Publication:

Dermatological manifestations of chronic liver disease

Background The present study was conducted to assess the spectrum of cutaneous changes in chronic liver disease and to assess any correlation between the skin findings and the type of the liver disease.

Methods A total of 100 patients above 18 years of age suffering from chronic liver disease with cutaneous manifestations and attending the Gastroenterology and Dermatology and Venereology department of Gauhati Medical College and Hospital, Guwahati, India during the period from June 2016 to May 2017 were included in the study.

Results Out of 100 cases, there were 84 males (84%) and 16 females (16%) with the male to female ratio of 5.25:1. Alcoholic liver disease comprised 62% of the patients in the study, other causes being cryptogenic liver disease (14%), chronic hepatitis infection (12%), Wilson’s disease (2%), autoimmune hepatitis (2%), hepatocellular carcinoma (2%), methotrexate induced liver disease (1%) and non-alcoholic steatohepatitis (1%). Most common skin finding was xerosis (62%). Other key findings included nail changes (60%), pigmentary changes (55%), hair changes (50%), jaundice (40%), cutaneous infections (31%), pruritus (27%).

Conclusions Patients with chronic liver disease can have a wide spectrum of cutaneous manifestations the most important being xerosis, nail changes, pigmentary changes, hair changes, jaundice, infections, pruritus and spider angioma. These changes can give a clue to the presence of the underlying liver disease and its severity. Hence, identifying these signs earlier can lead to prompt diagnosis and effective management of the underlying condition, thereby preventing its complications.