is it only skin deep? dermatologic evidence of systemic disease maj amanda cuda, md 7 sept 2011
TRANSCRIPT
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
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
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
Dermatologic Exam: Patient lying • Inspect skin of chest• Inspect skin of abdomen• Inspect skin of lower extremities
Systemic Conditions
• Skin wellness = overall wellness• Many manifestations, many conditions
Systemic Conditions
• View photo of a skin manifestation• Write 3 descriptive exam findings• Identify systemic condition(s)
Beau’s Lines
Café au Lait Spots
Erythema Multiforme
Telangiectasia
Butterfly Rash
Heliotrope rash
Viral Exanthems
Viral Exanthems con’t
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]
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]
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]
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]
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]
Clinic Challenge
• Derm exam, hair and nails included, • 1 patient/day for 1 week
Conclusion
• Reviewed dermatologic exam• Learned dermatologic conditions
and their systemic associations• Identified these conditions on photo
quiz
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