logo Connective tissue diseases

Systemic dermatology

Connective tissue diseases

Objectives

  • Recognise cutaneous connective tissue diseases.

Introduction

The so-called connective tissue diseases are the result of environmental stimuli (such as drugs, infection or exposure to ultraviolet radiation) in genetically predisposed individuals. They are associated with a range of circulating autoantibodies.

Lupus erythematosus

Localised discoid LE

Severe discoid LE without systemic features

Subacute cutaneous LE


Butterfly rash in SLE

Discoid lupus in patient with SLE

Lupus chilblains (SLE)

© R Suhonen


Low power view shows dense perivascular and periadnexal inflammatory infiltrate

Medium-powered view shows interface changes and lymphocytic infiltrate

High-power view of vacuolar degeneration of basal layer


Systemic lupus erythematosus

Investigations should include:

Scleroderma

Scleroderma (tight skin) is seen in the following conditions:


Morphoea

Linear morphoea

© R Suhonen

En coup de sabre


Severe systemic sclerosis

CRST syndrome

Calcinosis cutis


Chronic graft-versus-host disease (GVHD)

Dermatomyositis

Heliotrope rash

Gottron’s papules


Rheumatoid arthritis

Rheumatoid nodules

Rheumatoid nodules

Palmar erythema

Ragged cuticles

Rheumatoid neutrophilic dermatosis


Rheumatic fever