Cutaneous Manifestations of Common Liver Diseases

Skin functions as a window to our overall health and a number of systemic diseases result in various cutaneous changes. Knowledge of these manifestations helps in suspecting an underlying systemic illness. Cutaneous abnormalities are quite common in patients with liver diseases and this article aims to focus on these dermatoses. Cutaneous manifestations seen in patients with liver disease though common are nonspecific. They can also be seen in patients without liver diseases and generally do not indicate about a specific underlying hepatic disorder. The presence of a constellation of signs and symptoms is more useful in pointing toward an underlying hepatobiliary condition. The commonest symptom in patients with liver disease is pruritus which is often protracted and disabling. Other common features include spider angiomas, palmar erythema, paper money skin, xanthelasmas, pigmentary changes, and nutritional deficiencies. In this article, first the common cutaneous manifestations that may be associated with liver disorders are discussed and then common liver diseases with their specific cutaneous findings are discussed. Cutaneous abnormalities may be the first clue to the underlying liver disease. Identifying them is crucial for early diagnosis and better management.

Keywords:  Alcohol , cholestasis , cirrhosis , cutaneous manifestations , dermatosis , liver , pruritus , viral hepatitis , vitamin

Abbreviations:  ALD, alcoholic liver disease , HBeAg, hepatitis B ‘e’ antigen , HBsAg, hepatitis B surface antigen , HBV, hepatitis B virus , HCC, hepatocellular carcinoma , LPA, lysophosphatidic acid , PAN, polyarteritis nodosa , PBC, primary biliary cirrhosis , PCT, porphyria cutanea tarda

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