diabetes, thyroid disease), renal insufficiency/ESRD, hepatobiliary disease |
|
|
Term
| violacious ulcer with an undermined border and a boggy base= |
|
Definition
|
|
Term
| How does pyoderma gangrenosum heal? |
|
Definition
|
|
Term
| What are the systemic diseases associated with pyoderma gangrenosum? |
|
Definition
| hematologic disease (leukemia, monoclonal gammopathy, myelofibrosis), inflammatory bowel disease (esp Crohn's), arthritis, chronic active hepatitis, connective tissue disease |
|
|
Term
| Describe the appearance of aphthous ulcers? |
|
Definition
| shallow mucosal ulcerations |
|
|
Term
| What are the systemic diseases associated with aphthous ulcers? |
|
Definition
| SLE, Crohn disease, Behcet disease |
|
|
Term
| Which HLA type is associated with Behcet disease? |
|
Definition
|
|
Term
| Describe the cutaneous manifestations of Behcet's disease. |
|
Definition
| oral and genital aphthae, cutaneous pustular vasculitis |
|
|
Term
| Besides cutaneous manifestations what are the other symptoms of Behcet's disease? |
|
Definition
| uveitis, arthritis, meningoencephalitis, vasculitis (large vessel) |
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|
Term
| Where is the typical location of venous leg ulcers? |
|
Definition
|
|
Term
| What are teh signs of venous stasis associated with venous ulcers? |
|
Definition
| edema, coppery color, +/- eczematous changes |
|
|
Term
| What causes venous ulcers? |
|
Definition
| venous hypertension due to underlying valvular incompetence, fluid overload, or venous thrombosis (hypercoagulable states) |
|
|
Term
| Where are arterial ulcers typically located? |
|
Definition
| punched out ulcers over bony prominences (lateral foot, toes) |
|
|
Term
| What are teh features specific to arterial ulcers? |
|
Definition
| shiny atrophic skin and decreased pulses, change in limb color with elevation; very painful (worsens with elevation) |
|
|
Term
| What symptom is associated with arterial leg ulcers? |
|
Definition
|
|
Term
| What causes arterial leg ulcers? |
|
Definition
|
|
Term
| What's another name for neuropathic ulcers? |
|
Definition
|
|
Term
| What are neuropathic ulcers located usually? |
|
Definition
| weight-bearing surfaces (great toe, heel, metatarsal heads) |
|
|
Term
| What causes neuropathic leg ulcers? |
|
Definition
| diabetes, leprosy, tertiary leus (tabes dorsalis) |
|
|
Term
| What is the pathology of vitiligo? |
|
Definition
|
|
Term
| What is depigmentation associated with? |
|
Definition
| autoimmune disease (DM, thyroiditis, pernicious anemia, Addison's disease) |
|
|
Term
| What is the ddx for hypomelanotic macules? |
|
Definition
| "ash-leaf" macules of tuberous sclerosis versus decreased sensation in leprosy |
|
|
Term
| Name the three common symptoms of tuberous sclerosis? |
|
Definition
| MR, epilepsy and adenoma sebaceum |
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|
Term
| What is the first sign (like at birth) of tuberous sclerosis? |
|
Definition
|
|
Term
| Patients with tuberous sclerosis can have tumors of the... |
|
Definition
|
|
Term
| What is the ddx for diffuse hyperpigmentation? |
|
Definition
| addison's disease, hemochromatosis ("bronze diabetes"), heavy metal ingestion |
|
|
Term
| Where do patients with addison's disease get hyperpigmented? |
|
Definition
| palmar creases, nails, gums |
|
|
Term
| What is the characteristic triad of hemochromatosis? |
|
Definition
| hyperpigmentation, cirrhosis, diabetes mellitus |
|
|
Term
| What types of organs are affected in NF type I? |
|
Definition
| skin, eye, CNS, osseous lesions |
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|
Term
|
Definition
| axillary freckling= pathognomonic for NF 1 |
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|
Term
| What are the CNS problems associated with NF type 1? |
|
Definition
| optic nerve glioma and other tumors 9usually benign), intellectual impairment in 40%, epilepsy |
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|
Term
| What are the distinctive osseous lesions of NF type 1? |
|
Definition
| sphenoid wing dysplasia, pseudoarthrosis, kyphoscoliosis |
|
|
Term
| What is the FALCON mneuomnic for? |
|
Definition
| NF type 1: family history, axillary freckling, lisch nodules, cafe au lait macules, optic nerve glioma, osseous lesions, neurofibromas |
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|
Term
| What are teh cutaneous manifestations of Peutz Jeghers? |
|
Definition
| lentigines on lips nose, buccal mucosa, hands and feet |
|
|
Term
| What is Peutz-Jeghers syndrome? |
|
Definition
| hamartomatous polyps of the GI tract (especially small bowel) with an increased risk of malignancy (GI and extraintestinal) |
|
|
Term
| What is Leopard syndrome? |
|
Definition
| lentigines, EKG conduction defects, ocular hypertelorism, pulmonary stenosis, abnormal genitalia, retarded growth, deafness |
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|
Term
| Where is acanthosis nigricans found? |
|
Definition
|
|
Term
| What are the associations with acanthosis nigricans? |
|
Definition
| idiopathic (in obesity), familial, endocrinopathy (insulin resistance), malignancy (usually occurs simultaneously with tumor) |
|
|
Term
| What kinds of malignanceis are associated with acanthosis nigricans? |
|
Definition
| GI (stomach most commonly), breast, ovarian, prostate lung |
|
|
Term
| What are the underlying diseases associated with tripe palms form of acanthosis nigricans? |
|
Definition
| underlying malignancy (lung, GI, uterine) |
|
|
Term
|
Definition
| hyper-estrogen states (pregnancy) |
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|
Term
| What causes the skin to have a blue-grey color? |
|
Definition
| drugs= amiodarone, tetracycline; argyria (chronic silver ingestion), chrysiasis (gold) |
|
|
Term
| What causes the skin to look purple? |
|
Definition
|
|
Term
| What causes skin to look orange? |
|
Definition
|
|
Term
| What are teh dermatologic stigmata of cirrhosis? |
|
Definition
| jaundice, spider angiomata, palmar erythema, terry's nails, caput medusae, gynecomastia |
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|
Term
|
Definition
| opaque white proximal nail with distal erythema |
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|
Term
| How do you tell the difference between carotenemia and jaundice? |
|
Definition
| patients with carotenemia have a normal, white sclera |
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|
Term
|
Definition
| sweet potatos, squash, carrots |
|
|
Term
| What is the appearance of erythema nodosum? |
|
Definition
| transient tender nodules on shins |
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|
Term
| What causes erythema nodosum? |
|
Definition
| strep/sarcoid, paracoccidiodes, lymphoma/leukemia, OCPs, TB, Crohn's/IBD, histoplasmosis, yersinia |
|
|
Term
|
Definition
| deposits of monosodium urate crystals in synovial and nonarticular tissues |
|
|
Term
| Where are gouty tophi most likely to occur? |
|
Definition
| elbows, knees, ears, hands |
|
|
Term
| Where do rheumatoid nodules occur? |
|
Definition
| often over sites of pressure |
|
|
Term
| What kind of xanthoma often occurs in normolipemic patients? |
|
Definition
|
|
Term
| What type of xanthoma is associated with a paraproteinemia? |
|
Definition
|
|
Term
| What are the types of planar xanthomas? |
|
Definition
| xanthelasma and diffuse plane xanthoma |
|
|
Term
| What causes eruptive xanthomas? |
|
Definition
| very high triglyceride levels |
|
|
Term
| Describe the apperance of eruptive xanthomata? |
|
Definition
| yellow-brown papules on extensor extremities, shoulders, and buttocks |
|
|
Term
| "Plum-colored" nodules are often a sign of... |
|
Definition
|
|
Term
|
Definition
| can be a mammary intraductal carcinoma or an exrammary lesion (50% with underlying adenocarcinoma) |
|
|
Term
| What are the MC sites for internal malignancy in a patient with extramammary paget's disease? |
|
Definition
|
|
Term
| Unilateral nipple eczema is suspicious for _____. |
|
Definition
|
|
Term
| In the first step of managing a patient with mycosis fungoides, it is important to... |
|
Definition
| evaluate for nodal involvment |
|
|
Term
| Zinc deficiency leads to what papulosquamous lesion? |
|
Definition
| acrodermatitis enteropathica |
|
|
Term
| What kind of lesion is associated with an underlying glucagonoma? |
|
Definition
| necrolytic migratory erythema |
|
|
Term
| What papulosquamous lesion suggests an underlying lung cancer? |
|
Definition
|
|
Term
| Some immunodeficiency syndromes can manifest as what kind of papulosquamous lesions? |
|
Definition
|
|
Term
| What causes an underlying zinc deficiency? |
|
Definition
| inherited or aquired (consider in alcoholics) |
|
|
Term
| What is the morphology of acrodermatitis enteropathica? |
|
Definition
| periorificial and acral dermatitis (starts as flaccid bullae and then crusts) |
|
|
Term
| What lesions look like acrodermatitis enteropathica? |
|
Definition
| seb derm, intertrigo, candidiasis, psoriasis |
|
|
Term
| What percent of the time is a glucaconoma metastatic at time of dx? |
|
Definition
|
|
Term
| What are the other signs associated with necrolytic migratory erythema to suggest glucagonoma? |
|
Definition
| diabetes, weight loss, anemia, hypoaminoacidemia, diarrhea |
|
|
Term
| What type of skin lesion has a wood grain appearance with rapid migration? |
|
Definition
|
|
Term
| What causes erythema gyratum repens? |
|
Definition
| underlying bronchogenic carcinoma |
|
|
Term
| What causes exfoliative erythroderma? |
|
Definition
| psoriasis, paraneoplastic, lymphoma, leukemia, atopic dermatitis, allergic contact, idiopathic, ichthyosis, drugs, sezary syndrome, seb derm |
|
|
Term
|
Definition
| gneric term for visible hemorrhagic into the skin and mucous membranes |
|
|
Term
| What are intravascular causes of purpura? |
|
Definition
| thrombocytopenia (idiopathic thrombocytopenic purpura, leukemia, TTP, DIC), abnormal platelet function |
|
|
Term
| T/F You can palpate intravascular purpura. |
|
Definition
|
|
Term
| What type of purpura is due to poor blood vessel support? |
|
Definition
|
|
Term
| What causes extravascular purpura? |
|
Definition
| corticosteroid excess, vitamin C deficiency, multiple myeloma, Ehlers-Danlos |
|
|
Term
| What are the cutaneous manifestations of scurvy? |
|
Definition
| extravascular purpura, corkscrew hairs with perifollicular hemorrhage |
|
|
Term
| What kind of purpura is associated with amyloidosis/multiple myeloma? |
|
Definition
| extravascular ("pinch purpura"/"raccoon eyes") |
|
|
Term
| Why does scurvy result in collagen defects? |
|
Definition
| because ascorbic acid is a cofactor for lysyl hydroxylase |
|
|
Term
| What are the cutaneous manifestations of amyloidosis? |
|
Definition
| pinch purpura, waxy papules, macroglossia, deposition of amyloid in GI, heart, kidneys, underlying multiple myeloma |
|
|
Term
| What is the clasic palpable purpura? |
|
Definition
| leukocytoclastic vasculitis (LCV) |
|
|
Term
| What causes leukocytoclastic vasculitis? |
|
Definition
| bacteria (endocarditis, RMSF), viral (hep C and cyroglobulinemia, hep B), drugs (PCNs, thiazides, PTU), CTD, malignancy, idiopathic, Henoch-Schonlein purpura |
|
|
Term
| What is another name for osler-Weber-Rendu? |
|
Definition
| hereditary hemorrhagic telangiectasia |
|
|
Term
| What diseases are associated with telangiectasias? |
|
Definition
| hereditary hemorrhagic telangiectasia, ataxia telangiectasia, scleroderma, connective tissue disease |
|
|
Term
| What is ataxia telangiectaseia? |
|
Definition
| combined humoral and cell-mediated immune defects, increased risk of malignancy (lymphoproliferative), and telangiectasia usually appera after ataxia is evident (involves conjunctiva, auricles, neck, extremities) |
|
|
Term
| Describe the telangiectasias of slceroderma? |
|
Definition
|
|
Term
| Nailfold telangiectasia is a sign of .... |
|
Definition
| connective tissue disease |
|
|
Term
| What is a common presentation for hereditary hemorrhagic telangiectasia? |
|
Definition
|
|
Term
| Where are the telangiectasias of hereditary hemorrhagic telangiectasia? |
|
Definition
| mucosal and palmar telangiectasia, AVMs in GI/pulmonary tree |
|
|
Term
| What do you call yellow waxy translucent tleangiectatic plauqes on the lower legs associated with diabetes? |
|
Definition
|
|
Term
| What are the signs of sturge-weber? |
|
Definition
| port wine stain in V1 + ipsilateral leptomeningeal angiomatosis, may have ipsilateral glaucoma, "tram-track" calcifications along cerebral cortex |
|
|
Term
| What is Klippel-Trenaunay? |
|
Definition
| port wine stain + venous maliformation + hypertrophy of affectedlimb |
|
|
Term
| Urticaria is swelling of the ____ while angioedema is swelling of the ____. |
|
Definition
|
|
Term
| What's the difference between urticaria and urticarial lesions? |
|
Definition
| urticaria individual lesions lsat <2 hours; if they last more than 24 horus they are termed urticarial lesions |
|
|
Term
| What causes chronic urticaria? |
|
Definition
| idiopathic in 50% to 75% although some believe it is an autoimmune phenomenon (maybe due to infections, CTD, endocrinopathy, malignancy=lymphoma/leukemia) |
|
|
Term
| What causes angioedema without wheals? |
|
Definition
| hereditary= C1 esterase deficiency; or acquired= underlying lymphoma |
|
|
Term
| What causes erythema multiforme? |
|
Definition
| HSV is the MC cause!!! also, histoplasmosis |
|
|
Term
| Describe the lesions of erythema multiforme? |
|
Definition
| "multiform" target lesions, urticarial plaques, bullae |
|
|
Term
| What are the cutaneous stigmata of glucocorticoid excess? |
|
Definition
| atrophy, striae, purpura, telangiectasia, acne, lipodystrophy (moon facies, buffalo hump) |
|
|
Term
| What's the difference between acne due to steroids and normal acne vulgaris? |
|
Definition
| monomorphous erythematous papules and pustules without comedones |
|
|
Term
| What are the cutaneous signs of androgen excess? |
|
Definition
| thick coarse skin, acne, hirsutism, androgenic alopecia |
|
|
Term
| What is the name for hyperkeratosis on the palmar or plantar surface that is NOT due to friction? |
|
Definition
|
|
Term
| What is the name for the hyperkeratosis associated with menopause? |
|
Definition
|
|
Term
|
Definition
| syndrome of esophageal cancer with keratoderma of the hand |
|
|
Term
| Rieter's syndrome is associated with what HLA? |
|
Definition
|
|
Term
| What is Reiter's syndrome? |
|
Definition
| urethritis, conjunctivitis, and arthritis with nongonnoccocal urethritis or dysentary and keratoderma |
|
|
Term
| What kind of poisoning causes keratosis? |
|
Definition
|
|
Term
| What causes aquired ichthyosis? |
|
Definition
| lymphoma, HIV/AIDS, Sarcoidosis, Statins |
|
|
Term
|
Definition
| thyrotoxicosis, psoriasis |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What causes Beau's lines? |
|
Definition
|
|
Term
| What causes Muehrcke's nails? |
|
Definition
|
|
Term
| What causes half and half nails? |
|
Definition
|
|
Term
| What causes splinter hemorrhages? |
|
Definition
|
|
Term
| Koilonychia is associated with... |
|
Definition
| iron deficiency anemia, polycythemia vera and plummer-vinson syndrome |
|
|
Term
| What do you call seperation of the nail plate from the nail bed? |
|
Definition
|
|
Term
|
Definition
| transverse white bands in the nail plate that move distally with nail growth |
|
|
Term
|
Definition
| transverse ridging associated temporarly with acute systemic stress |
|
|
Term
| What are Muehrcke's nails? |
|
Definition
| double white transverse bands int eh nail bed; associated with hypoalbuminemia as in nephrotic syndrome or cirrhosis; problem with nailbed so do not "grow out" with nail plate like Mee's lines |
|
|
Term
| Half and half nails are also known as... |
|
Definition
|
|
Term
| Describe the appearance of Lindsay's nails? |
|
Definition
| white proximal portion with a normal distal portion |
|
|
Term
| What causes splinter hemorrhages? |
|
Definition
| can be seen in endocarditis but more often just due to trauma |
|
|
Term
| What are the cutaneous manifestations of endocarditis? |
|
Definition
| osler's nodes, janeway lesions, splinter hemorrhages, LCV |
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|
