1. Cutaneous Manifestations of Systemic Diseases Hayden H. Franks, MD June 13, 2013

2. Who Is This Guy? • Private practice Dermatologist • Clinics in Little Rock and Texarkana • Fellow of the American Academy of Dermatology • Diplomat of the American Board of Dermatology • Honorary Member of the Arkansas Academy of Family Physicians

3. Disease Categories • Autoimmune Diseases • Endocrine Diseases • Cardiac Diseases • Pulmonary Diseases • Neurological Diseases • Infectious Diseases • Hematologic Diseases • Gastrointestinal Diseases • Diseases not otherwise specified

4. Cutaneous Manifestations of Systemic Diseases • Frequently encountered • May be the initial sign of internal disease • May occur late in the course of the disease • May assist in making the diagnosis • May be obvious or subtle • Overlap of Family Practice and Dermatology

5. AUTOIMMUNE DISEASES • Systemic Lupus Erythematosus • Scleroderma • Dermatomyositis • Rheumatoid Arthritis

6. ENDOCRINE DISEASES • Diabetes Mellitus • Thyroid Disease • Adrenal Disease

7. CARDIAC DISEASES • Congestive Heart Failure • Hypertension

8. PULMONARY DISEASES • Sarcoidosis • Tuberculosis • Scleroderma • Blastomycosis

9. GASTROINTESTINAL DISEASES • Inflammatory Bowel Disease • Celiac Disease • Hepatitis

10. NEUROLOGICAL DISEASES • Neurofibromatosis • Tuberous Sclerosis • Parkinson’s Disease

11. INFECTIOUS DISEASES • HIV • Tuberculosis • Blastomycosis

12. HEMATOLOGIC DISEASES • Expressed in a limited number of ways • Extravasation of whole blood • Infiltration by migrating blood cells • Changes in color or pigmentation • Ulceration

13. Ulceration • Self inflicted excoriations from intense pruritus • Hodgkin’s Disease, PCV, Cutaneous Lymphomas • Sickle Cell Disease

14. Blood Extravasation • Thrombocytopenia • Defects in Platelet Function • Purpura • Easy or spontaneous bruising • Petechiae • Senile Purpura (Bateman’s Purpura)

15. Change in Color and Pigmentation of the Skin • Progressive Pigmentary Purpura (Schamburg’s Purpura) • Anemia • Cyanosis

16. Cutaneous Manifestations of Gastrointestinal Diseases • Jaundice • Melanosis • Nail Changes • Edema • Purpura • Pruritus • Vascular Changes • Spider Telangiectasias • Palmar Erythema

17. Cutaneous Manifestations of Hepatitis • Urticaria • Vasculitis • Polyarteritis Nodosa • Relapsing Papulovesicular Rash

18. DERMATITIS HERPETIFORMIS

19. Cutaneous Manifestations of Ulcerative Colitis and Crohn’s Disease • Pyoderma Gangrenosum • Erythema Nodosum • Aphthous Ulcers • Lichen Planus

20. DISEASES NOT OTHERWISE SPECIFIED • Sarcoidosis