Half-and-half nail (and also terry’s nails) in CRF Calciphylaxis in CRF Can be preceded by livedo reticularis Metastatic calcification of vessels near the skin surface results in damage and ischemia necrotic ulcers form Fatal condition Sarcoidosis: Chronic systemic granulomatous disease characterized by granulomas (with lungs almost always involved) The condition is most frequently seen in women, particularly in African Americans Age group 20 40 – Skin manifestations (25%): Lupus pernio (chronic, raised/indurated purplish skin lesion on nose, ears, lips, cheeks and forehead) Associated with a poorer prognosis Another is pernio (chilblains) Erythema nosodum Don’t forget about other manifestations and notes: Cardiovascular involvement (arrhythmias, RCM, HTN) CNS involvement (neurosarcoidosis facial palsy, hypopituitarism, meningism?) Arthritis and eye manifestations Most patients get complete recovery, some of them progress Wilson’s disease: AR disorder in copper metabolism in the body, resulting in copper accumulation in various organs Signs: Kayser Flescher rings (also seen in PBC) Best visualized with slit lamp Does NOT interfere with vision Copper in lunula of resulting in BLUE NAILS (AZURA LUNULA) Primary biliary cirrhosis Autoimmune condition that primarily affects the intrahepatic bile ducts resulting in cholestatic liver disease and eventually cirrhosis Skin findings? Jaundice, xanthomas, pruritis (bile salts) and skin findings relevant to fat-soluble vitamin deficiencies (ADEK)
Half-and-half nail (and also terry’s nails) in CRF Calciphylaxis in CRF Can be preceded by livedo reticularis Metastatic calcification of vessels near the skin surface results in damage and ischemia necrotic ulcers form Fatal condition Sarcoidosis: Chronic systemic granulomatous disease characterized by granulomas (with lungs almost always involved) The condition is most frequently seen in women, particularly in African Americans Age group 20 – 40 Skin manifestations (25%): Lupus pernio (chronic, raised/indurated purplish skin lesion on nose, ears, lips, cheeks and forehead) Associated with a poorer prognosis Another is pernio (chilblains) Erythema nosodum Don’t forget about other manifestations and notes: Cardiovascular involvement (arrhythmias, RCM, HTN) CNS involvement (neurosarcoidosis facial palsy, hypopituitarism, meningism?) Arthritis and eye manifestations Most patients get complete recovery, some of them progress Wilson’s disease: AR disorder in copper metabolism in the body, resulting in copper accumulation in various organs Signs: Kayser Flescher rings (also seen in PBC) Best visualized with slit lamp Does NOT interfere with vision Copper in lunula of resulting in BLUE NAILS (AZURA LUNULA) Primary biliary cirrhosis Autoimmune condition that primarily affects the intrahepatic bile ducts resulting in cholestatic liver disease and eventually cirrhosis Skin findings? Jaundice, xanthomas, pruritis (bile salts) and skin findings relevant to fat-soluble vitamin deficiencies (ADEK)
Dermatology+Notes.docx