? KOH mount from a patient of
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vulvovaginitis (vaginal discharge)
? Budding yeast
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? KOH mount from a patient of
vulvovaginitis (vaginal discharge)
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? Pseudohyphae
? KOH mount from a patient of
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vulvovaginitis (vaginal discharge)? Hyphae (True)
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? CANDIDAL INFECTION? Candidal intertrigo (groins, interdigital, and inframammary),
? paronychia,
? vulvovaginitis, and
? balanoposthitis
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? may be the presenting manifestations of undiagnosed diabetes? CARBUNCLE
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? Diabetic dermopathy
? Most common dermatosis associated with diabetes
? Begins as small, dull red papules with a superficial scales;
? slowly resolve to leave small, brown, depressed scars
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? Shins.? Necrobiosis Lipoidica
? single or multiple,
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? asymptomatic,? indurated annular, yellowish brown plaque(s).
? Center is atrophic with ectatic blood vessels visible through the
thinned skin
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? Shins.
? Acanthosis Nigricans
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? velvety, hyper pigmented plaques with a feathered edge
? Axillae, inguinal region, and inframammary folds.
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? Granuloma Annulare
? Skin colored or erythematous dermal papules
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? arranged in an annular pattern
Eruptive xanthomas
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? 1 to 5 mm erythematous to yellow papules
? appear in crops
? have an abrupt onset
? extensor surfaces of the extremities and buttocks
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? highly suggestive of hypertriglyceridemia? Occasionally, eruptive xanthomas are the initial sign of diabetes
? HYPOTHYROIDISM
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? ichthyosis .? Skin -dry, cold, and pale.
? Facies: Broad nose, thick lips, and large, thick tongue. Upper lid may
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droop and the face appears expressionless.
? Myxedema: Podgy, nonpitting edema, which is generalized.
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? Hair: Dry, coarse brittle hair.? Follicular keratoses.
? Alopecia of scalp- patchy or diffuse.
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? Supraciliary madarosis of lateral third of eyebrows is typical.
? HYPERTHYROIDISM
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? Pretibial myxedema? Asymmetric firm plaques with a "peau d'orange" appearance
? Cold, moist, smooth skin,
? Palmoplantar hyperhidrosis
? Persistent flush of the face and palmar erythema.
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? Pigmentary changes: hyperpigmentation of face? vitiligo
PITUITARY DISORDERS
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? ACROMEGALY? excess secretion of growth hormone
? pituitary adenoma.
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? CUTIS VERTICIS GYRATA? Coarsening of facial features, often resulting in corrugated
appearance of forehead and scalp
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? Seborrhea? Macroglossia
? Spade-like hands
Adrenal Disorders
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? Cushing's Disease/Syndrome? chronic glucocorticoid excess
? Increased ACTH by pituitary gland, e.g., pituitary adenoma.
? Increased secretion of corticosteroids by adrenal gland independent
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of adrenocorticotrophic hormone.
? Iatrogenic, due to intake of steroids.
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? An exaggeration of the normalpigmentation, seen especially on
the photo-exposed areas and at
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sites of trauma--pressure points
and areas of friction (Addisonian
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pigmentation).typical y wide and red
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Acneiform eruption? Monomorphic papules
? No comedones
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ADRENAL INSUFFICIENCY
? pigmentation
? An exaggeration of the normal pigmentation
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? photo-exposed areas? sites of trauma--pressure points and areas of friction (Addisonian
pigmentation).
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? chloasma-like pigmentation? Mucosal pigmentation
? Pigmentation of nails
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SKIN IN RENAL DISEASE? PrurituS-
? Generalized xerosis of the skin.
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? Nephrogenic systemic fibrosis? use of radiocontrast agents that contain gadolinium in patients with
renal failure.
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? erythematous/yellowish indurated plaques with finger-likeprojections.
? Perforating keratosis
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Half-and-half nails
? Pigmentation of distal half of
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the nail, while the proximal partremains pale.
SKIN IN LIVER DISEASES
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? SPIDER ANGIOMA
? Pruritus- Due to accumulation of ? Spider nevi and palmar
bile salts, when there is
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erythema: Due to accumulation
obstructive jaundice.
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of estrogen and progesterone.? Yellowish pigmentation:Due to
? White nails:Due to
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accumulation of bile pigments.
hypoproteinemia.
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SKIN AND METABOLIC DISEASES? Porphyrias
? partial deficiency of one of the
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? accumulation of substrate
many enzymes required for
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(intermediary porphyrins), manybiosynthesis of haem.
of which cause photosensitivity
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induced by light of wave length
400 nm (Soret band).
? Blistering photosensitivity/
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? Non- Blistering photosensitivity
? CONGENITAL ERYTHROPOIETIC
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? ERYTHROPOIETICPORPHYRIA-
PROTOPORPHYRIA-
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? brown teeth,
? Burning, oedema & urticaria on
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? yellow colored urine,sunexposure
? Blistering photosensitivity
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? Wood's lamp emits ultraviolet A
light with a peak emission at 365
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nm? PORPHYRIA CUTANEA TARDA
? VARIEGATE PORPHYRIA
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? Blisters in photo-exposed parts
? Cutaneous lesions Like those in
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on sun exposure.PCT
? Sclerodermoid changes
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? Hypertrichosisxanthomas
? Investigations- MUST in xanthomas
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? LIPID PROFILE? IF NORMOLIPEMIC.......
? Rule out Diabetes, liver disease, hypothyroidism
SARCOIDOSIS
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? multisystem inflammatory disorder
? Non caseating granulomas in many organs
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? Skin prototype lesion- juicy, shiny , infiltrated, red-brown papules------discoid/annular plaque
? Variants-
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? lupus pernio (nose, earlobes, cheeks and digits)
? Angiolupoid sarcoidosis
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? Scar sarcoidosis? Erythema nodosum
? Skin biopsy- naked granulomas
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? Treatment- steroids? THANK YOU