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Dermatology > Skin and Systemic Disease > Flashcards

Skin and Systemic Disease Flashcards

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1
Q

Presentation of carcinoid syndrome

A

Episodic flushing mins - hours
No sweating
Facial telagiectasia

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2
Q

What is paraneoplastic pemphigus?

A

Blistering skin condition caused by weakness in certain areas of the skin

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3
Q

Presentation of paraneoplastic pemphigus

A

Blisters
Erosive stomatitis
Rash
Very dry and painful mouth

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4
Q

What causes carcinoid syndrome?

A

GI carcinoid
Bronchial carcinoid
Ovarian carcinoid

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5
Q

What can cause paraneoplastic pemphigus?

A

Non hodgkins lymphoma

Castlemans disease

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6
Q

What is erythema gyratum repens?

A

Concentric erythematous lesions

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7
Q

What is acquired hypertrichosis lanuginose?

A

Acute onset of lanugo hairs at face and body

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8
Q

Who normally have lanugo hairs?

A

Neonates

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9
Q

Causes of acquired hypertrichosis lanuginose

A

Severe eating disorders
Colorectal cancer >
Lung cancer >
Breast cancer

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10
Q

What is bazex syndrome?

A

Hyperkeratosis of extremities
Resembles psoriasis
Non specific diagnosis on skin biopsy

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11
Q

Causes of bzex syndrome

A

SCC; bronchial, oropharyngeal, GI

Gastric, colon, biliary tumours, adenocarcinomas

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12
Q

What is ectopic ACTH syndrome?

A

Tumour production of ACTH leads to generalised hyperpigmentation

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13
Q

Why does ectopic ACTH syndrome lead to hyperpigmentation?

A

ACTH -> increased MSH -> Release of melanin from melanocytes

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14
Q

Pathology of pagets disease

A

Extension of underlying ductal adenocarcinoma

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15
Q

Presentation of Pagets disease

A

Eczematous plaque at nipple / areola

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16
Q

Causes of extra mammary pagets

A

Primary intraepithelial adenocarcinoma (>75%)
Secondary to underlying visceral tumour
- bladder
- colon

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17
Q

What skin conditions are strongly associated with cancer?

A

Acanthosis nigricans

Dermatomyositis

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18
Q

How is acanthosis nigricans related to cancer?

A

Can preceed malignancy (particularly a gastric adenocarcinoma)

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19
Q

Concerns arise with acanthosis nigricans if;

A 
Older patient
Rapid onset
Other skin signs 
Involves lips
Weight loss
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20
Q

What is dermatomyositis?

A

Inflammatory myopathy + rash

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21
Q

Presentation of dermatomyositis

A 
Periorbital heliotrope rash 
Gottrons papules 
- red maculo popular lesions over bony prominences 
Shawl sign 
Photosensitive poilkiloderma 
Scalp erythema
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22
Q

Skin conditions that may be associated with malignancy

A 
Bullous pemphgoid 
Sweets syndrome
Pyoderma gangrenosum 
Acquired ichthyosis 
Acquired angioedema 
Primary systemic amyloid 
Cryoglobulinaemia
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23
Q

Presentation of sweets syndrome

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A

Juicy nodules which tend to be in upper back, upper limbs and neck

24
Q

3 examples of genetic tumour syndromes

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A

MEN syndromes
Xeroderma pigmentosum
Peutz-Jeghers

25
What is xeroderma pigmentosum?
Inability to repair sun damage
26
Diabetes skin signs
``` Acanthosis nigricans Acral erythema Carotenemia Diabetic bullae Diabetic dermopathy Disseminated granuloma annulare Eruptive xanthomas Necrobiosis lipoidica Rubeosis Scleroderma ```
27
What is alopecia?
Patchy loss of hair
28
What is the medical condition of alopecia called?
Alopecia areata
29
Pathology of alopecia
T lymphocyte, cytokine rejection of hair - totalis - universalis
30
Differential diagnosis of alopecia areata
Scarring alopecia | Androgenic alopecia
31
What is scarring alopecia?
Attack of the follicles Leading to fibrosis Hair will never grow back
32
What is vitiligo?
Segmental patches of different coloured skin
33
What type of condition is alopecia?
Autoimmune
34
Presentation of alopecia areata
Localised, well demarcated patches of hair loss | At edge of hair loss, may be small broken "exclamation mark" hairs
35
What % of people regrow their hair in alopecia areata?
50% by 1 year | 80 - 90% eventually
36
Treatment options of alopecia
``` Hair regrowth naturally Topical or intralesional corticosteriods Topical minoxidil Phototherapy Dithranol Contact immunotherapy Wigs ```
37
What is bullous pemphigoid?
Autoimmune condition causing sub epidermal blistering of the skin
38
Pathology of bullous pemphigoid
Secondary to the development of antibodies against hemidesmosomal proteins BP180 and BP230
39
Diagnosis of bullous pemphigoid
Immunofluroescence | - IgG and C3 at the dermoepidermal junction
40
Management of bullous pemphigoid
Oral corticoids MAINSTAY Topical corticosteriods Immunosuppressants Antibiotics
41
What is dermatitis herpetiformis?
Autoimmune blistering skin disorder
42
What condition is dermatitis herpetiformis associated with?
Coeliac disease
43
Pathology of dermatitis herpetiformis
IgA deposition in the dermis
44
Presentation of dermatitis herpetiformis
Itchy, vesicular skin lesions on the EXTENSOR surfaces (elbows, knees, buttocks)
45
Diagnosis of dermatitis herpetiformis
Skin biopsy | - direct immunofluorescence shows deposition of IgA in a granular pattern in the upper dermis
46
Management of dermatitis herpetiformis
Gluten free diet | Dapsone
47
Presentation of lichen planus
Itchy, popular rash most common on palms, soles, genitalia and flexor surfaces of the arms Rash often polyglonal in shape - white lines pattern on the surface Koebener phenomenon may be seen (new skin lesions appearing at the site of trauma) Oral involvement in 50% - white lace pattern on buccal mucosa Nails - thinning of nail plate - longitudinal ridging
48
Causes of lichenoid drug eruptions
Gold Quinine Thiazides
49
Management of lichen planus
Topical steroids mainstay of treatment Benzydamine mouthwash if oral Extensive may require oral steroids or immunosuppression
50
What skin manifestations can be associated with SLE?
Photosensitive "butterfly rash" Discoid lupus Alopecia Livedo reticularis (net like rash)
51
What is vitiligo?
Autoimmune condition which results in loss of melanocytes and consequent depigmentation of the skin
52
When do symptoms of vitiligo typically develop?
20 - 30 y/o
53
Where tends to be most affected in vitiligo?
Peripheries
54
What may precipitate new lesions in vitiligo and what is this called?
Trauma - koebner phenomenon
55
Assosiated conditions of vitligo
``` T1DM Addisons Autoimmune thyroid disease Pernicious anaemia Alopecia areata ```
56
Management of vitiligo
``` Suncream on affected areas Camoflague make up Topical steroids may reverse changes if applied early Topical tacrolimus maybe Phototherapy maybe ```
57
First line treatment for hyperhidrosis
Aluminium chloride

Dermatology (11 decks)

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