Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda Cuda, MD 7 Sept 2011.
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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.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/1.jpg)
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.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/2.jpg)
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.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/3.jpg)
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.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/4.jpg)
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.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/5.jpg)
Dermatologic Exam: Patient lying • Inspect skin of chest• Inspect skin of abdomen• Inspect skin of lower extremities
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Systemic Conditions
• Skin wellness = overall wellness• Many manifestations, many conditions
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Systemic Conditions
• View photo of a skin manifestation• Write 3 descriptive exam findings• Identify systemic condition(s)
![Page 8: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda Cuda, MD 7 Sept 2011.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/8.jpg)
Beau’s Lines
![Page 11: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda Cuda, MD 7 Sept 2011.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/11.jpg)
Café au Lait Spots
![Page 12: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda Cuda, MD 7 Sept 2011.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/12.jpg)
Erythema Multiforme
![Page 13: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda Cuda, MD 7 Sept 2011.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/13.jpg)
Telangiectasia
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Butterfly Rash
![Page 15: Is it Only Skin Deep? Dermatologic Evidence of Systemic Disease MAJ Amanda Cuda, MD 7 Sept 2011.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/15.jpg)
Heliotrope rash
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Viral Exanthems
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Viral Exanthems con’t
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Which of these skin findings can be normal?
A. Acanthosis nigricans
B. Palpable purpura
C. Heliotrope rash
D. Café au Lait macule[Default][MC Any][MC All]
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Which of the following is not a cause of this nail finding?
A. Diabetes Mellitus
B. Psoriasis
C. Thyrotoxicosis
D. 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.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/21.jpg)
All of the following are manifestations of an underlying vasculitis except:
A. Acanthosis nigricans
B. Erythema multiforme
C. Purpura
D. Telangiectasia[Default][MC Any][MC All]
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Possible cause of this nail finding?
A. Kawasaki Disease
B. Telogen Effluvium
C. Scarlet Fever
D. 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.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/23.jpg)
Which of the following, pictured here, was known as Sixth Disease?
A. Rubella
B. Measles
C. Roseola
D. 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.](https://reader030.fdocuments.net/reader030/viewer/2022032313/56649e6f5503460f94b6cec4/html5/thumbnails/24.jpg)
Clinic Challenge
• Derm exam, hair and nails included, • 1 patient/day for 1 week
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Conclusion
• Reviewed dermatologic exam• Learned dermatologic conditions
and their systemic associations• Identified these conditions on photo
quiz
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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