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MSCT > MSCT Week 6: Cutaneous Signs of Systemic Disease > Flashcards

MSCT Week 6: Cutaneous Signs of Systemic Disease Flashcards

1
Q

Skin findings and systemic disease

A
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2
Q

Question 1

A

Acanthosis Nigricans

Screen for Diabetes

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3
Q

Acanthosis Nigricans Clinical Features

A
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4
Q

Acanthosis Nigricans most commonly found where on the body?

A
  • Posterior neck fold
  • axillae most common
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5
Q

Acanthosis Nigricans is a sign of

A

Insulin Resistance

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6
Q

Identify features of histology

A

acanthosis

IDGF-1 causes thickening and overdevelopment of the epidermis

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7
Q

Acanthosis Nigricans should screen for diabetes mellitus by?

A

glucose tolerance test

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8
Q

Malignant Acanthosis Nigricans Clinical Features

A
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9
Q

“Tripe Palms”

A

Think Malignant Acanthosis Nigricans

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10
Q

Strange manifestations of Malignant Acanthosis Nigricans

A

thickened velvety plaques

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11
Q

Diabetes and Skin

A
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12
Q

Diabetes and Skin: Diabetic Dermopathy Clinical Features

A

deposition of glycosylated proteins in the skin

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13
Q

Identify

A

Acanthosis Nigricans

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14
Q

Associations with Acanthosis Nigricans

A

no collagen vascular disease

some hereditary some syndromic

some insulin resistance

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15
Q

Why does this occur?

A

Diabetic Neuropathy

don’t realize that they are damaging their feet because they have lost sensation

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16
Q

What is this?

A
  • Scleroderma from poorly controlled diabetes or from other disorders but diabetes is most common
  • typically asymptomatic, infiltration of the skin (usually in the back) with mucin
  • thickened hardened, can be pruritic
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17
Q

What is this?

A

Bullosis Diabeticorum

  • non-infectious
  • not-inflammed
  • sterile blisters filled with water on the lower limbs and feet
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18
Q

What is this?

A

Necrobiosis Lipoidica

  • typically occurs on the anterior shins
  • the atrophic skin where vessels can be seen underneath
  • yellowish hue
  • if ulcerate are difficult to treat
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19
Q

What is this

A

Acquired Perforating Disorder

  • common for diabetics on renal dialysis
  • build up of abnormal collagen and elastin in the skin and the body tries to eliminate it
  • epidermis tries to envelope abnormal collagen
  • transepidermal elimination
  • associated with renal failure
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20
Q

Acquired Perforating Disorder is associated with?

A

Renal failure

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21
Q

What is this?

A

Eruptive Xanthomas

  • grouped yellow tender papules
  • firm
  • extensor surfaces and buttocks
  • happen when cholesterol and triglycerides are very high
  • This is an emergency
  • as cholesterol is brought down they resolve
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22
Q

Question

A

Malignancy

This is called the sign of leser-Trelat

a large number of seborrheic keratoses suddenly appearing responding to same growth factor as does the malignancy

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23
Q

Sign of Leser-Trelat

A
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24
Q

Identify Histological Features

A

Pseudocysts

thickened epidermis

well defined basal layer

comedo blackhead like openings

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25
Q

Question

A
  • Abdominal cramping, bloating, especially after consuming bread
  • and fatigue from malabsorption
  • Gluten-sensitive enteropathy or celiac disease

Dermatitis Herpetiformis

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26
Q

Dermatitis Herpetiformis Clinical Features

A
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27
Q

Dermatitis Herpetiformis Etiology

A

IgA Autoantibodies mucosal antibodies are spilling out targeting epidermal

  • Tissue transglutaminase
  • Epidermal Transglutaminase
  • Gliadin
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28
Q

Identify Histological Features

A

neutrophilic infiltrate in the dermal papillae with some vesiculation separating the dermal papillae from the epidermis

Dermatitis Herpetiformis

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29
Q

Dermatitis Herpetiformis HLA Association

A

HLA DQ2 and HLA DQ8

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30
Q

Dermatitis Herpetiformis Immunofluorescence Features

A
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31
Q

Dermatitis Herpetiformis Treatment

5 listed

A
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32
Q

Question

A

Autoimmune Disease (Graves Disease, Lupus, Rheumatoid Arthritis)

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33
Q

Dermatitis Herpetiformis Risks for

A
  • Hypothyroidism
  • Intestinal lymphoma from chronic intestinal inflammation
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34
Q

Vitiligo Clinical Features

A
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35
Q

Vitiligo appears where on the body?

A

in areas that favor trauma

symmetric

depigmented macules and patches

36
Q

identify Histological Features

A

Normal skin

37
Q

Identify Histological Features

A
  • No melanocytes in the basal layer
  • when stained for melanin nothing shows up
38
Q

Koebnerization

A

when some lesions more likely to occur in areas of trauma

39
Q

Vitiligo Treatment

4 listed

A
40
Q

Question

A

Systemic Lupus Erythematosus

41
Q

Systemic Lupus Erythematosus Clinical Features

A
42
Q

Why is lupus named?

A

wolf mask

43
Q

Identify Histological Features

A

SLE

  • Perivascular infiltrate (lymphocytes and a few histiocytes
  • peradnexal (around hair follicles and eccrine ducts
  • vacuolization of the basal layer
  • destruction of basal keratinocytes
  • thickening of basement membrane
  • mucus deposition
44
Q

Identify Histological Features

A

SLE

  • destruction of keratinocytes
  • keratinocytes undergoing apoptosis
  • basal layer cuboidal
  • vacular dermatitis
  • think about erythema multiforme and drug reactions they would look very similar
  • do immunofluorescence for antibody deposition to distinguish
45
Q

Identify Histologic Features

A

SLE

stained for mucin

thickened basement membrane

46
Q

Subacute Cutaneous Lupus Erythematosus Clinical Features

A

10-20% have systemic symptoms as well

47
Q

Subacute Cutaneous Lupus Erythematosus flares with?

A

Sun exposure

48
Q

Discoid Lupus Erythematosus Clinical Features

A
49
Q

Question

A

Muscle Weakness

50
Q

Dermatomyositis Clinical Features

A
51
Q

“Heliotrope Rash” think?

A

Dermatomyositis

52
Q

“Shawl Sign” think?

A

Dermatomyositis

53
Q

Dermatomyositis Lesion

A

Erythematous to dusky lilac patch-plaques usually w/ minimal scale

54
Q

Dermatomyositis Associations

A

proximal muscle weakness

muscle fatigue

muscle tenderness

fever malaise

55
Q

Dermatomyositis Treatment

A
56
Q
A
57
Q

Question

A

Breast Cancer

worry about malignancy with Dermatomyositis

58
Q

Dermatomyositis & Malignancy

A
59
Q

Question

A

Erythema Nodosum

60
Q

Erythema Nodosum Clinical Features

A

can be mistaken with cellulitis

61
Q

Identify Histological Features

A

inflammation primarily in the fat

lymphocytes and histiocytes

Erythema Nodosum

62
Q

Identify Histological Features

A

Erythema Nodosum

can have giant cells

63
Q

Erythema Nodosum Associations

A
64
Q

Other Erythemas

4 listed

A
65
Q

Question

A

Pyoderma Gangrenosum

66
Q

Pyoderma Gangrenosum Clinical Features

A
67
Q

Identify Histological Features

A

Pyoderma Gangrenosum

can look like folliculitis (pustular ingflammation around the hair follicle

in any ulcer see inflammation of blood vessels

biopsy on the edge

68
Q

Question

A

Inflammatory Bowel Disease

69
Q
A
70
Q

Pyoderma Gangrenosum Associations

A
71
Q

Pyoderma Gangrenosum Associations continued

A
72
Q

Question

A

Cutaneous T-Cell Lymphoma

73
Q

Identify Histologic Features

A

atypical epidermotropic lymphoid infiltrate

Cutaneous T-cell Lymphoma

74
Q

Identify Histologic Features

A
75
Q

Cutaneous T-cell Lymphoma Clinical Features

A
76
Q

Cutaneous T-cell Lymphoma AKA

A

Mycosis Fungoides

77
Q

Pruritus

A
78
Q

Mediators of Pruritus

A
79
Q

Common skin conditions with pruritus

A
80
Q

Systemic Disease that cause Pruritus

A
81
Q

signs of chronic pruritus

A
82
Q

Skin signs of chronic pruritus & workup

A
83
Q

Laboratory studies for systemic diseases

A
84
Q

Physical Exam for systemic diseases

A
85
Q

Hx for systemic diseases

A
86
Q

Diagnoses for systemic diseases

A

MSCT (30 decks)

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