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1. DERMATOLOGIC MANIFESTATIONS OF GASTROINTESTINAL DISEASES Micheline Maamari Chalouhi,MD
2.
4. ESOPHAGUS Dysphagia
1-Diseases extending to the esophagus
2-connective tissue diseases
3-cancer
5. Candida
6. Pemphigus vulgaris
Autoimmune
Sore throat, dysphagia
7. Systemic sclerosis
Crest
Lower 2/3
90%
Premature fullness,reflux dysphagia,abdominal pain
8. Plummer vinson
(paterson kelly) syndrome
Postcricoidal web
Koilonychia
Sore tongue angular stomatitis
Iron deficiency
9. cancer
Tylosis
10. Gastrointestinal Bleed Hereditary hemorrhagic telangiectasias
AD
Vascular dilatation:oral, nasal, GI
Epitaxis(1)
Severe GI bleed (2) first decade
11. Gastrointestinal Bleed Ehlers-Danlos
Type 3 & 4 collagen defect
12. Gastrointestinal Bleed Pseudoxathoma elasticum
13. Gastrointestinal Bleed Kaposi sarcoma(HHV8)
Endothelial & lymphoreticular cells
GI: 50-80% cutaneous
100% oral
stomach,esophagus,
SI
14. Polyposis Gardner’s syndrome
AD(defect ch 5)
Epidermoid cysts,fibromas,
lipomas,osteomas
adenomatous polyps colon
Carcinoma
15. POLYPOSIS Canada cronkhite syndrome
Macular hyperpigmentation
Alopecia(rapid onset)
Nail atrophy (onycholysis,
triangular deformity)
16. POLYPOSIS Cowden disease
AD
Skin tags,acral keratoses,oral fibroma
Breast,thyroid,cervical,colon cancer
17. POLYPOSIS Muir-torre
Sebaceous gland tumors
Visceral malignancies(colon,kidney,uterus…)
18. POLYPOSIS Peutz-jegher’s syndrome
AD
Hamartomatous polyps(jejunum)
Lips,buccal mucosa,gingiva,..
Ovary,thyroid,cervix CA
19. 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
20. INFLAMATORY BOWEL DISEASES
Granulomas
21. INFLAMATORY BOWEL DISEASES
Erythema nodosum
22. INFLAMATORY BOWEL DISEASES
Aphtous ulcers
23. PANCREATITIS acute
24. pancreatic fat necrosis
25. Signs of specific GI tumors Stomach
Pernicious anemia
Vitiligo
Alopecia areata
26. Signs of specific GI tumors Small bowel
Carcinoid
Release of serotonin & bradykinin
Hepatic metastasis
Paroxysmal
Telangiectasia,
plethora….
27. Signs of specific GI tumors Large bowel
Paget
Intense pruritis
Glandular adnexal ca or regional internal ca
28. Signs of specific GI tumors Glucagonoma
APUD
Necrolytic migratory erythema
29. Paraneoplastic signs
Dry skin
Eczema craquele malabsorption
30. Paraneoplastic signs Dermatomyositis
Early sign
Life saving
31. Paraneoplastic signs Acanthosis nigricans
32. Paraneoplastic signs sister Mary Joseph nodule
33. Paraneoplastic signs Lesser trelat
34. Thank you……..