Multisystem diseases affecting the skin and eye

There exist a wide variety of multisystem diseases that can affect both the eyes and skin. The skin and eyes may be the initial sites affected, leading to a new diagnosis of a systemic illness, or severe skin and eye involvement can drive treatment for patients with multisystem disease. It is important for physicians to be aware of how to recognize and diagnose these conditions, to evaluate patients for extent of disease, and to initiate appropriate therapies to combat these potentially severe diseases. This contribution will discuss the following diseases with a special emphasis on the mucocutaneous and ophthalmologic manifestations: reactive arthritis, sarcoidosis, necrobiotic xanthogranuloma and other granulomatous diseases, amyloidosis, Behçet disease, cholesterol emboli, Vogt-Koyanagi-Harada syndrome, and the primary vasculitides. In each case, a thorough understanding of the cutaneous manifestations and ocular manifestations are critical to help guide appropriate evaluation of these patients, and managing the ocular and cutaneous manifestations are critical to prevent morbidity and potentially devastating long-term sequelae.