×
MedSchool: Ace Your OSCEsThe Medical Company
 
 
 
 
 
GET - On the App Store
View
Hand & Wrist Exam
 
Hand & Wrist Exam
 

Skin Examination

 
 
 
Bookmark

Psoriatic Plaques

  • Look For

  • Raised erythematous patches, particularly affecting the extensor surfaces of joints, scalp, periumbilicus, lower back and skin folds
  • Significance

  • In a patient with a symmetric polyarthritis, the presence of psoriatic plaques is pathognomonic for psoriatic arthritis, and are very useful in distinguishing this from rheumatoid arthritis - the other major differential.

Gottron’s Papules

  • Look For

  • Thickened erythematous lesions over the dorsal aspects of the metacarpophalangeal and interphalangeal joints.
  • Significance

  • Gottron’s papules are pathognomonic for dermatomyositis.

Sclerodactyly

  • Look For

  • Thickening of the skin of the fingers and / or toes.
  • Causes of Sclerodactyly

  • Scleroderma
  • Mixed connective tissue disease

Raynaud’s Phenomenon

An episode of Raynaud’s phenomenon manifests as subsequent white, blue and then red discolouration of the fingers (or toes) due to ischaemia, cyanosis and then hyperaemia. These may occur in response to cold or emotional stress.
  • Look For

  • Areas of white, blue or red change in the hands.
  • Causes of Raynaud’s Phenomenon

  • Raynaud’s disease (primary / idiopathic)
  • Connective tissue disease - scleroderma, systemic lupus erythematosus, rheumatoid arthritis, mixed connective tissue disease, inflammatory myopathies
  • Arterial occlusion - acute ischaemia, peripheral vascular disease, thromboangiitis obliterans, thoracic outlet obstruction
  • Haematologic - cold agglutinin disease, paraproteinaemia, cryoglobulinaemia, Waldenstrom’s
  • Trauma - vibration injury, cold injury
  • Drugs - beta blockers, ergotamine, chemotherapy
Next Page
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge
Sign Up Now
   
 
 

Snapshot: Initialising...