Medical Articles
Acanthosis nigricans - smooth, velvet-like, hyperkeratotic plaques in the folds eg, groin, axillae, neck; commonly seen in obesity, insulin-resistant diabetes (syndrome X), with systemic corticosteroids, nicotinic acid, diethylstilbestrol and isoniazid (INH). It may, rarely, indicate an underlying Adenocarcinoma, especially of the GI tract.
People with Addison's disease develop patches of dark skin; this darkness may seem like tanning, but it appears on areas not even exposed to the sun. Even people with dark skin can develop excessive pigmentation, although the change may be harder to recognize. Black freckles may develop over the forehead, face, and shoulders; a bluish black discoloration may develop around the nipples, lips, mouth, rectum, scrotum, or vagina. Read more
A patient of Cushing's syndrome will show evidence of thinning of the skin, with easy bruisability. Also there are purple striae on the abdomen, thighs, breasts and shoulders. The patients will also complain of increased acne. There will be hirsutism with excessive facial hair growth, and scalp hair loss in women. Some may have evidence of Acanthosis nigricans on the nape of the neck due to the presence of insulin resistance. Read more
Cutaneous metastases occurring in less than 5% of patients with metastatic cancer, usually reflect the most prevalent types of cancer in the general population, eg, cancers of the breast, lung or GI tract. Cutaneous metastases are usually skin-colored to violaceous nodules that appear in close proximity to the primary neoplasm, most commonly occurring on the head, neck and trunk.
Dermatitis herpetiformis - is a chronic, intensely itchy, papulovesicular disease characterized by symmetric groups of vesicles, papules and wheals on the elbows, knees, scalp and buttocks. Most patients have an asymptomatic gluten-sensitive enteropathies or less commonly, thyroid disease.
Ehlers-Danlos syndrome - an abnormality in collagen biosynthesis is characterized by hyper extensibility, hyper mobility, skin fragility and "fish-mouth" scars. Associated features include mitral valve prolapse, blue sclerae, aneurysm, aortic dissection, hernias, angina, GI bleeding (perforation) and peripheral vascular disease, depending on the type and severity of disease.
Erythema Nodosum - the most common type of panniculitis is characterized by painful, reddened nodules on the shins. The most common cause of erythema Nodosum is a streptococcal pharyngitis; less commonly it occurs due to drug sensitivity (sulfonamides, OCPs) and a variety of diseases, most often inflammatory bowel disease and sarcoidosis.
Erythema multiforme - a cutaneous hypersensitivity reaction, is usually caused by infection (herpes simplex virus or Mycoplasma pneumoniae) and less commonly by drug sensitivity eg with sulfonamides or antibiotics). Mauls, papules, plaques, vesicles or bulla often with a targetoid or iris appearance, occur on the skin, often with an acral distribution (extremities) and mucosal surfaces.
Exfoliative dermatitis - or erythroderma, is an inflammatory skin disease characterized by generalized erythema and scaling, often with pruritus, malaise and chills. The most common causes are preexisting skin diseases, eg, psoriasis, atopic eczema and drug hypersensitivity, less commonly cutaneous T-cell lymphoma.
Haemochromatosis-This is also known as bronzed diabetes which gives a particular golden colour to the skin. The increased levels of iron in the skin of patients stimulates melanin pigment production leading to diffuse hyperpigmentation of the skin. Read more
Hirsutism- the presence of coarse, male-type hair in a woman may indicate androgen excess, eg, an adrenal or ovarian tumor. By contrast, hypertrichosis or excessive growth of vellums hairs in any hair-bearing area may occur with malignancy, metabolic disorders or medications, such as cyclosporine and Minoxidil. Read more
Hypertriglyceridaemia-Xanthelasmas are yellow coloured papules also known as eruptive xanthemas due to high serum triglycerides and they are seen generally on the eyelid and on the extensor surface of the buttocks. These disappear with treatment of Hypertriglyceridaemia.
Lupus erythematosus- is an autoimmune photosensitive dermatosis, which can be localized or systemic in nature. The cutaneous manifestations of SLE include: malar erythema, photosensitivity oral ulcers, discoid plaques, bullae, purpura and alopecia. The butterfly "rash" (malar erythema) is the most common cutaneous finding.
Melasma is a very common skin disorder. Though it can affect anyone, young women with brownish skin tones are at greatest risk.Melasma is often associated with the hormones estrogen and progesterone. It is especially common in pregnant women, women who are taking oral contraceptives ("the pill"), and women taking hormone replacement therapy during menopause. Sun exposure is also a strong risk factor for Melasma. It is particularly common in tropical climates.
Paget's disease of the breast - is a unilateral, eczematous plaque of the nipple and areola. Disease is nearly always associated with an underlying intraductal carcinoma of the breast.
Psoriatic arthritis-is commonly characterized by asymmetric fusiform swelling of the distal IP joints. Active disease may resemble rheumatoid arthritis. The most common among five types is oligoarthritis of the joints of the hand, characterized by "sausage" fingers and toes.
Reiter's syndrome - is the triad of urethritis, conjunctivitis and oligoarthritis. Affected patients, usually young men, often have vesicles and crusted plaques on the penis and erythematous pustules and papules on the palms and soles that may mimic pustular psoriasis. Read more
Sarcoidosis - It is a multisystem, granulomatous disease of the lungs, bones, eyes and skin. Skin disease, affecting 15 - 30% of patients, includes red to purple plaques of the nose; midfacial papules; annular plaques; and plaques or nodules on the trunk and extremities. Erythema Nodosum, the most common cutaneous manifestation of sarcoidosis, is an acute, painful panniculitis that usually affects the shins. Read more
Scleroderma - is an autoimmune skin disease which can be localized or extensive. In the localized form, known as morphea, erythematous patches evolve into dusky, hypopigmented, indurated plaques with violaceous borders, usually on the trunk. Read more
Seborrhoeic keratoses - most common benign cutaneous growths; they are warty, age-related hyperkeratotic plaques which appear anywhere on the body, most commonly the trunk. Rarely, it indicates an underlying Adenocarcinoma of the GI tract especially if they appear suddenly in great numbers.
Skin changes in Diabetics-Approximately 30 - 50% of diabetic patients either have or will have skin disease.Cutaneous Manifestations of Diabetes Mellitus are as follows:
Urticaria - are most often caused by medication (commonly penicillin or other antibiotics, sulfa drugs, aspirin) or food (shellfish, nuts, chocolate), less so by infection. Hives are pruritic, edematous, evanescent wheals that resolve within 24 hours. Read more
Vitiligo - is characterized by a focal or generalized distribution of depigmented macules and patches. Disease commonly occurs around orifices (mouth orbits, vagina or anus) or at sites of trauma (hands, elbows, knees). The disorder is often associated with thyroid disease, diabetes mellitus, pernicious anemia or Addison's disease.
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