Dermatology and Internal
Medicine Part-II
SCLERODERMA & SYSTEMIC SCLEROSIS
Personal Notes
| Scleroderma - thickening of skin → collagen deposits
Cutaneous Systemic sclerosis
(skin + systemic
involvement)
| Morphea | Limited
| Diffuse
Morphea:
| Localized skin thickening
¯
Indurated violaceous lesion
¯
Fibrosed
¯
White in color
| Cannot pinch lesson
| Oval shaped lesion
Fronto parietal morphea:
| ‘En coup de sabre’
| Looks like Sword injury
| Linear morphea
Personal Notes
SYSTEMIC SCLEROSIS
1. Limited cutaneous systemic sclerosis (lcSSc).
2. Diffuse cutaneous systemic sclerosis (dcSSc).
1. Limited cutaneous systemic sclerosis (lcSSc):
| Thickening of skin - face + extremities (area below knees, elbows).
| C - calcinosis cutis (calcium deposition)
| R - Raynaud’s phenomenon
| E - esophageal dysmotility
| S - Sclerodactyly
| T - telangiectasia
| Anti - centromere antibody
(Calcinosis cutis)
(Raynaud's phenomenon)
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Personal Notes
(Telangiectasia, microstomia)
2. Diffuse cutaneous systemic sclerosis (dcSSc):
| Face + proximal to elbows & knees + distal to elbows & knees.
| Internal organ fibrosis
| Anti Scl 70 antibody
Changes seen over face:
| Mask like an expressionless face
| Initially during the disease patients may look younger than their age.
| Microstomia
| Perioral furrowing
| Beak like nose
Changes seen over hands:
| Puffiness of hands
| Sclerodactyly
| Pitted digital ulcers
| Digital scarring
(Digital ulcers)
210 Dermatology
Personal Notes
(Salt & pepper pigmentation)
DERMATOMYOSITIS
| Dermato = skin
| Myositis = muscle
| Muscle - weakness of proximal muscles
¯
Tiredness while climbing stairs
Weakness while combing hair
| Skin - purple colored erythema → Heliotrope flower
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| Gottran's sign or Gottron's papules - lesion over interphalangeal joints & knuckles.
Personal Notes
| Note: In SLE there is sparing of the joints.
(SLE - sparing of joints)
| Photosensitive skin rashes - shawl sign & ‘V’ shaped erythema around neck.
212 Dermatology
| Holster sign - lateral part of thigh
Personal Notes
Note: Dermatomyositis may be associated with internal malignancy like ovarian cancer, PNS
cancer.
HENOCH SCHONLEIN PURPURA (HSP)
| Small vessel disease/vasculitis
| Palpable purpura + joint pain + abdominal pain
| Young adults / children
| Renal ±
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