Cutaneous Signs in Select Internal Dieases| | | | | | | Table 3-27 Cutaneous Signs in Select Internal Diseases | | | Endocrine | | | Diabetes mellitus | | – Acanthosis nigricans
– Bullous diabeticorum: (Figure 3.48B) tense noninflammatory blisters on lower extremities
– Diabetic dermopathy: atrophic yellow to brown macules on lower legs
– Disseminated granuloma annulare
– Necrobiosis lipoidica diabeticorum
– Scleredema of Buschke
– Eruptive xanthomas (Figure 3.48F) | | | Hypothyroidism | | – Coarse dry skin
– Generalized myxedema: boggy and edematous
– Dull, brittle hair
– Alopecia of lateral 1/3 eyebrows (madarosis)
– Onycholysis | | | Hyperthyroidism
(Graves’ disease) | | – Velvety, smooth or moist skin
– Hyperpigmentation (localized or generalized)
– Pretibial myxedema: (Figure 3.48E) yellow-brown waxy papules on lower extremities
– Fine hair
– Mild but diffuse alopecia
– Koilonychia
– Onycholysis | | | Addison’s disease | | – Hyperpigmentation | | | GI | | | Cirrhosis | | – Spider angiomas
– Palmar erythema
– Gynecomastia
– Terry’s nails | | | Hemochromatosis | | – Generalized hyperpigmentation | | | Primary biliary cirrhosis | | – Pruritus
– Eruptive/planar xanthomas | | | Wilson’s disease | | – Kayser-Fleischer rings
– Blue lunulae | | | Hepatitis C | | – Mixed cryoglobulinemia
– Porphyria cutanea tarda
– Lichen planus (particular oral) (Figure 3.48C)
– Pruritus
– Necrolytic acral erythema
– Polyarteritis nodosa | | | Inflammatory bowel disease | | – Erythema nodosum (Figure 3.48D)
– Pyoderma gangrenosum (also oral pyostomatitis vegetans) | | | Renal | | | End stage renal disease | | – Pruritus
– Uremic frost
– Calciphylaxis
– Acquired perforating disorder (Figure 3.50B)
– Nephrogenic systemic fibrosis | | | | | |
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| Figure 3.47
A: Pellagra (Courtesy of Dr. Paul Getz)
B: Glossitis (Courtesy of Dr. Paul Getz)
C: Zinc deficiency with acral bulla (Courtesy of Dr. Paul Getz)
D: Scurvy (‘corkscrew’ hairs, perifollicular hemorrhage) (Reprint from Feldman M, ed. Gastroenterology and Hepatology. Philadelphia, PA: Churchill Livingstone, Inc; 1998) |
| | | Figure 3.48
A: Acanthosis nigricans
B: Bullous diabeticorum (Courtesy of Dr. Paul Getz)
C: Oral lichen planus
(Courtesy of Dr. Iris K. Aronson)
D: Erythema nodosum (Courtesy of Dr. Paul Getz)
E: Pretibial myxedema (Reprint from Krause W. Cutaneous Manifestations of Endocrine Diseases. London: Springer; 2009)
F: Eruptive xanthomas (Reprint from Morgan MB, Smoller BR, Somach SC. Deadly Dermatologic Diseases. New York, NY: Springer; 2007) |
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| Figure 3.49
A: Primary amyloidosis (‘pinch’ purpura)
B: Paget’s disease (Reprint from Morgan MB, Smoller BR, Somach SC. Deadly Dermatologic Diseases. New York, NY: Springer; 2007)
C: Tripe palms
(Reprint from Krause W. Cutaneous Manifestations of Endocrine Diseases. London: Springer; 2009)
D: Multicentric reticulohistiocytosis
(Reprint from Morgan MB, Smoller BR, Somach SC. Deadly Dermatologic Diseases. New York, NY: Springer; 2007)
E: Pyoderma gangrenosum
(Courtesy of Dr. Paul Getz)
F: Cutaneous metastases (bronchogenic carcinoma) (Courtesy of Dr. Paul Getz) |
| | | Figure 3.50
A: Bazex sign (acrokeratosis paraneoplastica)*
B: Acquired perforating disorder (in ESRD)
C: Acquired angioedema (resolving)
* Reprint from Burgdorf WH, Plewig G, Landthaler M, Wolff HH, eds. Braun-Falco’s Dermatology. 3rd ed., Berlin: Springer; 2009
D: Erythema gyratum repens
(Courtesy of Dr. Paul Getz) |
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