THE CUTANEOUS MANIFESTATIONS OF SYSTEMIC DISEASES
د.هدف عبدالأمير1- Infection
Bacterial: staph aureus, pseudomonas, E coli, ….etcFungal : mainly candida albicansMay be the presenting sign2- Diabetic dermopathy
Most common, 50% 0f diabetics mostly men, dull red papules progressing to small round, well circumscribed atrophic, hyperpigmented spots on shins3-Diabetic bullae
painless, spontaneously occurring & resolving within 4-6 weeks, mostly acral parts.4-Diabetic ulceration
Especially on the feet, the limb is neuropathic, microvascularly compromised, & infection prone May pose a threat to both life & limb of the patient5- carotenosis
Yellowish discoloration of the skin especially on palms & soles, the sclera usually remain white
6- necrobiosis lipoidica
Well-circumscribed depressed, firm, waxy lesion, sulfur yellow center, violaceous border with telangectasia in the yellow portion Ulceration not unusual85% on shins ���� : ����= 3:10nly seen in 0.3-0.7% of diabetics 60%of patients with NL have diabetes 20% abnormal GT or +ve FHx of diabetes.Control of diabetes won’tInfluence the course
Treatment is unsatisfactory Topical or intralesional steroids in the advancing border Sometimes even excision & grafting Recurrence rate is high
7- granuloma annulare
Dermal nodules arranged singly or in an annular configuration asymptomatic mostly hands & feet doubtful association8-porphyria cutanea tarda
bullae, scarring & dyspigmentation on sun-exposed skin Enzyme defeciency in the heam synthesis pathway with increase in the intermediate metabolites of heamoglobin (porphyrin), that is deposited in the skin, teeth & excreted in urine Wood's lamp of urine gives a pinkish fluorescence.9-Eruptive xanthoma, & Acanthosis Nigricans, many other minor complications
THE SKIN IN LIVER DISEASES1- Pruritis: usually related to obstructive jaundice, but may precede it. 2- jaundice. 3- spider nevi. 4-palmar erythema. 5-white nails. 6-xanthoma in primary biliary cirrhosis. 7-porphyria cutanea tarda: bullae, scarring & dyspigmentation sun exposed skin.
CUTANEOUS MANIFESTATIOS OF RENAL FAILURE
1- Pruritis & a generally dry skin. 2- Pigmentation: earthy color with a yellowish tinge & pallor from anemia. 3- Half & half nail: proximal white & distal pink or brown. 4- Infections: as onychomycoses & tinea pedis. 5-xanthoma.TYHROID DISEASES HYPOTHYROIDISM
1- Dry & pale skin. 2- edema of eyelids & hands. 3- Decreased sweating. 4- Hair changes: coarse, thin, brittle hair with loss of pubic,axillary, outer eyebrows 5- Brittle, poorly growing nails. 6- Purpura & bruisingHYPERTHYROIDISM
CUSHING SYNDROME1- Truncal obesity +moon face.2- Striae distensiae.3- Hypertension &↓ CHO tolerance.4- Protein catabolism.5- Psychiatric disturbances.6- Amenorrhea & hirsutism in females.