13 Skin Eruptions Signaling Underlying Disorders

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. [1–3] It also reveals why some skin erup­tions are resistant to topical treat­ments; the underlying condition must be addressed. Finger­nail irregu­lari­ties can also signal underlying disorders. [4]

Cutaneous Disorder Description Internal Differential
Seborrheic Dermatitis Chronic 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 Multiforme Cutaneous 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 Metastases Metastases 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 Disease Unilateral 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 Nigricans Smooth, 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 Syndrome Wartlike 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 Syndrome Painful 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.
Amyloidosis Papules 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 Pemphigus Intractable 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.
Sarcoidosis Red 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 Repens Red 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 Arthritis Silvery, 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.
Derma­tomyo­sitis Scaly, 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.

13 Skin Eruptions Signaling Underlying Disorders #dermatology

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. [5] Sweet’s syndrome may also be a reaction to a more serious condition, such as leukemia, or response to certain medications. [6] 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 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.

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January 04, 2019 by Kevin Williams