1. Demonstrate an ability to recognise skin signs of common or important systemic diseases including: granuloma annulare, dermatitis herpetiformis, necrobiosis lipodica, acanthosis nigricans, splinter haemorrhage, dermatomyositis, systemic lupus erythematosus, erythema nodosum, erythema multiforme, pruritis[]
Granuloma annulare[]
Photo from missinglink.ucsf.edu
A ring of waxy, erythematous papules.
Associated diseases: diabetes, HIV infection.
Dermatitis herpetiformis[]
photo from dermatlas.med.jmhi.edu
An itchy, blistering, persistent skin eruption.
Disease associations: Coeliac's
Necrobiosis lipodica
from dermatlas.med.jmhi.edu
Patches of redness on the shins. If larger, they will have a well-defined border, and a shiny yellowy centre, usually with visible blood vessels.
Disease associatons: Insulin dependent and Non-Insulin dependent diabetes mellitus
Acanthosis Nigricans[]
from rfes.upta.edu
Hyperpigmentation and thick, velvety skin, especially in the skinfolds.
Disease associations: obesity, type 2 diabetes mellitus
Splinter Haemorrhage[]
from nhs.uk
Thin, reddish-brown lines of blood running vertically under the nails
Disease associations: infective endocarditis
Dermatomyositis[]
Copyright University of Iowa
Rash which appears on the face, knuckles, neck, shoulders, upper chest and back.
Systemic Lupus Erythematosus (SLE)[]
As well as the classic 'butterfly' malar rash, skin manifestations of SLE include:
- Vasculitic lesions around the nail folds
- Purpura
- Urticaria
- Photosensitivity
- Palma and plantar rashes
- Pigmentation
- Alopecia
- Reynaud's phenomenon
- Livedo reticularis (see picture below)
from londonlupuscentre.co.uk
Erythema Nodosum[]
Picture from dermatlas.med.jhmi.edu
Flat, firm, hot, red, painful lumps approximately an inch in diameter. They progress to purple, then brown colour.
Disease Associations: Streptococcus infection, bacterial gastroenteritides, pregnancy, antibiotic sensitivity reaction, leukaemia, lymphoma, sarcoidosis, rheumatic fever, Behcet's disease, ulcerative colitis, tuberculosis, leprosy, fungal infection, Chlamydia
Erythema Multiforme[]
Literally meaning "Redness of many shapes"
from dermatlas.med.jhmi.edu
Disease associations: Herpes Simplex Virus (HSV), other viral infections, mycoplasma infection, connective tissue disease, HIV infection, Wegener's granulomatosis, carcinoma, lymphoma.
Pruritis[]
Itchiness.
In the absence of rash, pruritis has the following disease associations:
- Iron Deficiency Anaemia
- Internal malignancy (especially lymphoma)
- Diabetes mellitus
- Chronic Kidney Disease
- Chronic liver disease (especially primary biliary cirrhosis)
- Thyroid disease
- HIV infection
- Polycythaemia vera
- Herbal Supplement Review