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Clinical quiz - skin manifestations of internal disease

Are these statements about the following four skin manifestations of internal diseases true or false? Click on the answers link at the bottom of the page to find out

Are these statements about the following four skin manifestations of internal diseases true or false? Click on the answers link at the bottom of the page to find out

1. Dermatitis herpetiformis

• Causes intensely itchy vesicles on extensor surfaces

• Is strongly associated with Crohn's disease

• ‘Herpetiformis' refers to the tendency for the vesicles to be grouped together, as in herpes simplex

• Often improves with dietary treatment

• May be treated with dapsone

2. Necrobiosis lipoidica

• Is associated with diabetes mellitus in 25% of cases

• Usually resolves spontaneously and completely

• Typically affects the skin of the pre-tibial area

• Is more common in men

• Can develop into squamous cell carcinoma

3. Acanthosis nigricans

• Begins with hyperpigmented patches that progress to palpable plaques

• Is usually associated with underlying malignancy

• Typically occurs in the axillary, inguinal, inframammary and neck creases

• Is intensely pruritic

• May regress with weight reduction

4. Erythema nodosum

• Typically presents as symmetrical red nodules over the shins

• Is caused, in 10% of cases, by sarcoidosis

• Usually resolves in two weeks

• In about 50% of patients is associated with arthralgia

• May be caused by infection, in which case, streptococci, chlamydia and TB are common pathogens

Picture 2 Picture 1 Picture 3 Picture 4 Answers

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