Skin conditiond and associated disease

Acanthosis Nigricans-insulin resistance (Diabetes Mellitus, PCOS)-GIT malignancy

AN can be divided into benign and malignant forms -Benign AN :

-younger individuals

-associated with insulin-resistant states (eg:DM,obesity,PCOS) increased levels of insulin and/or insulin-like growth factor are thought to stimulate epidermal and dermal proliferation.

-Similarly,skin tags(acrochondrons),which are pedunculated outgrowths of normal skin,are also commonly present on regions,affected byn AN

Malignant AN

underlying neoplasms ,especially of the GIT and genitourinary tracts.

The sudden appearance of such skin changes in middle-aged or elderly pt is suggestive of underlying malignancy.

These patient are not obese(but instead may have lost weight) and lesions can occur in uncomon areas(eg.mucous membrances, palms,soles.)

Answer : E- Polycystic ovarian sydrme

Porphyria Cutanea Tarda

PCT is a blistering skin disease of sun-exposed areas in those with a history of : Liver disease (hepatitis C,

alcoholism) Estrogen use Iron overload (hemochromatosis)

Look for involvement of thebacks of the hands and the

face.

PCT is a hypersensitivityof the skin to abnormalporphyrins when they areexposed to light.

Minimal hypertrichosis and erosions with crusts over the left side of the face

Diagnostic Tests/Treatment

The most accurate diagnostic test is increased uroporphyrins in a 24-hour urine collection.

It is a deficiency of uroporphyrin decarboxylase activity.

Correct the underlying cause (stop alcohol, stop estrogens) and remove iron with phlebotomy.

Bright pink fluorescence on woods lamp examination

Seborrheic Dermatitis (Dandruff)

Seborrheic dermatitis is a hypersensitivity reaction to a dermal infection with noninvasive dermatophyte organisms.

This is why both topical steroids (hydrocortisone, alclometasone) and antifungal agents (ketoconazole) are useful.

It is increased in:• AIDS• Parkinson disease

The term seborrheic is synonymous with benign

Dermatitis herpetiformis- celiac disease

Multiple skin tags

Insulin resistance Pregnancy Crohn disease(perianal)

Explosive onset of Seborrheic keratoses –GIT malignancy

Seborrheic Keratoses

These lesions are extremely common in the elderly.

They are hyperpigmented lesions commonly referred to as liver spots. They give a "stuck on" appearance.

Although they may look like melanoma to some people, seborrheic keratoses have no premalignant potential. They do not transform into melanoma.

They are removed with cryotherapy, surgery, or laser for cosmetic reasons.

Pyoderma gangrenosum - IBD