Systemic Derm mainfestations

Question 1

Lupus

Answer 1

• butterfly rash (malar rash)

- Due to trapping of immune complexes in capillaries

Question 2

Progressive Systemic Sclerosis (Scleroderma)

Answer 2

aka statue disease
Inflammatory, vascular and sclerotic changes of the skin and various internal organs
Most prominent clinical feature:
Thickening of the skin= scleroderma
Loss of joint mobility, contracture development, dry skin, hair loss
-think mask facies or shiny/stretched skin

Question 3

90% of scleroderma pts will have….

Answer 3

Raynaud’s phenomenon (a pale-blue-red sequence of color changes of the digits, most commonly after exposure to cold)

Question 4

CREST syndrome

Answer 4

associated w/scleroderma
Cutaneous Calcinosis (Ca deposits in fingers)
Raynaud’s phenomenon
Esophageal dysfunction
Sclerodactyly (scleroderma limited to the fingers)
Telangiectasia

Question 5

scleroderma tx

Answer 5

• immunosuprresion

- specific organ tx

Question 6

Polymyositis & Dermatomyositis

Answer 6

Bilateral proximal muscle weakness & skin manifestations

Question 7

cutaneous manifestations of dermatomyositis

Answer 7

A dusky, purplish red rash is important diagnostic finding
face, scalp, neck, shoulders, upper chest and back (photosensitive)
Periorbital heliotrope of upper eyelids with or without edema

Question 8

sarcoid

Answer 8

• noncaseating granulomas in multiple organ systems
• presents w/pulmonary symptoms
• Erythema nodosum is the most common nonspecific cutaneous lesion
• “great imitator”
• “apple jelly” plaques

Question 9

pemphigus vulgaris

Answer 9

• Uncommon epidermal blistering condition that typically begins in the mouth
• positive nikolsky sign

Question 10

bullous pemphigoid

Answer 10

• Chronic blistering eruption usually in elderly patients
• large bulla
• negative nikolsky sign

Question 11

dermatitis herpetiformis

Answer 11

• Extremely itchy grouped vesicles usually on extensor surfaces
• related to gluten intolerance
• tx w/dapsone to decrease inflammation