POPULAR

Skin Eruptions Signal Underlying Disorders

ESTIMATE 6-MINUTE READ
By Kevin RR Williams

Which Skin Condition Concerns You?

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Skin is a window to the soul. Common cutaneous disorders may be benign or could be an outward mani­festa­tion of internal or systemic disease. DermNet lists over 130 skin signs of systemic disease. This non-comprehensive table of 13 skin disorders expands diagnosis beyond acne or eczema and symptomatic cutaneous inflammation.

It also reveals why some skin erup­tions are resistant to topical dermatology treat­ments; the underlying condition must be addressed. Finger­nail irregu­lari­ties can also signal underlying disorders.

Cutaneous DisorderDescrip­tionInternal Differen­tial
Sebor­rheic Dermati­tisChronic superficial inflam­matory disease of the scalp, face (i.e. eyebrows and nasola­bial folds), ears and central chest.Possible associa­tion with systemic disease such as Parkinson’s disease and human immu­no­defi­ciency virus (HIV) infec­tion or cerebr­ovascu­lar accident.
Erythema MultiformeCutaneous hyper­sensi­tivity reaction. Macules, papules, plaques, vesicles or bullae, often with a targe­toid or iris appear­ance, often with distri­bu­tion through­out extre­mi­ties.Usually caused by infec­tion (herpes simplex virus or Myco­plasma pneu­moniae) and less commonly by drug sensi­tivity.
Cutaneous MetastasesMetastases to the skin are usually flesh-colored to viola­ceous nodules that appear in close proxi­mity to the primary neo­plasm; most common sites are the scalp, neck and trunk.Cancers of the breast and large intestine are the most likely primary tumors to metastasize to the skin in women.
Paget’s DiseaseUnilateral eczema­tous plaque of the nipple and areola. Persis­tent, eczema­tous plaque of the ano­genital or axillary regions.Strongly asso­ciated with an underlying inva­sive carci­noma of the affected breast or ductal car­ci­noma in situ.
Acanthosis NigricansSmooth, velvet-like, hyper­kera­totic plaques in inter­trigi­nous areas.Type I is asso­ciated with malignancy. Type II has no malig­nancy associa­tion. Type III acanthosis nigricans is associated with obesity and insulin resis­tance.
Cowden’s SyndromeWartlike growths around the mouth, nose and ears.Cancer of the breast, endo­me­trium, or thy­roid gland; and thy­roid disease (adenomas or goiter), mental retarda­tion, and fibro­cystic disease of the breast.
Sweet’s SyndromePainful erythema­tous to viola­ceous plaques on the face, extrem­ities, and trunk. Most have fever, malaise, arthral­gias, myalgias, and conjunctivitis.Inflam­ma­tory bowel disease, bowel bypass syn­drome, and preg­nancy. It occa­sionally occurs as a reac­tion to certain medica­tions.
AmyloidosisPapules on the eyelids and extremi­ties that become purpuric and ecchy­motic due to in­creased blood vessel fra­gility secon­dary to amyloid infil­tra­tion of the vessels.May be a sign of multi­ple myeloma.
Paraneo­plastic PemphigusIntractable stomatitis and blisters on the trunk and extremi­ties.Strong associa­tion with non-Hodgkin’s lymphoma, chronic lympho­cytic leukemia, and Castle­man’s disease with or without myas­the­nia gravis.
SarcoidosisRed to purple indu­rated plaques of the nose (lupus pernio), midfacial papules, annular plaques and plaques or nodules on the trunk and extre­mi­ties.Multi­system, granu­loma­tous disease of the lungs, bones, central nervous system, lymph nodes, eyes, and skin.
Erythema Gyratum RepensRed to purple indu­rated plaques of the nose (lupus pernio), mid­facial papules, annular plaques and plaques or nodules on the trunk and extremi­ties.Strong associa­tion with lung cancer; associa­tion with breast, cervical and gastro­intesti­nal cancers.
Psoriatic ArthritisSilvery, itchy scales and painful red patches can appear on the scalp, eyelids, ears, mouth and lips, skin folds, hands and feet, nails or other body areas optionally present with asym­metric fusi­form swelling of the distal inter­pha­langeal joints, in associa­tion with oligo­arthritis and teno­syno­vitis.Can resemble rheuma­toid arthritis.
Derma­tomyo­sitisScaly, telangie­ctatic plaques with atrophy and hypopig­menta­tion on the face, neck, trunk, and extre­mi­ties; malar erythema; and nail abnor­mali­ties (periungual telang­iec­tases and cuticular hyper­trophy).Symme­tric proximal muscle weakness (myositis); photo­sensi­tivity; papules and plaques on the hands, elbows, and knees.

Sweet Reaction

A patient noticed the sudden onset of painful, erythema­tous lesions on her forehead. It appeared to be an insect bite, vasculitis, atypical pyderma gangrenosum, Behcet’s disease or possible a herpes virus infection. But this turned out to be more than a dermato­logical concern.

The patient had acute febrile neutrophilic dermatosis, first described by Dr. Robert Douglas Sweet in 1964. Sweet’s syndrome may also be a reaction to a more serious condition, such as leukemia, or response to certain medications. Protecting your skin from prolonged sun exposure is a good way to avoid recur­rences of Sweet’s syndrome.

A person cannot easily see within the body without the aid of special equip­ment. So when something is going wrong inside, the skin on the outside may provide clues.

Included within the 19 illustrations, Anomalous Areolae depicts derma­titis, nevoid hyper­kerato­sis, Paget’s disease, carci­noma and malig­nant cancer of the breasts.

Skin and Common Disorders is an anatomical poster with 23 individual illustrations that highlight 22 of the most common lesions seen by derma­to­logists. Types of skin lesions are described: fissure, ulcer, cyst, macule, papule, wheal, vesicle, pustule, bulla and nodule. It also shows and describes acne (closed and open comedo), actinic keratosis (solar keratosis), junctio­nal nevus (mole), basal cell carci­noma, squamous cell carci­noma, verruca vulgaris (wart), seborrheic keratosis, dermato­fibroma and urticaria (hives). Order a poster to hang on your wall for reference.

To support the writing of useful articles about dermatology, ClinicalPosters sells human anatomy charts, scientific posters and other products online. You may sponsor specific articles, remit a small donation, or leave an encourag­ing comment to keep the work going.

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