gastrointestinal manifestations of systemic disease

... Respiratory disease usually follows the onset of bowel disease but may rarely antedate bowel symptoms 635 Imaging of the pulmonary manifestations of systemic disease Box 12: Pulmonary manifestations of ... lymphocytic infiltration of the airways causes a follicular lymphocytic 627 Imaging of the pulmonary manifestations of systemic disease Box 4: Pulmonary manifestations of Sjögren’s syndrome Airways ... presenting symptoms were of dyspnoea, dry cough, fever, and occasionally cyanosis 625 Imaging of the pulmonary manifestations of systemic disease Box 3: Pleuropulmonary manifestations of SLE Pleural x...

Ngày tải lên: 12/08/2014, 20:32

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 ... 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 ... 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,...

Ngày tải lên: 06/07/2014, 20:20

... lag time of 48 h Systemic : Gener alized Patie nt history has testing of Erythe allergic ma, fine scale, contact crust dermatitis to topical agent and Patch Same as local then receives systemic ... 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 ... 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

... 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 ... the result of a primary cutaneous disorder such as lichen planus, folliculitis decalvans, chroniccutaneous (discoid) lupus, or linear scleroderma (morphea) than it is a sign of systemic disease ... 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...

Ngày tải lên: 06/07/2014, 20:20

... 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 ... 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 ... 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

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

Ngày tải lên: 06/07/2014, 20:20

... variant of scleroderma (Chap 316) is associated with a chronic course and anticentromere antibodies Mat telangiectasias are an important clue to the diagnosis of the CREST syndrome as well as systemic ... 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 ... eccentric punctum with radiating legs is seen Although the degree of systemic involvement varies in this autosomal dominant disease (due to mutations in either the endoglin or activin receptor–like...

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

... (cryptorchidism, hypospadias); retardation of growth; and deafness (sensorineural)] syndromes, lentigines serve as a clue to systemic disease In LEOPARD syndrome, hundreds of lentigines develop during childhood ... 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...

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) ... but clues to the diagnosis of Kawasaki's disease are cervical lymphadenopathy, lip erosions, and thrombocytosis The most serious associated systemic finding in this disease is coronary aneurysm ... 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 ... acquired)b II Systemic diseases A Urticarial vasculitis B Hepatitis B or C infection C Serum sickness D Angioedema (hereditary and acquired) a A small minority develop anaphylaxis b Also systemic...

Ngày tải lên: 06/07/2014, 20:20