Dermatologic complaints are a common reason for presentation
to a general practitioner. In some cases, one needs to determine
if the complaint may be a manifestation of a more serious
underlying systemic disease.
This article aims to highlight common dermatologic
presentations where further assessment is needed to exclude
an underlying systemic disease, to discuss classic cutaneous
features of specific systemic diseases, and to outline rare
cutaneous paraneoplastic syndromes.
Skin manifestations of systemic disease are wide, varied,
specific and nonspecific. Generalised pruritus and cutaneous
vasculitis are more common cutaneous presentations where
an underlying systemic disease may be present and will
influence management. In certain chronic diseases such as
connective tissue disease and chronic liver disease, there are
characteristic cutaneous findings. Internal malignancies such
as multiple myeloma may present with distinctive cutaneous
findings, which need to be recognised to institute a search for
the underlying neoplasm. The skin has the potential to provide a
window into the patient and aid in the diagnosis of diseases of
all organ systems.
Dermatologic complaints are a common reason for presentation to a general practitioner. In such cases, one needs to determine if the complaint may be a manifestation of a more serious underlying systemic disease. Disorders of the every organ system may cause skin symptoms and signs, some of which are due to treatment of these conditions. It is beyond the scope of this review to cover all potential skin manifestations of systemic disease. This article highlights the more common, classic and important manifestations in three different groups:
- 'When to look further' – where dermatologic presentations require further assessment to exclude underlying systemic disease, and guide appropriate management
- 'What to look for' – where certain systemic diseases have classic cutaneous findings
- 'What not to miss' – where specific cutaneous signs might be the initial presentation of an underlying malignancy.
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