DERMATOLOGIC

SIGNS OF
SYSTEMIC DISEASES

Dr. Andaç Salman

ENDOCRINE SYSTEM

š Acromegaly
š Cushing’s syndrome and disease
š Addison’s disease
š Hypothyroidism
š Hyperthyroidism
š Diabetes mellitus
Acromegaly

š Growth hormone
š Glycosaminoglycans (GAG) and H2O retention
š Bone and cartilage esp face, limbs
š Too much skin: thick and doughy
 Acromegaly

š Prognathism
š Frontal bossing
š Thick and
edematous eyelids
š Enlarged lower lip
š Macroglossia
š Triangular nose
Cushing Syndrome

š Impaired collagen and GAG synthesis-atrophy

and vascular fragility of skin (ecchymoses)
š Fat distribution change-moon face, buffalo
hump, obese trunk,slender limbs
š Fragile skin, impaired wound healing
š Purple striae
Cushing Syndrome
Addison’s Disease (Primary
Adrenal Insufficiency)

šPigmentation : sun-exposed, pressure

points (knees, knuckles, intertriginous
areas), axilla, perineum, nipples, palmar
creases, nevi, mucosal, hair, nails
šFirst sign in 20-40%
Addison’s Disease
Graves Disease

š exophthalmos and thyroid acropathy

š pretibial myxedema
 Clubbing

š Respiratory
(tm,bronchiectasis,
fibrosis)
š Cardiovascular
(subacute bacterial
endocarditis, cyanotic
heart disease)
š Chronic liver disease
š İnflammatory bowel
disease
š Endocrine
(thyrotoxicosis-
”acropathy”)
Pretibial Myxedema

š Excess GAG synhesis and

deposition- antibodies to skin
Ag?
š Majority Graves’ (5%)
š Also in 10 hypothyroidism and
Hashimoto’s
š Usually independent of thyroid
status (1/2 euthyroid)
š Edema and thickening of
skin,esp shin, dorsal feet
š Bilateral
š Hypertrichosis
š Usually with ophthalmopathy
Dıabetes mellıtus
DIABETIC BULLAE
DIABETIC DERMOPATHY
ERUPTIVE XANTHOMA
ERUPTIVE XANTHOMA
NECROBIOSIS LIPOIDICA
NECROBIOSIS LIPOIDICA
NECROBIOSIS LIPOIDICA
ACRAL DRY GANGRENE
NEUROPATHIC ULCER
PERLECHE
 Acanthosis Nigricans

š Velvety epidermal
thickening with
hyperpigmetation
š Axilla,inguinal area
and neck folds
Chronıc renal faılure
CALCINOSIS CUTIS
CALCIPHYLAXIS
CALCIPHYLAXIS
Chronic Liver Disease
Spider Angioma

š Pregnancy
š Alcoholism
š Chronic liver
disease
š Thyrotoxicosis
š Eustrogen intake
 Palmar erythema

š Pregnancy
š Oral contraceptive
š Hepatic disease
š Thyrotoxicosis
š Rheumatoid arthritis
š Hyperglobulinemia
in chronic disease:
leukemia, bacterial
endocarditis,COPD
 VASCULITIS+HCV

LICHEN PLANUS+HCV
HEMOCHROMATOSIS
Crohn’s Disease

š 5% skin lesions
š Direct extension
š Metastatic Crohn
š Reactive lesions
-aphthous stomatitis
-erythema multiforme
-vasculitis
-erythema nodosum
-pyoderma gangrenosum
CROHN’S
Aphthous Stomatitis
Aphthous Stomatitis

š >10mm-Major AS
š Familial 1/3
š Behçet
š Cyclic neutropenia,other
immunodeficiency
š PFAPA sydrome
š Hematinic deficiency(iron,
folic acid,B12) 10-20%
š GI disease(coeliac di,
pernicious anemia,Crohn)
š HIV disease
š Other(stress,trauma,
cessation of smoking)
Ulcerative Colitis

š 10% skin lesions

š Pyoderma gangrenosum
š Pyostomatitis vegetans
š Erythema nodosum
š Erythema multiforme
š Vasculitis
š Sweet’s syndrome
 Pyoderma gangrenosum

š IBD
š Paraproteinemia,
myeloma
š Diverticulitis
š Leukemia
š Behçet
š Chronic active
hepatitis
š Arthritis
š No etio 50%
THANK YOU!