eMedicine Specialties > Dermatology > Internal Medicine

Dermatologic Manifestations of Pulmonary Disease: Multimedia

Author: Paul B Cornia, MD, Staff physician, Assistant Professor of Medicine, University of Washington, Department of Medicine, Veterans Affairs Puget Sound Health Care System
Coauthor(s): Gregory J Raugi, MD, PhD, Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle
Contributor Information and Disclosures

Updated: May 15, 2009

Multimedia

Clubbing. Photograph shows the palmar surface of ...Media file 1: Clubbing. Photograph shows the palmar surface of the hands of a patient with marked clubbing. Note the bulbous clublike digits.
Clubbing. Photograph shows the palmar surface of ...

Clubbing. Photograph shows the palmar surface of the hands of a patient with marked clubbing. Note the bulbous clublike digits.

Clubbing, phalangeal depth ratio. Photograph show...Media file 2: Clubbing, phalangeal depth ratio. Photograph shows clubbed fingers in profile. The phalangeal depth ratio refers to the ratio of the distal phalangeal to interphalangeal depth. Clubbing may be diagnosed when the distal phalangeal depth (A) is greater than the interphalangeal depth (B) (ie, phalangeal depth ratio >1).
Clubbing, phalangeal depth ratio. Photograph show...

Clubbing, phalangeal depth ratio. Photograph shows clubbed fingers in profile. The phalangeal depth ratio refers to the ratio of the distal phalangeal to interphalangeal depth. Clubbing may be diagnosed when the distal phalangeal depth (A) is greater than the interphalangeal depth (B) (ie, phalangeal depth ratio >1).

Lung cancer, skin metastasis. Photograph shows a ...Media file 3: Lung cancer, skin metastasis. Photograph shows a skin metastasis on the upper portion of the back in a patient with lung cancer. Note the prominent superficial telangiectasia.
Lung cancer, skin metastasis. Photograph shows a ...

Lung cancer, skin metastasis. Photograph shows a skin metastasis on the upper portion of the back in a patient with lung cancer. Note the prominent superficial telangiectasia.

Superior vena cava syndrome in a 63-year-old man ...Media file 4: Superior vena cava syndrome in a 63-year-old man with known lung cancer who presented with dyspnea and facial swelling. The anterior chest is shown. Note the engorged, parallel, superficial venules. CT scanning of the chest confirmed compression of the superior vena cava.
Superior vena cava syndrome in a 63-year-old man ...

Superior vena cava syndrome in a 63-year-old man with known lung cancer who presented with dyspnea and facial swelling. The anterior chest is shown. Note the engorged, parallel, superficial venules. CT scanning of the chest confirmed compression of the superior vena cava.

Sarcoidosis in a 20-year-old, asymptomatic woman....Media file 5: Sarcoidosis in a 20-year-old, asymptomatic woman. Marked bilateral hilar and paratracheal adenopathy are seen on this chest radiograph. Biopsy was performed and revealed noncaseating granulomas.
Sarcoidosis in a 20-year-old, asymptomatic woman....

Sarcoidosis in a 20-year-old, asymptomatic woman. Marked bilateral hilar and paratracheal adenopathy are seen on this chest radiograph. Biopsy was performed and revealed noncaseating granulomas.

Sarcoidosis, cutaneous. The cutaneous manifestati...Media file 6: Sarcoidosis, cutaneous. The cutaneous manifestations of sarcoidosis are highly variable. The photograph shows an annular plaque on the dorsal surface of the foot. Biopsy revealed noncaseating granulomas typical of sarcoidosis.
Sarcoidosis, cutaneous. The cutaneous manifestati...

Sarcoidosis, cutaneous. The cutaneous manifestations of sarcoidosis are highly variable. The photograph shows an annular plaque on the dorsal surface of the foot. Biopsy revealed noncaseating granulomas typical of sarcoidosis.

Wegener granulomatosis in a 71-year-old man. The ...Media file 7: Wegener granulomatosis in a 71-year-old man. The left image shows right middle and lower lobe airspace disease. The patient was treated with steroids, and the hemoptysis resolved. The follow-up chest radiograph (right) shows radiographic improvement.
Wegener granulomatosis in a 71-year-old man. The ...

Wegener granulomatosis in a 71-year-old man. The left image shows right middle and lower lobe airspace disease. The patient was treated with steroids, and the hemoptysis resolved. The follow-up chest radiograph (right) shows radiographic improvement.

Relapsing polychondritis. Photograph shows saddle...Media file 8: Relapsing polychondritis. Photograph shows saddle-nose deformity, which may be seen in persons with relapsing polychondritis as a result of the destruction of cartilage in the nasal septum.
Relapsing polychondritis. Photograph shows saddle...

Relapsing polychondritis. Photograph shows saddle-nose deformity, which may be seen in persons with relapsing polychondritis as a result of the destruction of cartilage in the nasal septum.

Hereditary hemorrhagic telangiectasia. Photograph...Media file 9: Hereditary hemorrhagic telangiectasia. Photographs show characteristic telangiectasias of the lips and tongue (left) and nail (right).
Hereditary hemorrhagic telangiectasia. Photograph...

Hereditary hemorrhagic telangiectasia. Photographs show characteristic telangiectasias of the lips and tongue (left) and nail (right).

Hereditary hemorrhagic telangiectasia in a 50-yea...Media file 10: Hereditary hemorrhagic telangiectasia in a 50-year-old man who presented with dyspnea. Workup revealed a large left lower lobe arteriovenous malformation (AVM). He was diagnosed with hereditary hemorrhagic telangiectasia. The pulmonary AVM was treated successfully using coil embolization. The image on the left shows an angiographic image of the AVM; on the right, the AVM is pictured after coil embolization.
Hereditary hemorrhagic telangiectasia in a 50-yea...

Hereditary hemorrhagic telangiectasia in a 50-year-old man who presented with dyspnea. Workup revealed a large left lower lobe arteriovenous malformation (AVM). He was diagnosed with hereditary hemorrhagic telangiectasia. The pulmonary AVM was treated successfully using coil embolization. The image on the left shows an angiographic image of the AVM; on the right, the AVM is pictured after coil embolization.

Lupus pernio in a patient with sarcoidosis. This ...Media file 11: Lupus pernio in a patient with sarcoidosis. This cutaneous manifestation typically portends a more chronic disease course.
Lupus pernio in a patient with sarcoidosis. This ...

Lupus pernio in a patient with sarcoidosis. This cutaneous manifestation typically portends a more chronic disease course.

Patient with relapsing polychondritis and cartila...Media file 12: Patient with relapsing polychondritis and cartilaginous inflammation. Only portions of the external ear containing cartilage are affected, and the ear lobe is spared
Patient with relapsing polychondritis and cartila...

Patient with relapsing polychondritis and cartilaginous inflammation. Only portions of the external ear containing cartilage are affected, and the ear lobe is spared

More on Dermatologic Manifestations of Pulmonary Disease

References
Further Reading

References

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Further Reading

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4. Benedek TG. Paraneoplastic digital clubbing and hypertrophic osteoarthropathy. Clin Dermatol. Jan-Mar 1993;11(1):53-9. [Medline].
5. Bentley D, Moore A, Shwachman H. Finger Clubbing: A quantitative survey by analysis of the shadowgraph. Lancet. Jul 24 1976;2(7978):164-7. [Medline].
6. Bird RM, Hammarsten JF, Marshall RA, Robinson RR. A family reunion: a study of hereditary hemorrhagic telangiectasia. N Engl J Med. Jul 18 1957;257(3):105-9. [Medline].
7. Bulger EM, Smith DG, Maier RV, Jurkovich GJ. Fat embolism syndrome. A 10-year review. Arch Surg. Apr 1997;132(4):435-9. [Medline].
8. Burrows NP, Lockwood CM. Antineutrophil cytoplasmic antibodies and their relevance to the dermatologist. Br J Dermatol. Feb 1995;132(2):173-81. [Medline].
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11. Currie AE, Gallagher PJ. The pathology of clubbing: vascular changes in the nail bed. Br J Dis Chest. Oct 1988;82(4):382-5. [Medline].
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Keywords

dermatologic manifestations of pulmonary disease skin, cutaneous, pulmonary, cyanosis, clubbing, lung cancer, hypertrophic osteoarthropathy, HOA, primary hypertrophic osteoarthropathy, primary HOA, secondary hypertrophic osteoarthropathy, secondary HOA, superior vena cava syndrome, SVC syndrome, sarcoidosis, papular sarcoidosis, lupus pernio, erythema nodosum, EN, Wegener granulomatosis, Churg-Strauss syndrome, relapsing polychondritis, pulmonary arteriovenous malformations, PAVM, alpha-1 antitrypsin deficiency, fat embolism syndrome, yellow nail syndrome

Contributor Information and Disclosures

Author

Paul B Cornia, MD, Staff physician, Assistant Professor of Medicine, University of Washington, Department of Medicine, Veterans Affairs Puget Sound Health Care System
Disclosure: Nothing to disclose.

Coauthor(s)

Gregory J Raugi, MD, PhD, Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle
Gregory J Raugi, MD, PhD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

Medical Editor

Kathleen David-Bajar, MD, Former Consultant to the Army Surgeon General, Department of Dermatology, Brooke Army Medical Center
Kathleen David-Bajar, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey P Callen, MD, Professor of Medicine, Chief, Division of Dermatology, University of Louisville School of Medicine
Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and American College of Rheumatology
Disclosure: Amgen Honoraria Consulting; Abbott Honoraria Consulting; Electrical Optical Sciences Honoraria Consulting; Centocor Honoraria Consulting; Medicis Honoraria Consulting; Celgene Honoraria Consulting

CME Editor

Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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