🩺 Section 686.1: Cutaneous Manifestations of Systemic Diseases

Nelson Textbook of Pediatrics 22nd Edition | Skin as a window to systemic illness — SLE (malar, discoid, neonatal lupus), juvenile dermatomyositis (Gottron, heliotrope), morphea, IgA vasculitis (HSP), Kawasaki disease, Behçet, IBD (erythema nodosum, pyoderma gangrenosum), Sweet syndrome, GVHD, autoinflammatory diseases.

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📋 30 Clinical Scenarios — Cutaneous Signs of Systemic Disease

📇 High‑Yield Review Cards | Skin & Systemic Disease

🩺 Rash Morphology → Systemic Disease

Select a cutaneous presentation to identify associated systemic disease, workup, and treatment.

📋 Stepwise Approach to Cutaneous Signs of Systemic Disease

🔑 Key Principles — Nelson 686.1
• SLE: Malar rash, discoid, photosensitivity, oral ulcers, non-scarring alopecia. ANA, anti-dsDNA, complement.
• Juvenile Dermatomyositis (JDM): Heliotrope rash, Gottron papules, shawl sign, nailfold telangiectasias. CK, aldolase, MRI.
• IgA Vasculitis (HSP): Palpable purpura (buttocks/legs), arthralgia, abdominal pain, renal. DIF: IgA vessel walls.
• Kawasaki: Polymorphous rash, strawberry tongue, conjunctivitis, acral desquamation, fever >5 days.
• IBD: Erythema nodosum (pretibial tender nodules), pyoderma gangrenosum (ulcer with undermined border).
• Sweet syndrome: Fever, painful edematous plaques, neutrophilic infiltrate. Associated with malignancy (AML).
• GVHD: Morbilliform (acute) or lichenoid/sclerotic (chronic) after stem cell transplant.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: Cutaneous Manifestations of Systemic Diseases (Nelson 686.1)