Medical conditions associated with skin disease

There are many medical conditions associated with skin disease. This chapter, which is set out as below, provides a snapshot into some of the more common and/or important associations. 

Connective tissue disorders 

• Several including: lupus erythematosus, systemic sclerosis, dermatomyositis 

Diabetes

• Diabetic dermopathy: round, brown, atrophic macules on shins

• Necrobiosis lipoidica: sharply demarcated, atrophic, yellowish patches or plaques on the shins  

Inflammatory bowel disease

• Pyoderma gangrenosum: painful, rapidly enlarging ulcer with undermined blue-purple edge

• Sweet's syndrome (syn. acute febrile neutrophilic dermatosis): tender papules, pustule, plaques. Fever common

• Neutrophilic dermatoses: several types including Sweet's syndrome 

• Erythema nodosum: mainly shins. Ill-defined, tender nodules

• Orofacial granulomatosis and Crohn's disease: sudden, diffuse or occasionally nodular swellings of the lips or face. Eventually the lip enlargement becomes permanent. Oral involvement is common

Paraneoplastic conditions

• Paraneoplastic conditions are a group of skin conditions that have strong associations with internal malignancies 

Others include:

• Thyroid - alopecia, pretibial myxoedema (a diffuse skin thickening of the shins and dorsa of the feet)

• Chronic liver and kidney disease - can both cause pruritus

• Haematological disorders eg pruritus, B-cell lymphoma, leukaemia cutis

• Sex-hormone abnormalities eg hirsutism and other signs of virilisation

• Addison’s disease: hyperpigmentation

• Acromegaly: thickening of skin