Module Q: Cutaneous Manifestations of Metabolic and Systemic Diseases

This content is designed to provide a comprehensive understanding of a wide range of conditions that manifest on the skin but are rooted in systemic or metabolic disorders. The sections of this module will guide you through the pathophysiology, clinical presentation, diagnosis, and management of various conditions, including mucinoses, amyloidosis, porphyrias, calcinosis cutis, osteoma cutis, nutritional disorders, and graft-versus-host disease. Each section will provide the knowledge necessary to recognize these complex conditions in clinical practice.

3.25 CME credits

After participating in this module, the learner will be able to:

Section 1: Mucinoses, Amyloidosis, and Deposition Disorders

1. Describe signs and symptoms along with treatment options for scleredema.
2. Recognize signs and symptoms of scleromyxedema and treatment options.
3. Recognize signs and symptoms of pretibial myxedema and treatment options.
4. Describe general symptoms and skin findings associated with generalized myxedema.
5. Describe the different types of mucinosis and treatment options.
6. Distinguish the difference between systemic amyloidosis and localized cutaneous amyloidosis.
7. Describe and list treatment options for localized cutaneous amyloidosis.
8. Recognize symptoms and treatment options for lipoid proteinosis, gout, colloid milium, and mucopolysaccharidoses (MPS).

Section 2: Porphyrias

1. Understand the pathophysiology of porphyrias.
2. Recognize symptoms of porphyria cutanea tarda and treatment options.
3. Understand work up and labs needed to diagnose porphyria cutanea tarda.
4. Recognize the common medications that can cause pseudoporphyria.
5. Understand the common presentation of erythropoietic protoporphyria.
6. Recognize features and manifestations of variegate porphyria.
7. Recognize features of congenital erythropoietic porphyria.

Section 3: Calcinosis Cutis and Osteoma Cutis

1. List the four types of cutaneous calcification.
2. Understand the common associations with dystrophic calcinosis cutis and locations of involvement.
3. Understand common causes of metastatic calcinosis cutis. Describe skin findings, evaluation, and treatment options for this condition.
4. Describe skin findings, associated mortality, and treatment options seen with calciphylaxis (a type of metastatic calcinosis cutis).
5. List common causes of iatrogenic cutaneous calcinosis.
6. List laboratory evaluation and studies that should be performed in patients diagnosed with cutaneous calcification/ossification.
7. Describe treatment of calcinosis cutis.
8. Define osteoma cutis and list common etiologies.
9. Describe treatment of osteoma cutis.

Section 4: Nutritional Disorders

1. Define exogenous and endogenous causes of malnutrition.
2. Recognize mucocutaneous findings associated with protein, vitamin, mineral and essential fatty acid deficiencies and excess syndromes
3. Recognize common skin findings with anorexia and bulimia.
4. Recognize common skin findings in obesity.

Section 5: Graft-Versus-Host Disease

1. Understand risk factors associated with graft-versus-host disease.
2. Understand the difference between acute graft-versus-host disease and chronic graft-versus-host disease.
3. Recognize the skin findings in acute graft-versus-host disease.
4. Recognize the skin findings in chronic graft-versus-host disease.
5. Recognize treatments for both acute and chronic graft-versus-host disease

*Previously known as Module 19 in the Diplomate Fellowship

This module and others will be released on a rolling basis through the remainder of 2025.