Musculoskeletal Conditions - NCLEX-PN
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You are a nurse at an orthopedics clinic. You are taking care of a football player who suffered a very painful right knee injury. You are concerned that he may have injured the "unhappy triad." Which of the following correctly lists all components of the "unhappy triad" within the knee?
You are a nurse at an orthopedics clinic. You are taking care of a football player who suffered a very painful right knee injury. You are concerned that he may have injured the "unhappy triad." Which of the following correctly lists all components of the "unhappy triad" within the knee?
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The correct answer is "ACL, MCL, and Medial meniscus." This is the only answer choice that correctly lists all three components of the "unhappy triad." The unhappy triad is frequently injured in athletes who participate in contact sports, such as football. The injury mechanism often involves a direct, forceful hit to a firmly planted leg. The hit is forceful enough to rupture two ligaments (ACL and MCL), as well as the medial meniscus. The treatment for such an injury involves surgical intervention and a lengthy recovery period, though for patients inclined to partake in the rehabilitation process, they can often return to their desired sports after completion of surgery and rehab.
The correct answer is "ACL, MCL, and Medial meniscus." This is the only answer choice that correctly lists all three components of the "unhappy triad." The unhappy triad is frequently injured in athletes who participate in contact sports, such as football. The injury mechanism often involves a direct, forceful hit to a firmly planted leg. The hit is forceful enough to rupture two ligaments (ACL and MCL), as well as the medial meniscus. The treatment for such an injury involves surgical intervention and a lengthy recovery period, though for patients inclined to partake in the rehabilitation process, they can often return to their desired sports after completion of surgery and rehab.
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A 35-year-old male client presents to the emergency department after sustaining a severe tibial fracture to the left leg. The nurse is assessing the injury for possible complications including compartment syndrome.
All of the following interventions would be appropriate to compartment syndrome except .
A 35-year-old male client presents to the emergency department after sustaining a severe tibial fracture to the left leg. The nurse is assessing the injury for possible complications including compartment syndrome.
All of the following interventions would be appropriate to compartment syndrome except .
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Elevation of the limb above the heart may slow arterial perfusion and raise venous pressure, and worsen circulation. Ice may cause vasoconstriction and further lead to circulation compromise. Both of these interventions would not be appropriate for compartment syndrome.
Know the six P's of compartment syndrome: pallor, pain on passive movement, paresthesia, paralysis, pulses, pressure: all of these may be present in compartment syndrome. Pulselessness is an ominous sign of impending permanent damage, the physician should be notified. Muscle damage can lead to myoglobinemia of the blood thereby damaging the kidneys leading to rhabdomyolysis and dark urine. A tight bandage could further increase the pressure in the compartment and should be loosened if this is so.
Elevation of the limb above the heart may slow arterial perfusion and raise venous pressure, and worsen circulation. Ice may cause vasoconstriction and further lead to circulation compromise. Both of these interventions would not be appropriate for compartment syndrome.
Know the six P's of compartment syndrome: pallor, pain on passive movement, paresthesia, paralysis, pulses, pressure: all of these may be present in compartment syndrome. Pulselessness is an ominous sign of impending permanent damage, the physician should be notified. Muscle damage can lead to myoglobinemia of the blood thereby damaging the kidneys leading to rhabdomyolysis and dark urine. A tight bandage could further increase the pressure in the compartment and should be loosened if this is so.
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You are the nurse assessing a 19-year old male who presents to the emergency department with chest pain. He localizes the pain to the left parasternal region, and the pain is reproducible with direct pressure. You take his vital signs and they are all within normal limits. He says that he is a very active student who frequently lifts weights, rows crew, and runs marathons. What is the most likely diagnosis?
You are the nurse assessing a 19-year old male who presents to the emergency department with chest pain. He localizes the pain to the left parasternal region, and the pain is reproducible with direct pressure. You take his vital signs and they are all within normal limits. He says that he is a very active student who frequently lifts weights, rows crew, and runs marathons. What is the most likely diagnosis?
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The correct answer is "costochondritis." Costochondritis is an inflammation of the cartilage that bridges the sternum to the ribs. It is a very common cause of acute chest pain in young, healthy, physically active individuals without known cardiovascular disease. In this case, we have a very prototypical case: a young, physically active (especially with physical activity involving the chest like weight-lifting and rowing crew), otherwise healthy male with focal, reproducible chest pain in the parasternal area, and normal vital signs on presentation. When you see this history, this is a rather convincing case for costochondritis. There is no information given that would seem to indicate a personal or family history of cardiovascular disease, and thus, costochondritis would be the best answer choice. He can be treated conservatively with NSAID's for anti-inflammatory and pain control effects.
Acute coronary syndrome (e.g. myocardial infarction) is very unlikely in this patient as he is young and healthy, has reproducible, focal chest pain, is very physically active, and has stable vital signs. If there was a personal or family history of cardiovascular disease, or any report of recent drug use (particularly cocaine), then this could be higher on the differential.
Pulmonary embolism is very unlikely in this patient as there is no leg swelling reported, the chest pain is focal, the patient is healthy and active, and his vital signs are normal.
Peripheral vascular disease would not present with chest pain, and would be highly unlikely to be present in an otherwise healthy 19-year old.
There is nothing to suggest that this healthy, active 19-year old patient has diabetes mellitus from the information provided.
The correct answer is "costochondritis." Costochondritis is an inflammation of the cartilage that bridges the sternum to the ribs. It is a very common cause of acute chest pain in young, healthy, physically active individuals without known cardiovascular disease. In this case, we have a very prototypical case: a young, physically active (especially with physical activity involving the chest like weight-lifting and rowing crew), otherwise healthy male with focal, reproducible chest pain in the parasternal area, and normal vital signs on presentation. When you see this history, this is a rather convincing case for costochondritis. There is no information given that would seem to indicate a personal or family history of cardiovascular disease, and thus, costochondritis would be the best answer choice. He can be treated conservatively with NSAID's for anti-inflammatory and pain control effects.
Acute coronary syndrome (e.g. myocardial infarction) is very unlikely in this patient as he is young and healthy, has reproducible, focal chest pain, is very physically active, and has stable vital signs. If there was a personal or family history of cardiovascular disease, or any report of recent drug use (particularly cocaine), then this could be higher on the differential.
Pulmonary embolism is very unlikely in this patient as there is no leg swelling reported, the chest pain is focal, the patient is healthy and active, and his vital signs are normal.
Peripheral vascular disease would not present with chest pain, and would be highly unlikely to be present in an otherwise healthy 19-year old.
There is nothing to suggest that this healthy, active 19-year old patient has diabetes mellitus from the information provided.
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What syndrome presents with pain or stiffness, usually in the neck, shoulders, and hips, which may be caused by an inflammatory condition of blood vessels such as temporal arteritis?
What syndrome presents with pain or stiffness, usually in the neck, shoulders, and hips, which may be caused by an inflammatory condition of blood vessels such as temporal arteritis?
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Polymyalgia rheumatica is an inflammatory musculoskeletal condition that presents with pain or stiffness, usually in the neck, shoulders, and hips. Amyotrophic lateral sclerosis (ALS) is a genetic disorder of muscle wasting and neuronal death. Symptoms include progressive muscular weakness, leading to paralysis and death. Guillain–Barré syndrome is a rapid-onset condition of reversible muscle paralysis and weakness following infection, most commonly C ampylobacter jejuni. Myositis is a general term for inflammation of the muscles, and can be due to various causes.
Polymyalgia rheumatica is an inflammatory musculoskeletal condition that presents with pain or stiffness, usually in the neck, shoulders, and hips. Amyotrophic lateral sclerosis (ALS) is a genetic disorder of muscle wasting and neuronal death. Symptoms include progressive muscular weakness, leading to paralysis and death. Guillain–Barré syndrome is a rapid-onset condition of reversible muscle paralysis and weakness following infection, most commonly C ampylobacter jejuni. Myositis is a general term for inflammation of the muscles, and can be due to various causes.
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Duchenne's muscular dystrophy is caused by dysfunctional production of what protein?
Duchenne's muscular dystrophy is caused by dysfunctional production of what protein?
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Duchenne's muscular dystrophy (DMD) is caused by dysfunctional production of dystrophin, a protein that is part of a complex of proteins that anchor the cytoskeleton of a muscle cell to the extracellular matrix, also known as the dystrophin-associated protein complex. Its absence disrupts multiple intracellular signaling pathways, leading to muscle necrosis. Dystroglycan is another protein in this complex, but it is unaffected in DMD. Actin and troponin are also unaffected in DMD.
Duchenne's muscular dystrophy (DMD) is caused by dysfunctional production of dystrophin, a protein that is part of a complex of proteins that anchor the cytoskeleton of a muscle cell to the extracellular matrix, also known as the dystrophin-associated protein complex. Its absence disrupts multiple intracellular signaling pathways, leading to muscle necrosis. Dystroglycan is another protein in this complex, but it is unaffected in DMD. Actin and troponin are also unaffected in DMD.
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Duchenne's muscular dystrophy has what inheritance type?
Duchenne's muscular dystrophy has what inheritance type?
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Duchenne's muscular dystrophy is an X-linked recessive disease. Because of this, it is almost exclusively seen in males and rarely presents in females (girls would have to receive a recessive gene on both the X-chromosome from their mother and their father; historically, boys with a defective gene on their X-chromosome rarely lived past their teens, decreasing the likelihood of reproduction).
Duchenne's muscular dystrophy is an X-linked recessive disease. Because of this, it is almost exclusively seen in males and rarely presents in females (girls would have to receive a recessive gene on both the X-chromosome from their mother and their father; historically, boys with a defective gene on their X-chromosome rarely lived past their teens, decreasing the likelihood of reproduction).
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What antibodies are present in 90% of patients presenting with myasthenia gravis?
What antibodies are present in 90% of patients presenting with myasthenia gravis?
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Myasthenia gravis is a condition in which the immune system makes antibodies to aceytlcholine receptors, thus blocking receptors and preventing the stimulating effect of acetylcholine at the neuromuscular junction. This results in muscle weakness that progresses during activity and improves with rest. Anti-ro antibodies are commonly seen in Sjögren’s syndrome and systemic lupus erythematosus (SLE), and anti-dsDNA antibodies are highly specific for SLE.
Myasthenia gravis is a condition in which the immune system makes antibodies to aceytlcholine receptors, thus blocking receptors and preventing the stimulating effect of acetylcholine at the neuromuscular junction. This results in muscle weakness that progresses during activity and improves with rest. Anti-ro antibodies are commonly seen in Sjögren’s syndrome and systemic lupus erythematosus (SLE), and anti-dsDNA antibodies are highly specific for SLE.
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What condition is characterized by a deficiency of normal type-1 collagen, resulting in the formation of brittle, fragile bones?
What condition is characterized by a deficiency of normal type-1 collagen, resulting in the formation of brittle, fragile bones?
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Osteogenesis imperfecta is a genetic condition characterized by a deficiency of normal type-1 collagen, resulting in the formation of brittle, fragile bones. Bones fracture easily, often with no obvious trauma. Osteogenesis imperfecta has many sub categories that range in severity, several of which are not compatible with life.
Ehlers–Danlos syndrome is a collagen abnormality that primarily affects the skin, joints, and vasculature, causing lax joints and general instability. Marfan syndrome is also a condition of connective tissue abnormality, which largely effects the structure and function of smooth muscle in the cardiovascular system. Legg-Calvé-Perthes syndrome is a condition of necrosis in the femoral head, not related to any alterations in collagen formation.
Osteogenesis imperfecta is a genetic condition characterized by a deficiency of normal type-1 collagen, resulting in the formation of brittle, fragile bones. Bones fracture easily, often with no obvious trauma. Osteogenesis imperfecta has many sub categories that range in severity, several of which are not compatible with life.
Ehlers–Danlos syndrome is a collagen abnormality that primarily affects the skin, joints, and vasculature, causing lax joints and general instability. Marfan syndrome is also a condition of connective tissue abnormality, which largely effects the structure and function of smooth muscle in the cardiovascular system. Legg-Calvé-Perthes syndrome is a condition of necrosis in the femoral head, not related to any alterations in collagen formation.
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The rehab nurse provides care to an immobilized patient. He bears weight down on the patient’s leg while the patient attempts to lift that leg. What type of exercise is this?
The rehab nurse provides care to an immobilized patient. He bears weight down on the patient’s leg while the patient attempts to lift that leg. What type of exercise is this?
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Active resistive range of motion is performed by the client against resistance (manual or mechanical). This exercise builds muscle strength. Isometric exercises are performed by the client without motion; rather, the client contracts and relaxes the muscle without moving the joint. This maintains strength in the muscle while the joint is immobilized. Passive range of motion is performed by the nurse without assistance from the client, which retains circulation and range of motion in the joint, Active range of motion is performed by the client without assistance of the nurse and maintains joint mobility and muscle strength. Active assistive range of motion is performed by the client with help of the nurse to increase motion in the joint.
Active resistive range of motion is performed by the client against resistance (manual or mechanical). This exercise builds muscle strength. Isometric exercises are performed by the client without motion; rather, the client contracts and relaxes the muscle without moving the joint. This maintains strength in the muscle while the joint is immobilized. Passive range of motion is performed by the nurse without assistance from the client, which retains circulation and range of motion in the joint, Active range of motion is performed by the client without assistance of the nurse and maintains joint mobility and muscle strength. Active assistive range of motion is performed by the client with help of the nurse to increase motion in the joint.
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In the emergency department, the nurse evaluates a patient with severe pain in the left calf after falling during a soccer game. Which of the following is the most appropriate action by the nurse?
In the emergency department, the nurse evaluates a patient with severe pain in the left calf after falling during a soccer game. Which of the following is the most appropriate action by the nurse?
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The nurse should begin assessment to determine the cause of the complaint. Obtaining an x-ray for the leg is the best assessment; you need to rule out possible fracture before giving pain medication or bandaging the leg. Heat is inappropriate for this injury because ice is best for sports injuries such as sprains and breaks. Notifying the physician may be done after all assessments are completed.
The nurse should begin assessment to determine the cause of the complaint. Obtaining an x-ray for the leg is the best assessment; you need to rule out possible fracture before giving pain medication or bandaging the leg. Heat is inappropriate for this injury because ice is best for sports injuries such as sprains and breaks. Notifying the physician may be done after all assessments are completed.
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The nurse evaluates a patient status-post right hip replacement and observes a moderate amount of serosanguinous drainage on the dressing 1 day after the surgery. Which of the following is the best action?
The nurse evaluates a patient status-post right hip replacement and observes a moderate amount of serosanguinous drainage on the dressing 1 day after the surgery. Which of the following is the best action?
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24 hours after surgery, surgical wounds are expected to drain small to moderate amounts of serous or serosanguinous drainage. The physician does not need to be notified because this observation is expected and not emergent; however, the doctor would be notified if drainage exceeds these expectations. The soiled dressing should be removed and replaced with a new dressing, and the wound site would not be irrigated unless infected; there are no signs of infection noted. The wound should not be open to air due to the risk of infection. The nurse should always document wound appearance and dressing changes.
24 hours after surgery, surgical wounds are expected to drain small to moderate amounts of serous or serosanguinous drainage. The physician does not need to be notified because this observation is expected and not emergent; however, the doctor would be notified if drainage exceeds these expectations. The soiled dressing should be removed and replaced with a new dressing, and the wound site would not be irrigated unless infected; there are no signs of infection noted. The wound should not be open to air due to the risk of infection. The nurse should always document wound appearance and dressing changes.
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The nurse prepares discharge information for a 70-year-old woman recently diagnosed with osteoporosis. Which of the following information is most essential for the nurse to share with the patient?
The nurse prepares discharge information for a 70-year-old woman recently diagnosed with osteoporosis. Which of the following information is most essential for the nurse to share with the patient?
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Osteoporosis is common among elderly women. Patients require important education on how to live with the disease. Lifestyle changes such as diet and exercise should be promoted by the patient during discharge, and should be specific to the patient’s condition. Of the available options, the most accurate and essential information for the nurse to share should concern physical activity and exercise, as osteoporosis affects bone density and body strength. A recommendation for a doctor that specializes in bone pain may be beneficial, but is not a responsibility of the nurse (education is the priority). Patients with osteoporosis that are being discharged usually take ibuprofen to manage pain (not opioids or acetaminophen). A soccer program may not be appropriate for a 70-year-old woman with osteoporosis; a flyer for an adult walking group might be better.
Osteoporosis is common among elderly women. Patients require important education on how to live with the disease. Lifestyle changes such as diet and exercise should be promoted by the patient during discharge, and should be specific to the patient’s condition. Of the available options, the most accurate and essential information for the nurse to share should concern physical activity and exercise, as osteoporosis affects bone density and body strength. A recommendation for a doctor that specializes in bone pain may be beneficial, but is not a responsibility of the nurse (education is the priority). Patients with osteoporosis that are being discharged usually take ibuprofen to manage pain (not opioids or acetaminophen). A soccer program may not be appropriate for a 70-year-old woman with osteoporosis; a flyer for an adult walking group might be better.
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What condition is described by the following: a syndrome of irritation of the patellar ligament at the tibial tuberosity, characterized by painful lumps just below the knee, most often seen in young adolescents?
What condition is described by the following: a syndrome of irritation of the patellar ligament at the tibial tuberosity, characterized by painful lumps just below the knee, most often seen in young adolescents?
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Osgood-Schlatter syndrome of irritation of the patellar ligament at the tibial tuberosity, characterized by painful lumps just below the knee, most often seen in young adolescents. Risk factors may include overzealous exercise but it's ultimately thought to be caused by adolescent bone growth. Osteosarcoma, the most common bone cancer in adolescent populations, can present with pain and a lump or frank swelling. This is caused by actual tumor growth, not by any ligamentous issue. Osteosarcoma does present frequently in the knee, and must be ruled out before a diagnosis of Osgood-Schlatter disease is made. Slipped capital femoral epiphysis causes pain and reduced movement in the hip, rather than the knee. Osteomalacia is a general softening of the bones caused by a deficiency in vitamin D.
Osgood-Schlatter syndrome of irritation of the patellar ligament at the tibial tuberosity, characterized by painful lumps just below the knee, most often seen in young adolescents. Risk factors may include overzealous exercise but it's ultimately thought to be caused by adolescent bone growth. Osteosarcoma, the most common bone cancer in adolescent populations, can present with pain and a lump or frank swelling. This is caused by actual tumor growth, not by any ligamentous issue. Osteosarcoma does present frequently in the knee, and must be ruled out before a diagnosis of Osgood-Schlatter disease is made. Slipped capital femoral epiphysis causes pain and reduced movement in the hip, rather than the knee. Osteomalacia is a general softening of the bones caused by a deficiency in vitamin D.
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A syndrome of pain in the front of the knee, frequently occurring in teenagers, manual laborers, and athletes. It's sometimes caused by wearing down, roughening, or softening of the cartilage under the kneecap.
What condition is described?
A syndrome of pain in the front of the knee, frequently occurring in teenagers, manual laborers, and athletes. It's sometimes caused by wearing down, roughening, or softening of the cartilage under the kneecap.
What condition is described?
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Patellofemoral syndrome presents as pain in the front of the knee, sometimes caused by wearing down, roughening, or softening of the cartilage under the kneecap. Osgood-Schlatter disease is a syndrome of irritation of the patellar ligament at the tibial tuberosity, characterized by painful lumps just below the knee, most often seen in young adolescents. Legg-Calvé-Perthes syndrome is due to disruption of blood flow to the femoral head, leading to avascular necrosis. Congenital scoliosis is a spinal deformity characterized by the curving of the spine at an angle greater than 10 degrees on radiography.
Patellofemoral syndrome presents as pain in the front of the knee, sometimes caused by wearing down, roughening, or softening of the cartilage under the kneecap. Osgood-Schlatter disease is a syndrome of irritation of the patellar ligament at the tibial tuberosity, characterized by painful lumps just below the knee, most often seen in young adolescents. Legg-Calvé-Perthes syndrome is due to disruption of blood flow to the femoral head, leading to avascular necrosis. Congenital scoliosis is a spinal deformity characterized by the curving of the spine at an angle greater than 10 degrees on radiography.
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What condition will show a pencil-in-cup deformity on x-ray?
What condition will show a pencil-in-cup deformity on x-ray?
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Psoriatic arthritis will often show a pencil-in-cup deformity on x-ray. Osteoarthritis will show joint space narrowing, sclerosis, and osteophytes. Rheumatoid arthritis and juvenile rheumatoid arthritis will both show soft tissue swelling, joint space narrowing, and may show marginal erosions.
Psoriatic arthritis will often show a pencil-in-cup deformity on x-ray. Osteoarthritis will show joint space narrowing, sclerosis, and osteophytes. Rheumatoid arthritis and juvenile rheumatoid arthritis will both show soft tissue swelling, joint space narrowing, and may show marginal erosions.
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Rheumatoid arthritis typically presents with what type of deformity in the distal joints of the fingers?
Rheumatoid arthritis typically presents with what type of deformity in the distal joints of the fingers?
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Swan neck deformity is often seen in patients with rheumatoid arthritis. This is a state in which the distal interphalangeal joint (DIP) becomes hyperflexed (bends toward the palm) while the proximal interphalangeal joint (PIP) is hyperextended (bending away from the palm). Shepherd's crook deformity is seen in Paget's disease of the bone, pencil-in-cup deformity is seen in psoriatic arthritis, and Heberden nodes are frequently seen in the distal phalanges of patients with osteoarthritis.
Swan neck deformity is often seen in patients with rheumatoid arthritis. This is a state in which the distal interphalangeal joint (DIP) becomes hyperflexed (bends toward the palm) while the proximal interphalangeal joint (PIP) is hyperextended (bending away from the palm). Shepherd's crook deformity is seen in Paget's disease of the bone, pencil-in-cup deformity is seen in psoriatic arthritis, and Heberden nodes are frequently seen in the distal phalanges of patients with osteoarthritis.
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What is the most common form of muscular dystrophy?
What is the most common form of muscular dystrophy?
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Duchenne's is the most common and most severe form of muscular dystrophy, accounting for a full 50% of cases of muscular dystrophy in the US. The next most common type is Becker's, followed by myotonic muscular dystrophy and Emery-Dreifuss.
Duchenne's is the most common and most severe form of muscular dystrophy, accounting for a full 50% of cases of muscular dystrophy in the US. The next most common type is Becker's, followed by myotonic muscular dystrophy and Emery-Dreifuss.
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Which of the following conditions is associated with auto antibodies to presynaptic calcium channels?
Which of the following conditions is associated with auto antibodies to presynaptic calcium channels?
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Lambert-Eaton syndrome is a condition of progressive muscle weakness caused by an auto antibodies to presynaptic calcium channels in the neuromuscular junction. This does not allow calcium to enter the presynaptic cell, which is required for neurotransmitter release into the synaptic cleft. Without the release of neurotransmitter, there will be no muscular response. Myasthenia gravis is an autoimmune condition in which antibodies are formed against acetylcholine receptors, and muscular weakness in multiple sclerosis is caused by destruction of myelin in the CNS due to antibodies against oligodendrocytes. Dermatomyositis is an inflammatory connective tissue condition that may be associated with a post-viral autoimmune reaction or triggered by a paraneoplastic syndrome.
Lambert-Eaton syndrome is a condition of progressive muscle weakness caused by an auto antibodies to presynaptic calcium channels in the neuromuscular junction. This does not allow calcium to enter the presynaptic cell, which is required for neurotransmitter release into the synaptic cleft. Without the release of neurotransmitter, there will be no muscular response. Myasthenia gravis is an autoimmune condition in which antibodies are formed against acetylcholine receptors, and muscular weakness in multiple sclerosis is caused by destruction of myelin in the CNS due to antibodies against oligodendrocytes. Dermatomyositis is an inflammatory connective tissue condition that may be associated with a post-viral autoimmune reaction or triggered by a paraneoplastic syndrome.
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What are the classic histological findings of dermatomyositis?
What are the classic histological findings of dermatomyositis?
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Histological findings of dermatomyositis will generally reveal mixed B cell and T cell perivascular inflammatory infiltrate and perifascicular muscle fiber atrophy.
Fibrosed muscle fibers and fatty infiltrates are typical of Duchenne's muscular dystrophy, while granulomas in muscle are rare but may be seen in sarcoidosis and other conditions of granulomatous myositis.
Histological findings of dermatomyositis will generally reveal mixed B cell and T cell perivascular inflammatory infiltrate and perifascicular muscle fiber atrophy.
Fibrosed muscle fibers and fatty infiltrates are typical of Duchenne's muscular dystrophy, while granulomas in muscle are rare but may be seen in sarcoidosis and other conditions of granulomatous myositis.
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What dermatological condition is often seen with dermatomyositis?
What dermatological condition is often seen with dermatomyositis?
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A periorbital heliotrope rash is often seen in dermatomyositis. It is bilateral, symmetric, purpuric, and macular, and erupts over the eyelids and surrounding periorbital area. Malar rash (often called a "butterfly rash") is seen in patients with systemic lupus erythematosus (SLE). Dermatitis herpetiformis is a rash on the elbows and knees generally seen with gluten allergy (celiac disease). Perioral dermatitis is an iatrogenic condition often associated with prolonged use of topical steroid creams.
A periorbital heliotrope rash is often seen in dermatomyositis. It is bilateral, symmetric, purpuric, and macular, and erupts over the eyelids and surrounding periorbital area. Malar rash (often called a "butterfly rash") is seen in patients with systemic lupus erythematosus (SLE). Dermatitis herpetiformis is a rash on the elbows and knees generally seen with gluten allergy (celiac disease). Perioral dermatitis is an iatrogenic condition often associated with prolonged use of topical steroid creams.
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