Skin Manifestations of Systemic Diseases
Terms in this set (49)
____% of patients with lupus have skin involvement
Criteria for lupus
need at least 4 of: SOAP BRAIN MD
- Oral ulcers (painless)
- Blood Disorders
- Renal involvement
- Anti-nuclear antibodies
- Immunologic phenomena
- Neurologic disorder
- Malar rash
- Discoid rash
The lupus rash usually spares ________
joints on hands
oval or annular scaly plaques that are atrophic in middle and have characteristic scar like appearance
What is a complication of discoid rash?
scarring hair loss
What is a malar rash?
flat and erythematous, looks like rosacea
subacute cutaneous lupus erythematous eruption
papulosquamous, looks like psoriasis
What is chillbain lupus?
erythematous, tender, inflamed toes (more common in colder weather environments)
What is neonatal lupus and what is it associated with?
annular plaques/patches on face and scalp. Associated with congenital heart blocks
What is dermatomyositis?
multisystem autoimmune disease with inflammatory myopathy and characteristic skin findings
Dermatomyositis pathognomonic skin findings
- Heliotrope eruption
- Gottron's papules
What should you screen for in individuals with dermatomyositis?
- Pulmonary disease
What is heliotrope eruption?
violaceous erythema, scaling and edema of eyelids
What are Gottron's papules?
violaceous, scaly papules/plaques over bony prominences (joints) of hands and elbows
What is the shawl sign?
violeceous erythema of upper chest
What is the holster sign?
violaceous erythema of lateral thighs
______% of dermatomyositis patients have an internal malignancy (ovarian, lung, pancreas, colon, breast, non-Hodgkins lymphoma, nasopharyngeal)
What is vasculitis?
inflammation of blood vessels
Causes of vasculitis (5)
- Connective tissue disease (e.g. lupus, dermatomyositis)
2 skin signs of vasculitis
- palpable purpura
4 signs of infective endocarditis
- Petechiae (conjunctiva, palate, extremities)
- Osler nodes
- Janeway lesions
- Splinter hemorrhages
What do petechiae look like?
What are osler nodes?
small, painful nodules on fingers and toes
What are Janeway lesions?
hemorrhagic, non-painful macules on palms and soles
What are splinter hemorrhages?
non blanching, reddish brown linear streaks in nails
6 skin signs of diabetes
- Acanthosis nigricans
- Diabetic dermopathy
- Diabetic foot ulcer
- Eruptive xanthomas
- Necrobiosis lipoidica
- Scleroderma-like skin findings
What is acanthoses nigricans?
velvety, hyperpigmented thickening of skin, mostly in skin folds
What is the most common cutaneous marker of diabetes?
Diabetic dermopathy (40% of diabetics)
What is diabetic dermopathy?
dull brown/light red scaly changes on shins
Eruptive xanthomas are pathognomonic of ______. Up to ______% of diabetics have ________ abnormalities causes by low insulin levels.
What is necrobiosis lipoidica?
yellow/orange/red plaques on lower extremities that look atrophic
___% of diabetics have necrobiosis lipoidica. ____% of people with necrobiosis lipoidica have diabetes.
Scleroderma like skin findings in diabetes
glycosylation end products cause skin tightening and they get the "Prayer Sign"- the inability to press palms together completely because of limited joint mobility
Skin sign of thyroid disease seen on the legs
Skin signs of thyroid disease seen on the face (6)
- Dry, pale skin
- Thinning of lateral eyebrows (Queen annes sign)
- Puffiness of face and eyelids
- increased # of skin creases
- Dull, expressionless face
xanthomas seen on elbows and knees
slightly yellow, flat or elevated soft plaque on eyelids
____% of patients with planar xanthomas on eyelids have normal lipid levels
Cushing's skin findings(5)
- Cutaneous atrophy
Subcutaneous fat distribution in Cushing's (4)
- Moon facies
- Buffalo hump
- Central adiposity
- Supraclavicular fat pad
4 face signs of acromegaly
- Elongated face
- Prognathia (jaw protrudes)
- Triangular/enlarged nose
What is sarcoidosis?
accumulation of T-cell lymphocytes, monocytes and epithelioid macrophages from unknown antigens--> induce formation of non-caseating granulomas--> abnormal tissue and organ function
What is diascopy?
press a glass slide on rash to test for blanching
What happens to sarcoidosis plaques in diascopy?
plaques turn from red to "apple jelly" colour
raised, hardened lesion of skin, often purplish. Seen on nose, ears, cheeks, lips, forehead.
Which organ does sarcoidosis almost always involve?
What other three parts of body are commonly involved in sarcoidosis?
- Lymph nodes
Sarcoidosis has a ___% mortality, spontaneously resolves in up to ____% of patients.
- Erythema nodosum
- Asymptomatic bilateral hilar lymphadenopathy