Liver diseases skin changesK74.6 + Hauterkrankung

Acute and chronic diseases of the liver influence the integument in many ways. On the one hand, the disturbed or altered metabolic functions, but also immunological reactions in liver diseases cause skin symptoms. On the other hand, chronic liver diseases in particular cause skin changes, e.g. in the context of portal hypertension (see Dermadrome below).

Classification of skin diseases that can be caused or co-triggered by liver diseases:

• Acute or chronic hepatitis C/B (see below hepatitis B; see below hepatitis C)
  • vasculitis, hepatitis C-associated.
  • Urticaria
  • Icteric phase: icterus, nevus araneus, erythema palmare et plantar symptomaticum.
  • Cryoglobulinemia
  • Erythema elevatum diutinum
  • Systemic lupus erythematosus
  • lichen planus
  • Pyoderma gangraenosum
  • Urticaria vasculitis
  • Pre-Italian hepatitis prodromal stage
    • Rare skin changes such as urticarial or maculopapular exanthema.
• Cirrhosis of the liver and its monitoring signs on the integument (see below the respective clinical picture):
  • Gynecomastia
  • caput medusae
  • Silvestrinian character
  • Abdominal Baldness
  • Chvostek sign
  • Banknote skin
  • Cryoglobulinemia
  • White nails
  • Splinter bleeding of the nail matrix
  • Erythema palmare et plantar symptomaticum
  • Erythema diffusum hepaticum
  • Ecchymoses, Purpura
  • different forms of telangiectasia (often also Naevi aranei)
  • Xanthom
  • Xanthelasma
  • Lacquer tongue ("liver tongue")
  • Icterus
  • Hypotrichosis
• Skin diseases in association with various chronic liver affections:
  • Dupuytren's contracture
  • Cryoglobulinemia
  • Lipomatosis, benign symmetrical (irregular association with chronic liver damage)
  • Melanoderma, diffuse
  • Hyperpigmentation of the skin in hemochromatosis
  • prurigo simplex subacuta
  • Pruritus, hepatic
  • Scleroderma, systemic (liver fibrosis, primary biliary cirrhosis)
  • Zinc Deficiency Dermatoses
  • Pyoderma gangraenosum
  • Cyanosis, yellow (in decompensated mitral valve defect with consecutive liver congestion)
• Hepatic co-reaction in infectious diseases affecting the integument:
  • Amebiasis
  • Brucellosis
  • typhus
  • Yellow fever
  • herpes simplex
  • Leprosy
  • Mononucleosis, infectious (enlargement of liver and spleen)
  • relapsing fever
  • syphilis acquisita
  • Tuberculosis
  • Because, M.
• Hepatic (toxic) co-reaction in severe skin diseases:
  • Anticonvulsant Hypersensitivity Syndrome
  • Budd-Chirari syndrome (extremely rare with bleomycin therapy)
  • Stevens-Johnson syndrome.
• Affection of the liver in systemic diseases affecting the integument
  • Choroidal melanoma (preferably liver metastasis)
  • Metastatic malignant melanoma
  • Angiosarcoma
  • Birt-Hogg-Dubé Syndrome
  • Blue Rubber Bleb Nevus Syndrome (angiomas of the liver)
  • Churg-Strauss Syndrome
  • Hippel-Lindau syndrome (liver cavernoma)
  • Histiocytoses, Langerhans cell histiocytoses
  • Liposarcoma
  • lymphohistiocytosis, familial hemophagocytosis (enlargement of liver and spleen)
  • Lymphoma, cutaneous T-cell lymphoma, cytotoxic (gamma-delta positive)
  • Melanoma, malignant (liver metastasis)
  • Panniculitis, AAT deficiency associated
  • Panniculitis, histiocytic, cytophagic
  • Panniculitis, pancreatic (liver carcinomas)
  • Paraneoplastic syndromes of the skin in malignancies of the liver
  • pustular psoriasis
  • Sarcoidosis (liver infestation)
  • Sjögren's Syndrome
  • Breastfeeding Syndrome
  • Watson-Alagille Syndrome (Ganghypoplasia)
  • Xanthogranuloma, juveniles (sensu strictu) (rarely liver infestation)
  • Icterus neonatorum gravis (Immature liver)
  • Progressive systemic scleroderma (primarily biliary cirrhosis of the liver)
  • Angioendotheliomatosis, reactive (benign)
• Metabolic disorders with liver and skin changes:
  • Amyloidosis, systemic
  • Porphyria, hepatic (hyperpigmentation; blistering, milia)
  • Protoporphyria erythropoetica (possible development of liver cirrhosis)
  • Refsum Syndrome
  • Gaucher, M.
  • α-1-antitrypsin deficiency
  • lichen myxoedematosus
  • Tangier Disease
  • Wilson, M. (Acanthosis nigricans, hyperpigmentations).

1. Altmeyer P (2007) Dermatological differential diagnosis. Springer publishing house, Heidelberg