Abstract
This appendix includes photographs of cutaneous manifestations of internal diseases broken into broad categories, including endocrine/metabolic, hematologic, rheumatologic, gastrointestinal, neurocutaneous, infectious, and renal diseases. Also included is a section of cutaneous manifestations of systemic disease. Some of the disorders covered in this appendix are not covered in the main text.
Keywords: endocrinology, gastroenterology, hematology, infections, malignancy, metabolic, neurocutaneous, renal, rheumatology.
A
Endocrine—metabolic
Pretibial Myxedema. Nonpitting, brawny plaques of pretibial myxedema found on both shins extending down to the foot of this patient with Graves’ disease.
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Hypothyroidism. Puffy periorbital tissue, sallow, dry, yellowish skin, and loss of lateral third of the eyebrow (Queen Anne’s sign) in this patient with hypothyroidism (Fitzsimons Army Medical Center Collection).
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Cushing Syndrome. Moon facies and abdominal striae in a patient with Cushing syndrome (Walter Reed Army Medical Center Collection).
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Acromegaly. Subtle frontal bossing, enlarged base of the nose, thickening of the lips, and prognathism and elongation of the face in a patient with acromegaly (Fitzsimons Army Medical Center Collection).
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Bullous Diabeticorum. This uncommon cutaneous finding in patients with diabetes is characterized by large, tense noninflammatory subepidermal bullae that usually appear spontaneously on the legs and feet (William Weston Collection).
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Multiple Endocrine Neoplasia Type 2 (MEN 2b, Sipple Syndrome). Multiple neuromas of the tongue in a man with medullary thyroid carcinoma. These patients may also develop benign and malignant tumors in the parathyroid and adrenal glands (Fitzsimons Army Medical Center Collection).
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Hirsutism. Hirsutism in the beard area of a woman with polycystic ovarian syndrome (Fitzsimons Army Medical Center Collection).
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Lipid Disorders. Tuberous xanthoma of the elbow (Fitzsimons Army Medical Center Collection).
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B
Hematology
Lymphoma. Primary cutaneous follicle center B-cell lymphoma of the forehead and scalp (William Weston Collection).
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Immune Thrombocytopenic Purpura (ITP). Petechiae and hemorrhage on the finger, lips, and tongue in this patient with ITP. The lips and gums are frequently involved (Fitzsimons Army Medical Center Collection).
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Systemic Amyloidosis in Multiple Myeloma. Elderly man with purpuric lesions of primary systemic amyloidosis (AL) due to underlying multiple myeloma. Approximately 10% to 15% of patients with multiple myeloma will develop AL amyloidosis (Fitzsimons Army Medical Center Collection).
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C
Rheumatology
Rheumatoid Vasculitis. Hemorrhagic lesions on the digits due to rheumatoid vasculitis. Ulceration due to vasculitis. Lesions of rheumatoid vasculitis frequently become necrotic (Fitzsimons Army Medical Center Collection).
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Rheumatoid Nodules. Multiple large rheumatoid nodules on the elbow (Fitzsimons Army Medical Center Collection).
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Juvenile Idiopathic Arthritis. Transient faint erythema of juvenile idiopathic arthritis (Fitzsimons Army Medical Center Collection).
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Gout. Large, yellow-red, gouty tophus of the toe (Fitzsimons Army Medical Center Collection).
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Gout. Birefringent gouty crystals taken from a gouty tophus of the finger (Fitzsimons Army Medical Center Collection).
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CREST Syndrome. CREST syndrome demonstrating telangiectatic mats on the neck in a woman who also had calcinosis cutis, Raynaud phenomenon, esophageal dysmotility, and sclerodactyly (Fitzsimons Army Medical Center Collection).
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