This document discusses the cutaneous manifestations of various systemic diseases. It covers connective tissue disorders like lupus erythematosus, infectious diseases like tuberculosis and leprosy, endocrine disorders such as thyroid disorders and adrenal disorders, and nutritional/metabolic conditions including iron deficiency, vitamin deficiencies, and amyloidosis. Many systemic illnesses present with characteristic skin findings that can help in early diagnosis and management of the underlying disease. Dermatological examination is important for identifying clues indicating internal medical conditions.
skin is an organ where internal disorders are manifested. some are early signs, some are late signs, some may be the only manifestation. they can result in diagnostic dilemma.
Cutaneous manifestations of hiv infectiontashagarwal
Dermatological problems occur in more than 90% of patients with human immunodeficiency virus (HIV) infection. In some patients, skin is the first organ affected. Skin diseases have proved to be sensitive and useful measures by which HIV progression can be monitored.
Erythroderma is defined as the scaling erythematous dermatitis involving 90% or more of the cutaneous surface.
Also known as exfoliative dermatitis
Idiopathic exfoliative dermatitis – also known as the “red man syndrome”, is characterized by marked palmoplantar keratoderma, dermatopathic lymphadenopathy,increased IgE.
Increased skin perfusion leads to
Temperature dysregulation >
Resulting in skin loss and hypothermia >
High output state >
Cardiac failure
BMR raises to compensate for heat loss
Increased dehydration due to transpiration (similar to burns)
All lead to negative nitrogen balance and characterized by edema, hypoalbuminemia, loss of muscle mass.
skin is an organ where internal disorders are manifested. some are early signs, some are late signs, some may be the only manifestation. they can result in diagnostic dilemma.
Cutaneous manifestations of hiv infectiontashagarwal
Dermatological problems occur in more than 90% of patients with human immunodeficiency virus (HIV) infection. In some patients, skin is the first organ affected. Skin diseases have proved to be sensitive and useful measures by which HIV progression can be monitored.
Erythroderma is defined as the scaling erythematous dermatitis involving 90% or more of the cutaneous surface.
Also known as exfoliative dermatitis
Idiopathic exfoliative dermatitis – also known as the “red man syndrome”, is characterized by marked palmoplantar keratoderma, dermatopathic lymphadenopathy,increased IgE.
Increased skin perfusion leads to
Temperature dysregulation >
Resulting in skin loss and hypothermia >
High output state >
Cardiac failure
BMR raises to compensate for heat loss
Increased dehydration due to transpiration (similar to burns)
All lead to negative nitrogen balance and characterized by edema, hypoalbuminemia, loss of muscle mass.
Skin or Dermatological Manifestations of Endocrine Diseases - diabetes thyroid adrenal cushings pituitary and acquired and cushings and myxedema and graves
Skin or Dermatological Manifestations of Endocrine Diseases - diabetes thyroid adrenal cushings pituitary and acquired and cushings and myxedema and graves
An educational presentation that consists of general complaint of skin diseases, history taking and examining various lesions and differentiating it and lastly tools required and investigation to be done to diagnose the skin manifestations
onchocerciasis, definition, onchocerca volvulus, epidemiology of onchocerciasis, management of onchocerciasis, prevention of onchocerciasis, pathology of onchocerciasis
8 July is World Hepatitis Day
World Hepatitis Day, 28 July, is an opportunity to step up national and international efforts on hepatitis, encourage actions and engagement by individuals, partners and the public and highlight the need for a greater global response as outlined in the WHO's Global hepatitis report of 2017.
The date of 28 July was chosen because it is the birthday of Nobel-prize winning scientist Dr Baruch Blumberg, who discovered hepatitis B virus (HBV) and developed a diagnostic test and vaccine for the virus.
Low coverage of testing and treatment is the most important gap to be addressed in order to achieve the global elimination goals by 2030.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Hot Selling Organic intermediates
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
4. DISCOID LUPUS ERYTHEMATOSUS
• Most patients have limited disease to head and
neck (localised DLE) but rarely may present as
disseminated disease potentially affecting any
area of skin (Disseminated DLE)
• It presents as rash (erythematous patches) with
adherent scale over it,
• Raynaud’s phenomenon found in 14% of
cases
5. Localised DLE-
• Face is most commonly affected area f/b
scalp, ears, arms, legs, and trunks to a
lesser extent
• Discoid erythematous rash appear most
commonly over the cheeks, bridge of the
nose, ears , scalp and side of the neck
• Alopecia occurs in 1/3rd of the patients
6.
7. Disseminated DLE
• Characteristic lesions of DLE may occur in
widespread pattern on trunk and limbs
• This occur almost always in women and
they are cigarette smokers
• This variety tends to be persistent ,
resistant to therapy and associated with
psychological upset
8.
9. SUBACUTE CUTANEOUS LUPUS
ERYTHEMATOSUS
• Lesions usually occur above the waist
particularly around neck, on the trunk and on
the outer aspects of arm.
• Predominantly affects adult age group
• Skin lesions comprises of non scarring
papulosquamous (two thirds) and annular
polycystic lesions (one third)
13. • Cutaneous erythema on light exposed area is the most common
feature
• Butterfly blush with fine scaling on butterfly area of the cheeks is
frequently found
• Epidermal necrosis may occur in some cases
• Alopecia occurs in around 50% of cases , hair becomes coarse
dry and fragile called ‘lupus hair’
• Persistent non itching urticaria like wheals are common
• Livedo reticularis(a mottled or bluish red discoloration, which
blanches on pressure and is not affected by temperature
changes) may develop over outer aspects of arms
14.
15.
16. SCLERODERMA
• At first lesions are indurated and faintly purplish later they lose their
colour especially in centre and appear as thickened waxy areas with
smooth and shiny surface , hairs are usually absent over these
surfaces
• Morphea i.e patches of hardened skin, appears over face, hands, and
feet which lacks sweat gland and ability to make skin folds
• Skin induration initially affects the fingers (sclerodactyly) and extend
proximally
• Raynauds phenomenon is a common finding
• Infarction and dry gangrene of fingers may occur sometimes due to
severe vasospasm
17.
18.
19. DERMATOMYOSITIS
A purplish-red or heliotrope erythema occurs on
the face, especially involving the eyelids, the
upper cheeks, forehead and temples
Oedema of the eyelids and periorbital tissues
may occur
Small erythematous or violaceous, flat papules
(Gottron’s papules) occur over the knuckles, on
the dorsa of the finger and around the nail folds .
20.
21. RHEUMATOID ARTHRITIS
Rheumatoid nodules these are subcutaneous
nodules affecting the extensor surfaces of the
forearms, back of hand, occipital region, auricular
region more commonly
Cutaneous small vessel vasculitis may lead to
purpura, bruise or ulcerative lesions over the skin.
Pyodermagangrenosum sterile pustules which
rapidly evolve over painful ulcers charactrized by
raised edges with erythematous purple covering
26. PRIMARY INOCULATION
Tubercular chancre skin
lesion may vary from brownish
papule ,nodule to an ulcer with
undermined edge. On
diascopy it shows apple jelly
nodules
Warty tuberculosis (verruca
cutis) leisions occur on area
exposed to trauma.Starts with
a small indurated warty
papule. Irregular extension
may cause finger like
27. SCROFULODERMA
At first bluish-red nodule
overlying the infected
gland forms which breaks
down to form undermined
ulceration with granulating
tissue at the base
39. THYROID DISORDERS
Cutaneous features of hyperthyroidism
• SKIN- palmar erythema ,facial flushing
,increased skin temp.,increased sweating,
hyper pigmentation , pretibial myxoedema
• NAILS- soft nails ,koilonychia,distal onycholysis
(plummer’s nail)
• HAIR- fine thin hair ,diffuse alopecia
40.
41. Cutaneous features of Hypothyroidism
• SKIN-Pale, cold, scaly and wrinkled skin, Ivory-
yellow skin colour, Xerosis, Absence of sweating,
puffy oedema of hands, face and eyelids
• NAILS- Brittle and striated nails
• HAIR- Coarse sparse scalp hair, Loss of pubic,
axillary and facial hair, Loss of lateral eyebrows
(madarosis)
42.
43. ADRENAL DISORDERS
Cutaneous manifestation of cushing’s syndrome
• Truncal obesity (classically deposits of fat over the clavicles and back of
the neck, the ‘buffalo hump’)
• Facial fullness and plethora (‘moon facies’)
• Slender limbs
• Skin atrophy
• Fragility, bruising and poor healing leading to Striae (typically white and
red)
• Hirsuties,Acneiform lesions
• Male-pattern baldness in women
44.
45. Cutaneous manifestation of Addison’s disease
• Hyperpigmentation of the skin, due to increased secretion of
pituitary MSH and ACTH as a response to low adrenal
corticosteroid levels, is the cardinal dermatological feature
• Patterns of addisonian pigmentation -
1. Light-exposed areas i.e.face, dorsa of hands,
2. Areas subject to friction—elbows, knees, waistline
3. Accentuation of normally high pigmentation areas—genital,
perineum, axillae, areolae, umbilicus
4. Palmar creases
5. Tongue and mucous membranes
46.
47. DIABETES MELLITUS
Periungual talengectasia-
A microangiopathic
complication seen in upto
49% of diabetics
Acanthosis nigricans- a
verrucous hyper pigmented
plaques seen over axilla ,
nape of neck which is due to
hyperinsulinemia
48. Granuloma annulare-
annular leisions with
raised skin colour having
symmetrical distribution
on arms,neck and upper
half of the trunk
Necrobiosis lipodica-
sharply demarcated
slightly depressed yellow
waxy plaques with
erythematous raised
border
51. LIVER CIRRHOSIS
Skin lesions associated with chronic liver disease
•Spiderangiomas , telangiectasis
•Palmar erythema
•Dilated abdominal/chest veins (including periumbilical
caput medusae)
•Jaundice
•Increased melanin pigmentation
•Thin ‘paper-money’ skin
•Loss of secondary sexual hair in males
52.
53. ACUTE PANCREATITIS
Grey Turner sign (Turner
sign)—tracks from the
pararenal space to the edge
of the quadratus lumborum
muscle then through a
defect in the fascia to the
subcutaneous tissues of the
flank (left sided in
pancreatitis)
54. Bryant’s sign—tracks to
the scrotum to produce
the ‘blue scrotum’ sign.
Cullen’s sign—tracks
into the falciparum
ligament then through the
connective tissues of the
round ligament to the
periumbilical area
57. IRON DEFICIENCY DISORDER
• Paleness of skin, palm creases and conjuctiva
• Painful cracks at corner of mouth (angular
cheilitis)
• Shiny smooth tongue (atrophic glossitis)
• Spoon shaped nails (koilonychiya)
• Dry and brittle hair
58.
59. VITAMIN B COMPLEX DEFICIENCIES
VitB3 (niacin)deficiency - Pellagra
• Red skin with large blebs or blisters that exfoliates
• Erethema over the dorm of hands
• Scaling over the sun exposed area of the skin
• Dry ,scaly and hyperkeratotic darkly pigmented skin
• Site- mostly over face, neck ,arms, hands and feet
60.
61. B12 Deficiency -
• Skin hyperpigmentation with accentuation
in flexural areas ,palms ,soles and oral
cavity
• Angular stomatitis , glossitis(hunters
glossitis), xerostomia
• Vitiligo
62.
63. VITAMIN C DEFICIENCY
SCURVY
• Perifollicular hemmorage with blood
pigment discolouration especially on the
trunk and lower limbs (purpuric rash)
• Swollen bleeding gums
• Epistaxis may occur sometimes
66. Myeloma associated cutaneous amyloidosis (AL
amyloid)
• Almost 40% of patients with AL amyloidosis
have skin manifestation
• leisions tend to aggregate around
mucocutaneous junctions like orbit, lips and
genital skin
• purpura is also a common finding which
results from vascular fragility due to amyloid
deposition in blood vessels
67.
68. Secondary systemic amyloidosis (AA amyloid)
• The amyloids are composed of fibrils of a protein
designated as AA
• AA protein is an acute phase reactant
• secondary amyloidosis occurs as a complication of
many chronic inflammatory diseases
• Skin lesions are wage and are non specific
• Most common are renal manifestation leading to
nephrotic syndrome
69. Dialysis associated amyloidosis
• cutaneous involvement is rare
• manifests as hyper pigmentation
,lichenoid eruptions,or nodules that
demonstrate amyloid deposition on HPE
examination
70. TAKE HOME MESSAGE
CUTANEOUS MANIFESTATIONS CAN HELP IN
EARLY DIAGNOSIS AND INTERVENTION OF MANY
HIDDEN SYSTEMIC DISEASES
IT ALSO HELPS IN UNDERSTANDING THE
PROGNOSIS AND MANAGING THE DISEASE
Good afternoon everyone today i will be presenting seminar on dermatological manifestation of systemic ds
There are 3 types of lupus
This shows a discoid erythematous rash over the face
This is a scalp leision showing alopecia and alopecia is usually permanent. Scalp leision occurs in almost 1/3 rd of pt.
This is a typical erethematous rash with adherent scale over it
These are lesions of disseminated dle these are actually classical dle leisions that may occur at any part of the skin
Now here we can see the leisions are occurring typically above the waist
This picture shows typical butterfly rash over cheecks
This shows characterstick lupus hair with alopecia
This is levido reticularid
This is an early leision showing central paleness with waxy smooth and shiny surface
This is frontopariteal morphea
This is a typical scleroderma facies with decreased skin fold
This shows radial furrowing round the mouth and decreased oral apurture
This shows infarction and dry gangrene of fingers
Due to sevre vasospasm
This is a typical heliotrope erethema seen in dermatomyositis
These are gotrons papule
This is rheumatoid nodule
This is pyoderma gangrenosum
This is cutaneous small vessel vasculitis
Showing purpuric leision over the skin
Tubercular skin infection can be divided into multibacillary and paucibacillary types
Lupus vulgaris has 5 forms
Plaque form, ulcerative form , vegitative form, tumor like form, papular and nodular form
Other types of tubercular skin leisions are lichen scrofulosorm. Tubercular gumma
Sensory loss
Here we can see a patient of seborrhoic dermatitis
Showing itchy scaly patches over face
Extensive forms may some times
lead to erythroderma in aids pt.
This is a picture showing lady with hypothyroid features