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Dermatology > Skin + Systemic Disease > Flashcards

Skin + Systemic Disease Flashcards

(75 cards)

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1
Q

What is carcinoid syndrome

A 
Facial telengiectasis
Flushing
Diarrhoea 
N+V
No sweating
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2
Q

What does carcinoid syndrome indicate

A

GI cancer with liver mets
Bronchial
Ovarian Ca

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3
Q

What does Ectopic ACTH do

A

Release of melanin

Hyperpigmentation of skin, gums and greases

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4
Q

How does Paraneoplastic pemphigus present

A

Erosive stomatitis
Ulceration of mouth and lips
Rash

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5
Q

What is associated with it

A

Non-Hodgkin’s

Castleman’s disease

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6
Q

What is erythema Graytum Repens

A

Parenoplastic erythematous lesion
Look at pics
Associated with malignancy particularly lung

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7
Q

What is acquired hypertrichosis

A

Androgen indedendent hair growth

Acute onset of lanugo hairs at face and body

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8
Q

What causes

A

Colorectal cancer
Lung and breast
Drugs
Anoreixa

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9
Q

What is Bazex syndrom

A

Hyperkeratosis of extremeties

Can look like psoriasis so biopsy

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10
Q

What underlies Bazex syndrome

A

SCC

Gastric / colon / biliary adenocarcinoma

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11
Q

What is Aconthosis Nigrican’s

A

Symmetrical brown, velvet plaques
Often neck, axilla or groin
Hyperkeratosis
Hyperpigmentation

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12
Q

What is associated with aconthosis nigrican’s

A

Insulin resistance = benign

  • Type II DM
  • Obesity
  • PCOS
  • Acromegaly / Cushing / hypothyroid
  • Prader-Willi
  • OCP

Malignancy
- GI adenocarcinoma

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13
Q

What is concerning

A

Lip involvement

Weight loss

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14
Q

What should you look for if dermatomyositis and how

A 
Underlying malignancy in 30% 
Muscle and skin biopsy 
CK
Ab - ANA / ANti-Jo1 
Age / gender cancer screen and follow up 5 years 
- Smear
- PSA
- Colonoscopy
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15
Q

How does it present

A 
Inflammatory myopathy
Shawl sign - photosensitivity / violet discolouration on sun exposed area 
Helitrope Rash - violet around eye 
Telangiectasia
Gottron's papules on knuckles 
Scalp erythema
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16
Q

What is Sweets Syndrome

A

Juicy nodules limited to neck and UL

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17
Q

What can cause

A

Post infection
Medication
Tumour

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18
Q

What is acquired ichthyosis

A

Dry rough skin with scaling

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19
Q

What can cause

A 
Congenital
Lymphoproliferaive disorder 
Autoimmune
Nutritional deficiency 
Tumours
Medication
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20
Q

Genetic tumour syndromes

A

See genetics

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21
Q

What is hereditary haemorrhagic telangiectasia and what system related too

A

AD
GI
Telangiectasia over skin and mucous membrane

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22
Q

What is criteria

A

Epistaxis
Telangiectasis of lips / oral cavity / nose
Visceral lesions
FH

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23
Q

What visceral lesions

A

Hepatic, cerebral or spina AVN
GI telangiectasia with or without bleeding
Risk of haemorrhage

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24
Q

What is needed for Dx

A 
2+ = possible 
3+ = definite
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25
What is erythema nodosum
Hypersensitivity reaction leading to inflammation of SC fat Usually over shins NOT bruises Painful, blue red raised nodular lesion
26
How do you Dx and how long to resolve
6 weeks Rest and analgesia Steroid to reduce inflammation Arrange follow up ``` Dx = clinical Depends on cause Biopsy CRP and ESR Throat swab for strep Stool MC+S Faecal calprotectin CXR to exclude sarcoid / malignancy / pneumonia Serum ACE ```
27
What causes
Granulomatous condition - IBD / Sarcoid / TB / fungal (macrophage around insult) Drugs - penicillin / COCP / NSAID Infection - strep / TB / gastroenteritis Malignancy Pregnancy ``` Pneumonic NO - idiopathic D - drugs - penicillin / COCP O - OCP / pregnancy S - sarcoid / TB U - UC / Chron's / Bechet's M - strep / Mycoplasma / EBV ``` MOST COMMON SARCOID / IBD IN EXAM
28
What causes pyoderma gangrenosum
``` IBD Autoimmune hepatitis PBC Granulomatosis with polyangiitis Myeloma Myeloproliferative RA / SLE ```
29
How does pyoderma gangreonsum present
``` Initially small red papule Develop pustular ulcers Tender red / blue Overhanging necrotic edge Purulent surface System fever / myalgia LL ```
30
How do you Rx
Oral steroid + ciclosporin = 1st line
31
What kind of skin disease does Chron's have
Orofacial granulmatosis - lip swelling, fissures, ulcers Erythema nodosum Pyoderma gangrenous
32
What is another shin lesion relating to Graves'
Pretibilal myxoedema Symmetrical erythematous lesions above lateral malleoli Oedema Shiny orange peel skin
33
What skin disease associated with rheumatic fever
Erythema marginatum Pink coalescent rings on trunk Come and go
34
What is coeliac associated with
Dermatitis herpetiform
35
What is dermatitis herpetiform and what leads to this
Autoimmune blistering skin condition due to deposition of IgA in dermis Itchy vesicles on extensor surfaces in clusters Cal appear like chicken pox Systemically well
36
How do you Dx
Biopsy Immunoflourescene showing IgA Coeliac serology - anti-TTG
37
How do you Rx
Dapsone = Ax and anti-inflammatory Emollient Topical steroid Gluten free diet
38
What skin manifestations of liver disease
``` Palmar erythema Spider naevi Gynaecomastia Decreased pubic hair Bruising Scratch marks ```
39
What skin manifestation of malabsorption
Dry pigmented skin Bruising Hair loss
40
What skin conditions associated with underlying malignancy
Acanothosis nigrican Dermatomyositis Thrombophlebitis Mets in skin
41
What can DM cause
``` Acanthosis nigrican Diabetic bullae Eruptive xanthoma due to hyperlipid Diabetic dermopathy Carotenemia Acral erythema Disseminated granuloma ```
42
What is disseminated granuloma
Papular lesion Hyperpigemnted Dorsal surface of hands, feet and extensors of arms and legs
43
Who is at risk of vitamin deficiency
Elderly Alcohol Eating disorder Isoniazid therapy - B3
44
What vitamin important for skin and what happens if deficienct
Vit A | Hyperkeratosis
45
What are the 5D's of niacin (B3) deficiency 'pellagra' and where does it affect
``` Neck region + photosensitive areas Dermatitis Dementia Diarrhoea Depression Death ```
46
What is scurvy
Lack of vitamin C
47
What can scurvy cause
``` Bruising Gum infection Hair loss Fatigue Weakness GI haemorrhage ```
48
What is alopecia acreata
Autoimmune condition causing localised, well demarcated patterns of hair loss May have small broken exclamation marks at edge of hair loss
49
Can it grow back
Yes
50
What are DDX
``` Scarring alopecia Androgenic alopecia PCOS Stress Hypothyroid ```
51
What is scarring
Attack of follicle = fibrosis | Will not grow back
52
What is androgenic linked to
Autoimmune thyroid | Pernicious anaemia
53
How do you investigate
FBC, ferritin, thyroid if generalised hair loss | Ask about menstrual if suspect PCOS
54
How do you Rx
Topical steroid Phototherapy Immunotherapy Wigs
55
What is vitiligo
``` Autoimmune condition resulting in loss of melanocytes and depigmentation Causes white patches Well demarcated Hyperpigmented Sunlight = itch Koebner +Ve ```
56
What is associated
``` Type 1 DM Addison Autoimmune thyroid Pernicious anaemia Alopecia acreata Premature ovarian failure ```
57
How do you Rx
Suncream Camoflauge make up Topical corticosteroids can reverse
58
If patients presents with nail ridging what should you do
Routine bloods | Can be a sign of a more serious underlying problem / anaemia
59
What is Peutz Jegher
AD Haemartous polyp Pigmented macule around lips, face, palms, soles Can cause obstruction / intusscetpion / GI bleed
60
What can it be a sign of
COlon cancer
61
What are Muir Torre
Facial bumps
62
What do you do
Biopsy to see if sebaceous tumour
63
If lots
Risk of GI and breast cancer
64
What is Xeroderma pigmentosum
Genetic inability to repair sun damage
65
What can be underlying
Sarcoma Leukaemia GI Lung
66
What is Howel exams
Palmar keratoderma
67
What is underlying
Usually oesophageal cancer
68
What is Kaposi Sarcoma
Vascular malignancy driven by HHV-8
69
How does it present
Mucosal and cutaneous purple tumour | Can be visceral
70
Who is affected
Immunocompromised
71
How do you investigate
HIV test for all | Biopsy as could be bacillary angiomatosis (bacteria)
72
How do you Rx
ART Lower dose immunosuppressoin Direct removal
73
What is migratory thrombophlebitis
Palpable nodular cord Pain and induration along superficial vein Can have previous episodes
74
What causes
Clots leading to inflammation Often underlying malignancy Typically pancreatic
75
How do. you investigate
USS / CT for pancreatic

Dermatology (12 decks)

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