DERMATOLOGIC MANIFESTATIONS OF GASTROINTESTINAL DISEASES

DERMATOLOGIC MANIFESTATIONS OF GASTROINTESTINAL DISEASES Micheline Maamari Chalouhi,MD case1 case2 case1 case2 ESOPHAGUS • Dysphagia • 1-Diseases extending to the esophagus • 2-connective tissue diseases • 3-cancer Candida Pemphigus vulgaris • Autoimmune • Sore throat, dysphagia Systemic sclerosis • Crest • Lower 2/3 • 90% • Premature fullness,reflux dysphagia,abdominal pain Plummer vinson • (paterson kelly) syndrome • Postcricoidal web • Koilonychia • Sore tongue angular stomatitis • Iron deficiency cancer • Tylosis Gastrointestinal Bleed Hereditary hemorrhagic telangiectasias • AD • Vascular dilatation:oral, nasal, GI • Epitaxis(1) • Severe GI bleed (2) first decade Gastrointestinal Bleed Ehlers-Danlos • Type 3 & 4 collagen defect Gastrointestinal Bleed Pseudoxathoma elasticum Gastrointestinal Bleed Kaposi sarcoma(HHV8) • Endothelial & lymphoreticular cells • GI: 50-80% cutaneous • 100% oral • stomach,esophagus, SI Polyposis Gardner’s syndrome • AD(defect ch 5) • Epidermoid cysts,fibromas, lipomas,osteomas • adenomatous polyps colon • Carcinoma POLYPOSIS Canada cronkhite syndrome • Macular hyperpigmentation • Alopecia(rapid onset) • Nail atrophy (onycholysis, triangular deformity) POLYPOSIS Cowden disease • AD • Skin tags,acral keratoses,oral fibroma • Breast,thyroid,cervical ,colon cancer POLYPOSIS Muir-torre • Sebaceous gland tumors • Visceral malignancies(colon,ki dney,uterus…) POLYPOSIS Peutz-jegher’s syndrome • AD • Hamartomatous polyps(jejunum) • Lips,buccal mucosa,gingiva,.. • Ovary,thyroid,cervix CA INFLAMATORY BOWEL DISEASES pyoderma gangrenosum • 50%PG have UC • 10% UC have PG • Severity & extent of ulceration are Linked to the activity of the disease INFLAMATORY BOWEL DISEASES Granulomas INFLAMATORY BOWEL DISEASES Erythema nodosum INFLAMATORY BOWEL DISEASES Aphtous ulcers PANCREATITIS acute pancreatic fat necrosis Signs of specific GI tumors Stomach • Pernicious anemia • Vitiligo • Alopecia areata Signs of specific GI tumors Small bowel • Carcinoid • Release of serotonin & bradykinin • Hepatic metastasis • Paroxysmal • Telangiectasia, plethora…. Signs of specific GI tumors Large bowel • Paget • Intense pruritis • Glandular adnexal ca or regional internal ca Signs of specific GI tumors Glucagonoma • APUD • Necrolytic migratory erythema Paraneoplastic signs Dry skin • Eczema craquele malabsorption Paraneoplastic signs Dermatomyositis • Early sign • Life saving Paraneoplastic signs Acanthosis nigricans Paraneoplastic signs sister Mary Joseph nodule Paraneoplastic signs Lesser trelat Thank you……..