CUTANEOUS MEDICINE PART 3

CUTANEOUS MEDICINE PART 3

TOM PAIGEDEPARTMENT OF DERMATOLOGYCCRMC

Medical Disorders

Diabetes mellitusThyroid diseaseCushing’s syndromeAcromegalyGastrointestinal diseaseRenal disease

Best Answer(s)

(A). Three slides represent examples of palpable purpura(B). Platelet count is less than 10,000/mm3

(C). Platelet count is greater than 1,000,000/mm3

(D). Petechiae are usually 5 mm or larger in size and non-palpable.(E). B. and C. are the correct answers

Petechiae

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Hematologic diseases

Cutaneous hemorrhages Petechiae Ecchymoses

Generalized pruritisLeukemia may be associated w/ Sweet’s syndrome or pyoderma gangrenosumLeukemia/lymphoma sometimes causes red, purpuric or ulcerated skin nodules

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Best Answer(s)

A. These slides represent cutaneous lymphomasB. Cutaneous lymphomas are the second most common group of extra nodal lymphomasC. B-cell lymphomas occur in the skinD. Mycosis fungoides is the most common form of cutaneous lymphomaE. (A) and (D)F. All the above

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Best Answer(s)

A. Mycosis fungoides is a CD4 helper T-cell malignancyB. CD8 suppressor T-cells are the predominate cell type in mycosis fungoidesC. Both A. and B.D. Neither A. and B.

Best Answers

A. All of the porphyrias have a photo component.B. Diagnosis may be made by examination of urine, feces, and blood. C. There is a strong association between hepatitis C virus and PCT D. (B.) and (C.)E. None of the above

Porphyria

Porphyrias are due to abnormalities of the heme pathway and result in cutaneous photosensitivity.Diagnosis is confirmed by detection of excessive porphyrins in Blood Urine Feces

The most common porphyrias seen by dermatologists are Erythropoietic protoporphyria (EPP) Porphyria cutanea tarda (PCT) Variegate porphyria (VP)

EPP

EPP SYMPTOMS

EDEMA SUN -INDUCED ERYTHEMAACUTE PAINFUL PHTODERMATITISURTICARIA

Porphyria Cutanea Tarda

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PCT

VP

PCT AND VP SYMPTOMS

BLISTERING LESIONSKIN FRAGILITYSCARRINGHYPERPIGMENTATIONPOSSIBLE HYPERTRICHOSIS

Hyperlipidemias

The disorders of lipid metabolism with cutaneous manifestations are primarily the hyperlipoproteinemias (hyperlipidemias).They can be Primary Secondary

Primary Hyperlipoproteinemias

Elevated lipoprotein class Chylomicrons Chylomicrons and VLDLs VLDLs LDLs LDLs and VLDLs IDLs

Table 22–1   -- Primary hyperlipoproteinemias

Elevated lipoprotein class

Synonyms and primary disorders

Chylomicrons

Type I, familial lipoprotein lipase deficiency, familial apoprotein C-II deficiencies

Chylomicrons and VLDLs

Type V, familial combined hyperlipidemia

VLDLs

Type IV, endogenous familial hypertriglyceridemiaL

DLs

Type IIa, familial hypercholesterolemia, familial combined hyperlipidemia

LDLs and VLDLs

Type IIb, familial multiple lipoprotein-type hyperlipidemia, combined hyperlipidemiaI

DLs

Type III, remnant hyperlipidemia, familial dysbetalipoproteinemia

VLDL = very-low-density lipoprotein, LDL = low-density lipoprotein, IDL = intermediate-density lipoprotein

Primary Hyperlipoproteinemias

Secondary Hyperlipoproteinemias

Secondary hypercholesterolemiaSecondary hypertriglyceridemia

Secondary hypercholesterolemia

Acute intermittent porphyria Cholestasis Hypothyroidism Pregnancy

Secondary Hypertriglyceridemia

MetabolicRenalHepaticHormonalLife styleMedications

Clinical Presentation of Hyperlipidemias

XanthelasmaEruptive, tuberous, plane, or tendinous xanthoma

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