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Summary Cluster Abdomen - Dermatology
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  • Course
  • Year 3 - Cluster Abdomen
  • Institution
  • Maastricht University (UM)

This is a summary of the educational activities provided in the abdomen cluster regarding Dermatology. This includes learning goals (ie. urticaria, psoriasis), lectures, and skillslab (chronic venous insufficiency). The link to abdominal diseases is also discussed.

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Document information

  • December 7, 2017
  • 11
  • 2017/2018
  • Summary

Subjects

  • year 3
  • jaar 3
  • cluster abdomen
  • abdomen
  • medicine
  • geneeskunde
  • dermatology
  • lectures
  • learning goals
  • skillslab

Written for

  • Maastricht University (UM)
  • Medicine
  • Year 3 - Cluster Abdomen
All documents for this subject (4)

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Content preview

3.1 Abdomen

Case - Dermatology

I. Urticaria and Pruritus

1. Urticaria

- Definition
- Urticaria: transient appearance of smooth elevated erythematous plaques due to
a vascular reaction ; accompanied by pruritus
- Acute: resolves within hours/days, self limiting, can be recurrent
- Chronic: recurrent episodes lasting >6 weeks
- Often isolated event
- Causes:
- Isolated event
- Idiopathic
- Immune mediated: hypersensitivity reactions I, II or III (allergies, contact)
- Complement mediated: viral/bacterial infections, serum sickness, transfusion
reactions, drug reactions, radiocontrast agents
- Physical: immediate/delayed pressure, contact urticaria, cold urticaria,
cholinergic urticaria

- Pathology
- Mast cell and basophils: release of histamine, bradykinin, leukotriene C4
prostaglandin D2, vasoactive substances
- Histamine: causes pruritus
- Extravasation of plasma into dermis => urticarial lesion

- Clinical Features
- History: precipitants, medical/family history

- Differential Diagnosis
- Dermatological: atopic contact dermatitis, atopic dermatitis, urticarial vasculitis

- Diagnostics
- P.E: angioedema, painful/long lasting urticarial lesions, systemic signs/symptoms,
scleral icterus, hepatic enlargement/tenderness, thyromegaly,
pneumonia/bronchospasm, signs of fungal infection
- Lab (chronic): CBC, ESR, TSH, ANA (antinuclear antibody)
- Other: imaging, punch biopsy

- Therapy
- Pharmacological:
- symptomatic treatment with antihistamines
- Other: omalizumab, glucocorticoids
- Other: avoidance

, 2. Pruritus

- Definition: skin itching due to a dermatological or systemic disease

- Clinical Features
- Risk factors: age, chronic/generalized pruritus, abnormal physical findings

- Diagnostics
- Initial: CBC, TSH, fasting glucose, alkaline phosphatase, bilirubin, creatinine,
blood urea nitrogen
- Extra: radiography (lymphoma)

- Differential Diagnosis
- Dermatological causes
- Systemic:
- Autoimmune
- neurological
- Hematological: iron deficiency anemia
- Hepatobiliary: biliary cirrhosis, chronic pancreatitis with biliary tract
obstruction, cholestasis, hepatitis (esp. C)
- Infectious: AIDS, hepatitis, parasitic (giardia lamblia)
- Malignancy
- Endocrine: chronic renal disease, diabetes, hyper/hypo(para)thyroidism
- Other: rapid weight loss, pregnancy

- Treatment
- Antihistamines: for histamine-mediated pruritus
- Other: Maintain moisture of skin, avoidance

3. Link to the Abdomen

- Infectious
- Hepatitis (A, B, C)
- Urticaria:
- prodromic stages of Hep infection ; pre-icteric symptoms
- Immune complex deposits ; decreased complement levels
- Pruritus
- Helicobacter pylori infection: studies show association with urticaria

- Endocrine
- Pregnancy
- Pruritic Urticarial Papules and Plaques
- Estrogen increase histamine release from mast cells and basophils ->
increased sensitivity to different pathogens ; fragility of skin to
itching/scratching leads to urticaria
- Diabetes Mellitus
- Urticaria:

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