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SYSTEMIC MANIFESTATIONS OF DISEASE Connie Fearnley DIABETES Necrobiosis lipoidica Granuloma annulare Leg ulcers Acanthosis nigricans ecythma HYPERLIDAEMIA Eruptive xanthoma Xanthelasma Tuberous xanthoma Tendinous xanthoma THYROID DISEASE Hyperthyroidism Hypothyroidism Xerosis Both Hair loss Thyroid acropathy Pruritis Myxoedema EXCESS CORTISOL - Truncal obesity - Moon face - Buffalo hump - Telangiectasia - Ecchymoses - Striae - hypertrichosis DECREASED CORTISOL increased pigment - Mucosal sites - Palmar creases - Scars - Friction sites - Areola skin - Genital skin - Hair - diffuse GASTROENTEROLOGY Dermatitis herpetiforms Hereditary haemorrhagic telangiectasia CAUSES OF VASCULITIS Connective tissues disease - Lupus erythematosus - Rheumatoid - Wegeners granulomatosis Infection - Meningococcal septicaemia - Post-streptococcal infection - Hep C CAUSES OF ERYTHEMA NODOSUM IBD – UC & crohns Sarcoidosis Infection – strep, TB Drugs e.g. sulphonamides, OCP idiopathic CAUSES OF PYODERMA GANGRENOSUM UC Crohns Myelodysplastic Myeloproliferative disorders Rheumatoid disease diabetes DRUG ERUPTIONS Toxic erythema Toxic epidermal necrolysis - - Measles- like Erythematous macules Begins on trunk 7-14 days after intro of dryg Pruritis, malaise and fever Rare Can be fatal 7-21 days after initiation Tenderness and erythema STOP DRUGS IMMEDIATELY Supportive care burns unit/ITU - >30% body surface area - NSAIDs, abx, anticonvulsants A 53-YEAR-OLD DIABETIC WOMAN PRESENTS WITH A FOUR MONTH HISTORY OF BILATERAL ERYTHEMATOUS LESIONS ON HER SHINS SURROUNDED BY TELANGIECTASIA. WHAT IS THE MOST LIKELY DIAGNOSIS? A) ERYTHEMA NODOSUM B) NEUROPATHIC ULCER C) CANDIDIASIS D) NECROBIOSIS LIPOIDICA E) GRANULOMA ANNULARE D)