Download MBBS Dermatology PPT 5 Cutaneous Manifestations Systemic Diseases Lecture Notes

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Dermatology PPT 5 Cutaneous Manifestations Systemic Diseases Lecture Notes

Cutaneous manifestations of

systemic diseases

DIABETES MELLITUS



? KOH mount from a patient of

vulvovaginitis (vaginal discharge)


? Budding yeast

? KOH mount from a patient of

vulvovaginitis (vaginal discharge)


? Pseudohyphae

? KOH mount from a patient of

vulvovaginitis (vaginal discharge)


? Hyphae (True)

? CANDIDAL INFECTION
? Candidal intertrigo (groins, interdigital, and inframammary),
? paronychia,
? vulvovaginitis, and
? balanoposthitis
? may be the presenting manifestations of undiagnosed diabetes


? CARBUNCLE


? 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
? Shins.


? Necrobiosis Lipoidica
? single or multiple,
? asymptomatic,
? indurated annular, yellowish brown plaque(s).
? Center is atrophic with ectatic blood vessels visible through the

thinned skin

? Shins.


? Acanthosis Nigricans

? velvety, hyper pigmented plaques with a feathered edge

? Axillae, inguinal region, and inframammary folds.



? Granuloma Annulare

? Skin colored or erythematous dermal papules

? arranged in an annular pattern


Eruptive xanthomas

? 1 to 5 mm erythematous to yellow papules
? appear in crops
? have an abrupt onset
? extensor surfaces of the extremities and buttocks
? highly suggestive of hypertriglyceridemia
? Occasionally, eruptive xanthomas are the initial sign of diabetes


? HYPOTHYROIDISM
? ichthyosis .

? Skin -dry, cold, and pale.

? Facies: Broad nose, thick lips, and large, thick tongue. Upper lid may

droop and the face appears expressionless.

? Myxedema: Podgy, nonpitting edema, which is generalized.

? Hair: Dry, coarse brittle hair.

? Follicular keratoses.

? Alopecia of scalp- patchy or diffuse.

? Supraciliary madarosis of lateral third of eyebrows is typical.

? HYPERTHYROIDISM

? 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.
? Pigmentary changes: hyperpigmentation of face
? vitiligo

PITUITARY DISORDERS

? ACROMEGALY

? excess secretion of growth hormone

? pituitary adenoma.
? CUTIS VERTICIS GYRATA
? Coarsening of facial features, often resulting in corrugated

appearance of forehead and scalp

? Seborrhea
? Macroglossia
? Spade-like hands
Adrenal Disorders

? Cushing's Disease/Syndrome
? chronic glucocorticoid excess

? Increased ACTH by pituitary gland, e.g., pituitary adenoma.
? Increased secretion of corticosteroids by adrenal gland independent

of adrenocorticotrophic hormone.

? Iatrogenic, due to intake of steroids.

? An exaggeration of the normal

pigmentation, seen especially on

the photo-exposed areas and at

sites of trauma--pressure points

and areas of friction (Addisonian

pigmentation).

typical y wide and red


Acneiform eruption

? Monomorphic papules

? No comedones

ADRENAL INSUFFICIENCY

? pigmentation
? An exaggeration of the normal pigmentation
? photo-exposed areas
? sites of trauma--pressure points and areas of friction (Addisonian

pigmentation).

? chloasma-like pigmentation
? Mucosal pigmentation
? Pigmentation of nails


SKIN IN RENAL DISEASE

? PrurituS-
? Generalized xerosis of the skin.

? Nephrogenic systemic fibrosis
? use of radiocontrast agents that contain gadolinium in patients with

renal failure.

? erythematous/yellowish indurated plaques with finger-like

projections.

? Perforating keratosis


Half-and-half nails
? Pigmentation of distal half of

the nail, while the proximal part

remains pale.

SKIN IN LIVER DISEASES

? SPIDER ANGIOMA
? Pruritus- Due to accumulation of ? Spider nevi and palmar

bile salts, when there is

erythema: Due to accumulation

obstructive jaundice.

of estrogen and progesterone.

? Yellowish pigmentation:Due to

? White nails:Due to

accumulation of bile pigments.

hypoproteinemia.

SKIN AND METABOLIC DISEASES

? Porphyrias

? partial deficiency of one of the

? accumulation of substrate

many enzymes required for

(intermediary porphyrins), many

biosynthesis of haem.

of which cause photosensitivity

induced by light of wave length

400 nm (Soret band).
? Blistering photosensitivity/

? Non- Blistering photosensitivity

? CONGENITAL ERYTHROPOIETIC

? ERYTHROPOIETIC

PORPHYRIA-

PROTOPORPHYRIA-

? brown teeth,

? Burning, oedema & urticaria on

? yellow colored urine,

sunexposure

? Blistering photosensitivity

? Wood's lamp emits ultraviolet A

light with a peak emission at 365

nm

? PORPHYRIA CUTANEA TARDA

? VARIEGATE PORPHYRIA

? Blisters in photo-exposed parts

? Cutaneous lesions Like those in

on sun exposure.

PCT

? Sclerodermoid changes
? Hypertrichosis


xanthomas
? Investigations- MUST in xanthomas
? LIPID PROFILE
? IF NORMOLIPEMIC.......
? Rule out Diabetes, liver disease, hypothyroidism

SARCOIDOSIS

? multisystem inflammatory disorder

? Non caseating granulomas in many organs

? Skin prototype lesion- juicy, shiny , infiltrated, red-brown papules------

discoid/annular plaque

? Variants-

? lupus pernio (nose, earlobes, cheeks and digits)

? Angiolupoid sarcoidosis

? Scar sarcoidosis

? Erythema nodosum
? Skin biopsy- naked granulomas

? Treatment- steroids
? THANK YOU