Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda Cuda , MD 7 Sept 2011

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Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda Cuda, MD 7 Sept 2011

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Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda Cuda , MD 7 Sept 2011. Objectives. To review the dermatologic exam, including hair and nails To learn dermatologic conditions and their systemic associations - PowerPoint PPT Presentation

Transcript of Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda Cuda , MD 7 Sept 2011

Page 1: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Is it Only Skin Deep?Dermatologic Evidence of Systemic

Disease

MAJ Amanda Cuda, MD

7 Sept 2011

Page 2: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Objectives

• To review the dermatologic exam, including hair and nails

• To learn dermatologic conditions and their systemic associations

• To identify these same conditions and associations from photographs

Page 3: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Dermatologic Exam

• Break up into pairs:–Examine your partner’s hands and

fingers only, include fingernails–Document exam using medical terms–Present exam to your partner

Page 4: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Dermatologic Exam:Patient seated• Inspect the hair

–Pattern of distribution and texture• Inspect nail beds• Inspect nails for clubbing, pitting• Inspect skin of face and neck• Inspect skin over back

Page 5: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Dermatologic Exam: Patient lying • Inspect skin of chest• Inspect skin of abdomen• Inspect skin of lower extremities

Page 6: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Systemic Conditions

• Skin wellness = overall wellness• Many manifestations, many conditions

Page 7: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Systemic Conditions

• View photo of a skin manifestation• Write 3 descriptive exam findings• Identify systemic condition(s)

Page 11: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Café au Lait Spots

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Telangiectasia

Page 14: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Butterfly Rash

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Heliotrope rash

Page 19: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Which of these skin findings can be normal?

A. Acanthosis nigricansB. Palpable purpuraC. Heliotrope rashD. Café au Lait macule

[Default][MC Any][MC All]

Page 20: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Which of the following is not a cause of this nail finding?

A. Diabetes MellitusB. PsoriasisC. ThyrotoxicosisD. Trauma

[Default][MC Any][MC All]

Page 21: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

All of the following are manifestations of an underlying vasculitis except:

A. Acanthosis nigricansB. Erythema multiformeC. PurpuraD. Telangiectasia

[Default][MC Any][MC All]

Page 22: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Possible cause of this nail finding?A. Kawasaki DiseaseB. Telogen EffluviumC. Scarlet FeverD. All of the above

[Default][MC Any][MC All]

Page 23: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Which of the following, pictured here, was known as Sixth Disease?

A. RubellaB. MeaslesC. RoseolaD. Scarlet Fever

[Default][MC Any][MC All]

Page 24: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Clinic Challenge

• Derm exam, hair and nails included, • 1 patient/day for 1 week

Page 25: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

Conclusion

• Reviewed dermatologic exam• Learned dermatologic conditions

and their systemic associations• Identified these conditions on photo

quiz

Page 27: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda  Cuda , MD 7 Sept 2011

References• DeGowin RL, Brown DD. DeGowin’s Diagnostic

Examination, Seventh Edition.• Fitzpatrick TB, Johnson RA, Wolff K, Suurmond D. Color

Atlas and Synopsis of Clinical Dermatology, Fourth Edition.• Habif TP etal. Skin Diseases Diagnosis and Treatment,

Second edition.• www.dermnet.com• http://en.wikipedia.org/wiki• http://www.myfootshop.com/• www.mdconsult.com• http://health.allrefer.com• http://www.clevelandclinicmeded.com• http://dermatlas.med.jhmi.edu• http://emedicine.medscape.com