The Significance of a Dermatologist’s Clinical Practice with Regard to Diagnosing and Managing Collagen Diseases

Abstract

　Skin changes can be significant early manifestations of collagen diseases. We discuss the clinical cases involving 5 patients who presented with skin complaints and skin changes whose final diagnoses were collagen diseases. In each case, the initial skin manifestations were important in confirming the diagnosis.

　Patient 1 visited our hospital with recurrent perniosis. The physical examination revealed sclerosis of the hands and a diagnosis of systemic sclerosis was established. Patients 2 and 3 presented with intractable hand eczema. Patient 2 exhibited“mechanic’s hands”on physical examination and a diagnosis of dermatomyositis was made. The condition was resolved following surgery for renal cell carcinoma. In this case, the condition of“mechanic’s hands”was a cutaneous sign of renal malignancy. Physical examination for patient 3 revealed an inverse Gottron’s sign. A diagnosis of interstitial lung disease was made.

　Patient 4 presented with recurrent pruritic skin eruptions that preceded a subsequent diagnosis of papulo-squamous-type subacute cutaneous lupus erythematosus.

　Patient 5 presented with evidence of persistent angioedema on the right side of the face. A diagnosis of Sjogren syndrome was later established.

　Based on the physical findings and final diagnoses in these cases, we identified the potential significance of clinical dermatology practice related to diagnosing and managing collagen diseases.

（日本皮膚免疫アレルギー学会雑誌, 3（2）：299-304, 2020）