Professional Documents
Culture Documents
DERMATOSES
P.ARUN PRASATH
CURTHS CRITERIA
1.
2.
3.
4.
5.
6.
CLASSIFICATION
1.
2.
3.
4.
5.
Acanthotic,
epidermal and
icthyotic conditions
CALM and
lentigines
Pigmentation
Pruritus
Hair, nail and skin
appendageal
involvement
6. Dermatoses
7.
8.
Vascular disorders
9.
Deposition disorders
10.
Bullous disorders
Acanthosis nigricans:
Acanthosis nigricans:
2.
TRIPE PALMS
65-year-old man presented with a 4-month history of left flank pain and
nocturia.
Dermatologic examination revealed multiple eruptive seborrheic keratoses,
(Panels A & B). Abdominal USG and CT revealed a localized mass (7 cm by 5
cm in diameter) of the
left lower renal pole with central necrosis.
4. Acquired icthyosis:
5. Pityriasis rotunda:
Fixed, annular, scaling, dry-skin associated with HCC
Also seen in leprosy and other systemic diseases
Acquired icthyosis
rotunda
Pityriasis
LENTIGINES(L) &
FRECKLES(F)
1.
Neurofibromatosis
1.
Peutz-jeghers syndrome(L)
2.
Epiloia
2.
3.
Blooms syndrome
3.
Cowdens disease(gL)
4.
MEN T I & II B
4.
5.
Fanconis anaemia
6.
VHL disease
7.
Ataxia telangiectasia
8.
Lynch syndrone
Paraneoplastic acral
lentiginosis
5.
XP(F)
6.
NF(F)
7.
Gardners syndrome(F)
3 PIGMENTATION
HYPERPIGMENTATION
1.
2.
3.
4.
5.
DIFFUSE:
Melanoma
PCC
Ectopic ACTH
syndrome
POEMS syndrome
Mastocytosis
6.
Lymphomas
7.
Werners syndrome
PATCHY/RETICULATED:
1.
Fanconis anaemia
2.
Dyskeratosis congenita
OTHERS:
1.
2.
Carcinoid syndrome
photodistribution
Pancratic, gastric, renal
tumours erythema ab igne
due to local heat application
Hypopigmentation
1.
Poikilodermatous:
Generalised:
Chediak-higashi
syndrome
1.
Dermatomyositis
Localised
2.
R-T syndrome
1.
TSC
2.
MF (Hypopigmented
variant)
4 PRURITUS
Localised pruritus:
Brachioradial pruritus: affects lateral upper arm
or dorsum of forearm due to spinal tumour and
mostly bony abnormalities
Facial or nasal pruritus: brain tumours, tumours
involving floor of fourth ventricle, trigeminal
neuralgia produce this distribution of pruritus
Hypertrichosis lanuginosa
acquisita(malignant down):
2. Clubbing of nails:
Clubbing involves an increased convexity of the nail
and soft tissue enlargement of the tips of the
fingers and toes.
There is a loss of the 15 to 20 angle between the
downward curve of the proximal nail and the
adjacent proximal nail fold.
It is associated with neoplasms of the chest, such
as bronchogenic carcinoma, mesothelioma,
Hodgkins disease of the lung, intestinal lymphoma,
and solid tumours metastatic to the thorax.
http://www.nejm.org/doi/full/10.105
6/NEJMicm066228
HOA:
56-year-old male smoker presented with cough, a weight loss, and diffuse
bone pain
.
The palms had a raised velvety texture (Panel A), and there was digital
clubbing (inset).
CT chest showed a mass in the upper lobe of the right lung (Panel B).
bone scan (Panel C) showed areas of diffuse linear uptake in the femoral
and tibial bones, consistent with hypertrophic pulmonary osteoarthropathy
3. Hyperhidrosis:
Generalised: consistent finding in
phaeochromocytoma
Nocturnal: pcc, lymphoma, carcinoid syndrome
Localised: poems syndrome
4. Sebaceous neoplasms:
Strongly associated with muir-torre syndrome
6 DERMATOSES
1.
BAZEX SYNDROME
2. Dermatomyositis:
Dermatomyositis
Gottron's papules.
Erythematous to violaceous
raised papules overlying the
metacarpal and
interphalangeal joints in a
patient with dermatomyositis
3.Migratory erythemas:
i.
.
.
.
Is a reactive erythema that is a marker for an alpha-2glucagon-producing islet cell tumour of the pancreas.
Eruptions begin as erythematous patches in the groin
and spread to the thighs, buttocks, perineum, and face.
This is followed by scaling, vesicles, pustules, and
bullae.
These heal over a period of 1 to 2 weeks, leaving
indurated, hyperpigmented scars. The course waxes
and wanes.
iv) Urticaria:
v)Erythroderma:
vi)Granuloma annulare:
TYPE / VARIANT
MALIGNANCY ASSOCIATED
LYMPHOMAS
LUPUS
ERYTHEMATOSUS
SLE
CA - BREAST, LUNG, CERVIX
MONOCLONAL GAMMOPATHY
SCLE
MYELOPROLIFERATIVE
DISORDERS
SCLERODERMOID
CONDITIONS
EOSINOPHILIC
FASCITIS PANNICULITIS
RELAPSING
POLYCHONDRITIS
MYELODYSPLASTIC SYNDROME
SARCOIDOSIS
LYMPHOMA
TESTICULAR TUMOUR, MM, MELANOMA
Contd..
DERMATOSES
NEUTROPHILIC
DERMATOSES
TYPE / VARIANT
PYODERMA
GANGRENOSUM
- SUPERFICIAL
- BULLOUS
SWEETS SYNDROME
MULTICENTRIC RETICULO
HISTIOCYTOSIS
MALIGNANCY
ASSOCIATED
MYELOPROLIFERATIVE
DISORDERS
IgA GAMMOPATHY
SOLID TUMOURS
MYELODYSPLASTIC DISORDERS
SOLID TUMOURS
HEMATOLOGICAL DISORDERS
8 VASCULAR DISORDERS
CONDITION
FEATURES
MALIGNANCY
ASSOCIATED
1. RAYNAUDS
ACROCYANOSIS
CUTANEOUS ISCHAEMIA
DUE TO MICROTHROMBI
DIGITAL INFARCTION AND
GANGRENE
RETICULOENDOTHELIAL
NEOPLASAMS
SOLID TUMOURS
HYPERVISCOSITY
SYNDROMES
(PCV, MYELOMA LINKED
CRYOGLOBULINEMIA)
HYPEREOSINOPHILIC
SYNDROME
PCV
ESSENTIAL
THROMBOCYTHEMIA
2. ERYTHROMELALGIA
3.PALMAR ERYTHEMA
HIGH GRADE
Contd..
CONDITION
FEATURES
MALIGNANCY
ASSOCIATED
4. VASCULITIS
PALPABLE PURPURA,
MACULOPAPULAR,
URTICARIAL
& PETECHIAL LESIONS
5.CHILBLAIN LIKE
LESIONS
PERSISTENT RATHER
THAN EPISODIC
RESISTANT TO RX
LEUKAEMIA
MYELOPROLIFERATIVE
DISORDERS
METS FROM BREAST CA
6.FLUSHING
PERSISTENT ERYTHEMA
+_ TELENGIECTASIA
(SCLERODERMA LIKE
CHANGES
PELLAGROID
DERMATITIS
CARCINOID SYNDROME*
MASTOCYTOSIS
PHAEOCHROMOCYTOMA
MCT, RCC, VIPOMAS
Contd..
CONDITION
FEATURES
MALIGNANCY ASSOCIATED
7.CANCER ASSOCIATED
THROMBOSIS
I) MIGRATORY
THROMBOPHLEBITIS
II) DVT
RECURRENT, MULTIPLE,
MIGRATORY
UPPER LIMB
CA PANCREAS, STOMACH,
COLON, LUNG
ADENOCA IN GIT,
UROGENITAL TRACT, BREAST,
LUNG
BREAST CA
8.OBSTRUCTION
VENOUS
PEMBERTON SIGN
LYMPHATIC
AXILLARY
9.OTHERS
GLOMERULOID ANGIOMA
TELANGIECTASIA
PAINFUL TELANGIEATATIC
RETROSTERNAL THYROID CA
ENLARGEMENT
BREAST CA., LIMB MELANOMA
POEMS SYNDROME
BLOOMS, RT, ADVANCED
CARCINOID
MALIGNANT
9 DEPOSITION DISORDERS
MATERIAL DEPOSITED
DISORDER
ASSOCIATED
INTERNAL
MALIGNANCY
AMYLOID PROTEINS
PARAPROTEINEMIA,
MYELOMA
SECONDARY
AMYLOIDOSIS
(AA PROTEIN )
HL, HYPERNEPHROMA,
SOLID ORGAN TUMOURS
MUCIN/PROTEOGLYCAN/
FIBROMUCINOSES
SCLEROMYXEDEMA/LICH
EN MYXOEDEMATOUS
PAPULAR MUCINOSES
ALOPECIA MUCINOSA
SCLEREDEMA
POEMS SYNDROME
PARAPROTEINE
MIA
Scleromyxedema
Contd..
MATERIAL DEPOSITED
DISORDER
ASSOCIATED
INTERNAL
MALIGNANCIES
LIPIDS
NECROBIOTIC
XANTHOGRANULOMA
PARAPROTEINAEMIA
NOROMOLIPEMIC PLANE
XANTHOMATOSIS
MYELOMA
XANTHOMA
DISSEMINATUM
GAMMOPATHY, BONE
MARROW DYSCRASIAS
METASTATIC
CALCIFICATION
CALCIUM
PANCREATIC CA
DYSTROPHIC
CALCIFICATION
Contd..
MATERIAL
DEPOSITED
DISORDER
ASSOCIATED INTERNAL
MALIGNANCIES
ICTERUS
IRON
HEMOCHROMATOSIS
(BRONZE DIABETES)
HEPATOCELLULAR CA
MELANIN
MELANOSIS
MALIGNANT PITUITARY
TUMOURS
METASTATIC MALIGNANT
MELANOMA
10 BULLOUS DISORDERS
PARANEOPLASTIC PEMPHIGUS
pemphigus-like,
pemphigoid-like,
erythema multiforme-like,
graft-versus-host disease-like or
Associated neoplasms :
Hodgkins lymphoma
BULLOUS PEMPHIGOID
Associated Malignancies
PEMPHIGUS VULGARIS
MALIGNANCY ASSOCIATED
DERMATITIS HERPETIFORMIS
LYMPHOMA- NHL
LIGA
LYMPHOPROLIFERATIVE MALIGNANCY
EBA
MYELOMA, LYMPHOMA
ICTHYOSIS,
INFECTIONS
RAYNAUDS, RT
B BULLOUS D, BLOOMS,
BAZEX,B-K MOLE
JAUNDICE
SK(LT), SWEETS,
SCLERDERMOID SKIN
C CLUBBING, CALM,CVG,
C-H SYN, COWDENS,
CARNEY
K KERATODERMA
D DM
L LENTIGINES,
LYMPHODEMA,
LICHENOID D
URTICARIA
M MIGRATORY TP,
MONDORS D, MT SYN,
MEN SYN
VASCULITIS, VHL
F FLUSHING, FREECKLES,
FANCONI
W-A, WERNER
G GA,GORLINS,GARDNER
S
XEROSIS, XANTHOMA,
XP
THANK YOU
http://www.nejm.org/doi/full/10.1056/N
EJMicm0901376
erythromelalgia
http://www.nejm.org/doi/full/10.1056/N
EJMicm1010271
neutrophilic dermatoses
http://www.nejm.org/doi/full/10.1056/N
EJMicm1109272
spider angioma
http://www.nejm.org/doi/full/10.1056/N