cardinal manifestations of gastrointestinal disease

Ngày tải lên: 03/11/2012, 11:11

Ngày tải lên: 15/03/2014, 12:20

... versed in the recognition of cutaneous lesions or their spectrum of presentations Therefore, the authors of this chapter have decided to cover this particular topic of cutaneous medicine not ... in the thickness of the lesions The diagnosis of CTCL is established by skin biopsy in which collections of atypical T lymphocytes are found in the epidermis and dermis As the disease progresses, ... Parapsoriasis f Bowen's disease (squamous cell carcinoma in situ)b Drugs Systemic diseases a Lupus erythematosus c b Cutaneous T cell lymphoma c Secondary syphilis d Reiter's disease e Sarcoidosisd...

Ngày tải lên: 06/07/2014, 20:20

... migration of the erythema and associated secondary changes such as pustules or erosions Migratory waves of erythema studded with superficial pustules are seen in pustular psoriasis Table 54-2 Causes of ... Systemic diseases a Cutaneous T cell lymphoma b Lymphoma Idiopathic a Discussed in detail in Chap 53 Table 54-3 Erythroderma (Primary Cutaneous Disorders) Initial Lesions Locati Othe Diag Treat on of ... Local: act Depen ds Irrita on nt—onset Patch testing Remo ve irritant or Erythe offending allergen; agent ma, often within hours topical crusting, vesicles, and glucocortico bullae Aller ids;...

Ngày tải lên: 06/07/2014, 20:20

... to 25% of the cases of erythroderma were due to CTCL The patient may progress from isolated plaques and tumors, but more commonly the erythroderma is present throughout the course of the disease ... late stage of the disease Alopecia (Table 54-4) The two major forms of alopecia are scarring and nonscarring In scarring alopecia there are associated fibrosis, inflammation, and loss of hair follicles ... cases of erythroderma where there is no apparent cause (idiopathic), longitudinal follow-up is mandatory to monitor for the possible development of CTCL There have been isolated case reports of...

Ngày tải lên: 06/07/2014, 20:20

... coalescence of associated lesions and/or diseases: involvement of other hyperthyroidism, hair-bearing surfaces hypothyroidism, contact of the body vitiligo, Down syndrome Pitting of the nails ... treatment of growing (anagen) hairs simultaneously enter the dying (telogen) phase Androgeneti Miniaturizatio Increased c alopecia (male n of hairs along the sensitivity If no evidence of of hyperandrogen ... Increased levels of circulating androgens (ovarian or adrenal source in women) Alopecia areata Well- The circumscribed, Topical germinative zones anthralin; circular areas of hair of the hair follicles...

Ngày tải lên: 06/07/2014, 20:20

... Scattered, poorly circumscribed patches of alopecia with a "moth-eaten" appearance are a manifestation of the secondary stage of syphilis Diffuse thinning of the hair is also associated with hypothyroidism ... the scarring lesions of discoid lupus can be seen in patients with systemic lupus, in the majority of cases the disease process is limited to the skin Less common causes of scarring alopecia ... phases of discoid lupus, lichen planus, and folliculitis decalvans, there are circumscribed areas of alopecia Fibrosis and subsequent loss of follicles are observed primarily in the center of the...

Ngày tải lên: 06/07/2014, 20:20

... Behçet's disease a EGFR, epidermal growth factor receptor Patients with the carcinoid syndrome have episodes of flushing of the head, neck, and sometimes the trunk Resultant skin changes of the ... acne rosacea, the two major forms of acne (Chap 53), there are drugs and systemic diseases that can lead to acneiform eruptions (Table 54-7) Table 54-7 Causes of Acneiform Eruptions I Primary ... lithium Administration of highdose systemic glucocorticoids can result in a widespread eruption of follicular pustules on the trunk, characterized by lesions in the same stage of development With...

Ngày tải lên: 06/07/2014, 20:20

... Table 54-8 Causes of Telangiectasias I Primary cutaneous disorders A Linear Acne rosacea Actinically damaged skin ... radiationa Poikiloderma vasculare atrophicans C Spider angioma Idiopathic Pregnancy II Systemic diseases A Linear Carcinoid Ataxia-telangiectasia Mastocytosis B Poikiloderma Dermatomyositis Cutaneous...

Ngày tải lên: 06/07/2014, 20:20

... pathognomonic signs of the three major autoimmune connective tissue diseases—lupus erythematosus, scleroderma, and DM They are easily visualized by the naked eye and occur in at least two-thirds of these ... decreased activity will acquire some pigmentation of the eyes, hair, and skin as they age The degree of pigment formation is also a function of racial background, and the pigmentary dilution ... correlate with the degree of hypopigmentation and include decreased visual acuity, nystagmus, photophobia, and a lack of normal binocular vision Table 54-9 Causes of Hypopigmentation I Primary...

Ngày tải lên: 06/07/2014, 20:20

... perifollicular macules of normal pigmentation are seen within areas of depigmentation The basis of this leukoderma is unknown; there is no evidence of inflammation in areas of involvement, but it ... (types I and II) Diseases of the thyroid gland are the most frequently associated disorders, occurring in up to 30% of patients with vitiligo Circulating autoantibodies are often found, and the ... absence of pigmentation Patients with vitiligo also have an increased incidence of several autoimmune disorders, including hypothyroidism, Graves' disease, pernicious anemia, Addison's disease, ...

Ngày tải lên: 06/07/2014, 20:20

... the result of the migration of two clones of primordial melanocytes, each with a different pigment potential Localized areas of decreased pigmentation are commonly seen as a result of cutaneous ... lesions, but in one rare clinical setting they are a sign of systemic disease, and that setting is the sudden appearance of multiple lesions, often with an inflammatory base and in association with ... the sign of Leser-Trélat and alerts the clinician to search for an internal malignancy Acanthosis nigricans can also be a reflection of an internal malignancy, most commonly of the gastrointestinal...

Ngày tải lên: 06/07/2014, 20:20

... serine threonine kinase gene) have multiple benign polyps of the gastrointestinal tract, testicular tumors, and an increased risk of developing gastrointestinal (primarily colon), pancreatic, and gynecologic ... location as circular areas of erythema that can become bullous and then resolve as brown macules The eruption usually appears within hours of administration of the offending agent, and common ... NAME [nevi, atrial myxoma, myxoid neurofibroma, and ephelides (freckles)] syndrome These patients can also have evidence of endocrine overactivity in the form of Cushing's syndrome, acromegaly,...

Ngày tải lên: 06/07/2014, 20:20

... widespread deposition of melanin resulting from the high concentration of circulating melanin precursors, there is more evidence to support the latter Of the autoimmune diseases associated with ... drugs or metals can result from one of several mechanisms—induction of melanin pigment formation, complexing of the drug or its metabolites to melanin, and deposits of the drug in the dermis Busulfan, ... level of iron in the skin of patients with hemochromatosis stimulates melanin pigment production and leads to the classic bronze color Patients with pellagra have a brown discoloration of the...

Ngày tải lên: 06/07/2014, 20:20

... simplex virusa,e Enteroviruses, e.g., hand-foot-and-mouth disease Staphylococcal scalded-skin syndromea,f Bullous impetigoa II Systemic diseases A Autoimmune Paraneoplastic pemphigusa B Infections ... Pseudoporphyriab Bullous dermatosis of hemodialysisb D Ischemia Coma bullae a Intraepidermal b Subepidermal c Associated with gluten enteropathy d Associated with inflammatory bowel disease ... herpetiformisb,c Linear IgA bullous dermatosisb Epidermolysis bullosa acquisitab,d B Secondary blistering diseases Contact dermatitisa Erythema multiformea,b Stevens-Johnson syndrome Toxic epidermal necrolysisb...

Ngày tải lên: 06/07/2014, 20:20

... diagnosis of EM, as opposed to a morbilliform exanthem, is the development of a "dusky" violet color or petechiae in the center of the lesions Target or iris lesions are also characteristic of EM ... diagnosis of SSSS versus TEN can be made by a frozen section of the blister roof or exfoliative cytology of the blister contents In SSSS the site of staphylococcal infection is usually extracutaneous ... addition, these patients may also have involvement of the mucous membranes and intestinal tract Drugs are the primary cause of TEN, and the most common offenders are phenytoin, barbiturates, carbamazepine,...

Ngày tải lên: 06/07/2014, 20:20

... infection, and hepatomas The differential diagnosis of PCT includes (1) porphyria variegata—the skin signs of PCT plus the systemic findings of acute intermittent porphyria; it has a diagnostic ... Early meningococcemia D Acute graft-versus-host disease E Kawasaki disease II Scarlatiniform A Scarlet fever B Toxic shock syndrome C Kawasaki disease D Early staphylococcal scalded-skin syndrome ... with retroauricular and suboccipital lymphadenopathy; and (3) erythema infectiosum (fifth disease) —erythema of the cheeks is followed by a reticulated pattern on extremities; it is secondary to a...

Ngày tải lên: 06/07/2014, 20:20

... (Chap 129), and three of these involve mucocutaneous sites (diffuse erythema of the skin, desquamation of the palms and soles 1–2 weeks after onset of illness, and involvement of the mucous membranes) ... petechiae of the palate; a facial flush with circumoral pallor; linear petechiae in the antecubital fossae; and desquamation of the involved skin, palms, and soles 5–20 days after onset of the eruption ... eruption A similar desquamation of the palms and soles is seen in toxic shock syndrome (TSS), Kawasaki's disease, and after severe febrile illnesses Certain strains of staphylococci also produce...

Ngày tải lên: 06/07/2014, 20:20

... scratching of the skin It is a common disorder, affecting ~5% of the population Solar urticaria characteristically occurs within minutes of sun exposure and is a skin sign of one systemic disease ... urticarias are the result of dermal edema, subcutaneous edema leads to the clinical picture of angioedema Sites of involvement include the eyelids, lips, tongue, larynx, and gastrointestinal tract ... resolved The patient may also complain of burning rather than pruritus On biopsy, there is a leukocytoclastic vasculitis of the small blood vessels Although many cases of urticarial vasculitis are idiopathic...

Ngày tải lên: 06/07/2014, 20:20

... II Skin-colored A Rheumatoid nodules B Neurofibromas (von Recklinghausen's disease) C Angiofibromas (tuberous sclerosis, MEN syndrome, type 1) D Neuromas (MEN syndrome, ... Adnexal tumors Basal cell carcinomas (nevoid basal cell carcinoma syndrome) Tricholemmomas (Cowden disease) F Osteomas (Gardner syndrome) G Primary cutaneous disorders Epidermal inclusion cysts Lipomas ... Pseudoxanthoma elasticum E Sebaceous adenomas (Torre syndrome) V Reda A Papules Angiokeratomas (Fabry disease) Bacillary angiomatosis (primarily in AIDS) B Papules/plaques Cutaneous lupus Lymphoma cutis...

Ngày tải lên: 06/07/2014, 20:20