Physical Signs of Illness

Physical signs of illness is another area well covered by the boards, additionally
we can encounter these at any given day in our clinical practice....may be as soon as
tomorrow!?

So, lets review some of the interesting ones.


Q: What is the HUTCHISON'S SIGN?

A: The appearance of vesicles on the tip or lateral aspect of the nose indicating involvement
of the nasociliary nerve branch by VZV (VARICELLA ZOSTER VIRUS). An opthalmology
referral is warranted, as it is likely to indicate onset of Herpes Zoster Opthalmicus.


Q: What is the sign of LESER-TRELAT?

A: Abrupt onset (eruption) of many pruritic Seborrheic Keratosis (scaly,reddish
lesions) on the face, most commonly associated with imminent dx. of GASTRIC
ADENOCARCINOMA.


Q: What is DARIER'S sign?

A: Eruption of a pigmented salmon-brown lesions with pruritus (Urticaria Pigmentosa)
at the site of stroking of the skin. This is found in MASTOCYTOSIS, a condition
caused by systemic histamine release, due to mast cell proliferation.


Q: What underlying condition does RACOON EYES (non-traumatic) represent?

A: PRIMARY AMYLOIDOSIS. They are peri-orbital "dark circles". Not to be confused
with melasma a normal hyperpigmentation associated with pregnancy.


Q: What is the NIKOLSKY'S SIGN?

A: Refers to superficial seperation of skin with lateral pressure on the lesion.
On the boards mainly associated with ERYTHEMA MULTIFORME.



Thanks again for your time!