Mixed or Lobular-predominant Panniculitis

There are only a few causes of septal panniculitis, ie SEAptal

- Scleroderma

- Erythema nodoSum (the 'S' reminds you it's septal)

- a-AT deficiency 

The other big group of panniculitis is the mixed / lobular pattern.  If you read Bolognia pg1641, the authors seemed SKEPTICAL about dichotomising panniculitides as such. 

Stasis - Lipodermatosclerosis 

Kids - Sclerema neonatorum, Fat necrosis of the newborn (needle-shaped clefts within lipocytes)

Erythema induratum (a/w vasculitis of sub-Q vessels) 

Pancreatitis (necrosis is an early feature) 

Traumatic - blunt trauma, injectable substances, cold panniculitis, sclerosing lipogranuloma

Infectious 

CTDs / Autoimmune - Dermatomyositis, Lupus 

Lipodystrophies

from Dermatology 3ed, Bolognia (eds)

Causes of Erythema Nodosum

The causes of Erythema Nodosum are very very varied.

A more abbreviated mnemonic would be DISSTend

Drugs (remember "POSH", see below)
IBD / Idiopathic
Streptococcal infection
Sarcoidosis
TB
end = erythema nodosum

A longer, but still non-exhaustive mnemonic is: POSH GUNSMITH

Penicillins
OCPs
Sulfonamides
Halides

Gastroenteritis (Yersinia > Salmonella or Campylobacter)
URTI (viral)
Neutrophilic dermatosis (Behcet's, Sweet's)
Streptococcus / Sarcoidosis
Malignancy (usu Haematologic)

IBD / Idiopathic 

TB

HIV / Hep B

Drug Causes of Pseudoporphyria - FATTeND

Pseudoporphyria demonstrates identical clinical (blisters, erosions, scarring/milia on sun exposed sites) and histological (cell-poor sub-epidermal blister, dermal festooning, caterpillar bodies, eosinophilic hyaline deposits around BV, DIF+ along the BMZ and perivascularly) features to Porphyria Cutanea Tarda (defect in Uroporphyrinogen Decarboxylase).

Risk factors include:

1. Dialysis
2. Use of tanning beds (UVA)
3. Drugs - FATTeND

Fluoroquinolones
Amiodarone
Tretinoin (and other Retinoids)
TEtracyclines
Naproxen and other NSAIDs
Diuretics (Loop and Thiazide)

Acid Base Balance Cheat Sheet

Winter's Equation: PCO2 = (1.5 × [HCO3-]) + 8 ± 2 

***Another useful tool in estimating the PCO2 in metabolic acidosis is the recognition that the pCO2 is always approximately equal to the last 2 digits of the pH.***

How severe is your Ulcerative Colitis?

The Truelove Criteria (awesome name BTW...) grades the severity of Ulcerative Colitis based on 5 parameters:

UC Severity - She Hasn't Even Finished Pooping!

Stool frequency per day (has to be bloody stool)

Haemoglobin

ESR

Fever

Pulse rate

	MILD	MODERATE	SEVERE
Stool frequency /day (bloody stools)	<4	Moderate severity are values that are in between MILD & SEVERE	>6
Haemoglobin	>11.0		<10.5
ESR	<30		>30
Fever	Afebrile		>37.8
Pulse rate	<70		>90

 

Myasthenia Gravis associations

Diseases associated with Myasthenia Gravis - STRAPD (read: 'strapped')

S - SLE or Sarcoid

T - Thymoma or Thyroid disease (hypo/hyper)

RA - Rheumatoid Arthritis

P - Pernicious Anaemia

D - the 2 DMs : diabetes mellitus & dermatomyositis

PGA - more Addison's than Tiger Woods....

Some quick notes about the group of diseases known as Polyglandular Autoimmune Syndrome (PGA).

• 2 types exist - PGA I and PGA II (PGA II is the MORE COMMON of the two)

• Each is a constellation of THREE diseases - but the diagnosis can be clinched by just having only 2 out of 3.

• The common link between the two is autoimmune Addison's disease

PGA I:

Parathyroid - autoimmune HYPOparathyroidism

Gandida (boo hoo....this represents a new low in mnemonic making) - chronic mucocutaneous candidiasis

Addison's disease

Chronologically, chronic mucocutaneous candidiasis appears first, followed by hypoparathyroidism, and lastly Addison's.

PGA II - also with Addison's and 1 of the 2:

1) Type 1 DM (contrast this with candidiasis, which is common in Diabetics)

2) autoimmune THYROID disease - more commonly Hashimoto's than Graves' (contrast this with Parathyroid involvement of PGA I)