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• Example of a mechanism:
UV light induces expression of “neoantigens” (i.e
intracellular antigens like Ro/SS-A,
La/ SS-B and calreticulin displaced to
keratinocyte cell surface) target of a
dysregulated immune attack.
B. Exfoliative dermatitis
(Erythroderma)
• Characterized by erythema and extensive scaling of skin (70% or
more)
• Scaling may be thick or thin, of large sheets or small flakes of
skin, exudative or thickly crusted
• Constitutional signs and symptoms are present
• Chilliness (+)inability of cutaneous blood vessels to constrict
• Hospitalization : For laboratory work-ups, proper therapeutics and
nutrition, patient convenience
• Varied etiologic factors: Inflammatory dses, Infectious dses,
Malignancies
• Skin biopsy by a dermatologist is IMPERATIVE
• Prognosis: Very good to grave depending on etiology
• Therapy : Months or years
C. Hyperpigmented Lesions
a. Post-inflammatory hyperpigmentation
b. Acanthosis nigricans
c. Amyloidosis –cutaneous/ systemic
d. Reaction to drugs (eg minocycline) heavy
metals, exogenous agents
e. Congenital d/o: Mongolian spot
f. Idiopathic: Ashy dermatosis
D. Hypopigmented Lesions
• VITILIGO
• - Loss of melanocytes
• - Etiology(?): autoimmunity,
autocytotoxicity, neurohumoral factors
• – most often associated with diseases of
the thyroid gland (hypo/hyperthyroidism)
• - localized (focal, segmental, acrofacial) or
generalized
E. ALOPECIA
-Definition: Loss of hair
- Most common area: Scalp
- SLE – scarring or nonscarring alopecia
- Syphilis – “moth-eaten” appearance
- Other causes: anemia, thyroid disorders,
infections
- Idiopathic
F. PURPURA
- Extravasation of blood
- Nonblanching (as opposed to
telangiectasia)
Example:
Hypersensitivity Vasculitis
Etiologies: Infections, Drug Reactions
II. Wheals = Urticaria
A. Primary or idiopathic
B. Secondary Varied etiology:
1. contact urticaria
2. food
3. drugs
4. physical urticaria
5. infectious etiology - UTI, PTB, Hepatitis, HIV
6. systemic disease - SLE, hyperthyroidism
7. genetic origin - hereditary angioedema
8. malignancy
Physical urticaria
d. Metabolic diseases –
e.g.Necrobiosis lipoidica diabeticorum
e. Idiopathic – e.g. pyoderma gangrenosum
V. Blistering disorders
a. Burns
b. Infection – viral, bacterial, fungal
c. Contact dermatitis
d. Autoimmune diseases –
Pemphigus, Bullous pemphigoid,
Epidermolysis bullosa, SLE