Cutaneous Manifestations of Internal Disease


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.


Pretibial Myxedema. Nonpitting, brawny plaques of pretibial myxedema found on both shins extending down to the foot of this patient with Graves’ disease.

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).

Cushing Syndrome. Moon facies and abdominal striae in a patient with Cushing syndrome (Walter Reed Army Medical Center Collection).

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).

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).

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).

Hirsutism. Hirsutism in the beard area of a woman with polycystic ovarian syndrome (Fitzsimons Army Medical Center Collection).

Lipid Disorders. Tuberous xanthoma of the elbow (Fitzsimons Army Medical Center Collection).


Lymphoma. Primary cutaneous follicle center B-cell lymphoma of the forehead and scalp (William Weston Collection).

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).

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).


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).

Rheumatoid Nodules. Multiple large rheumatoid nodules on the elbow (Fitzsimons Army Medical Center Collection).

Juvenile Idiopathic Arthritis. Transient faint erythema of juvenile idiopathic arthritis (Fitzsimons Army Medical Center Collection).

Gout. Large, yellow-red, gouty tophus of the toe (Fitzsimons Army Medical Center Collection).

Gout. Birefringent gouty crystals taken from a gouty tophus of the finger (Fitzsimons Army Medical Center Collection).

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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Sep 22, 2019 | Posted by in Dermatology | Comments Off on Cutaneous Manifestations of Internal Disease
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