Gastrointestinal and Hepatobiliary Disease
Crohn's Disease and Ulcerative Colitis
Erythema Nodosum of Crohn's - GastroHep Community
Crohn's disease and ulcerative colitis have similar skin findings. Erythema nodosum is well recognized in both conditions. Vasculitis may also be associated with both Crohn's and UC. Pyoderma gangrenosum is varies in frequency among the two diseases, with 12 percent of UC patients and only 2 percent of Crohn's patients developing gangrene.
Unique among Crohn's disease are two findings, cobblestone oral granulomatous nodules and perianal fistula.
Unique among Crohn's disease are two findings, cobblestone oral granulomatous nodules and perianal fistula.
Liver Cirrhosis
Telangiectasia - Fitzpatrick's Dermatology
Cirrhosis can lead to many skin exam manifestations. Most noticeable are changes in the nails, telangiectasias on the face, and in advanced disease, jaundice. The following findings may accompany liver cirrhosis:
-Spider angiomas and telangiectasia
-Palmar erythema
Gynecomastia
-Terry's or Muehrcke's nails
-Sparse axillary, pubic, and pectoral hair
-Jaundice
Additionally, primary biliary cirrhosis is associated with diffuse hyperpigmentation, eruptive xanthomas, and pruritis.
-Spider angiomas and telangiectasia
-Palmar erythema
Gynecomastia
-Terry's or Muehrcke's nails
-Sparse axillary, pubic, and pectoral hair
-Jaundice
Additionally, primary biliary cirrhosis is associated with diffuse hyperpigmentation, eruptive xanthomas, and pruritis.
Hepatitis C
Bologna, Dermatology
Hepatitis C has many cutaneous manifestations. The inflammatory damage occurring in the liver leads to unbalanced levels of enzymes and metabolic components, some of which can cause skin symptoms, such as porphyria cutanea tarda. Some of the more common skin findings with Hep C are listed below:
-Small vessel vasculitis
-Urticaria (hives)
-Porphyria cutanea tarda
-Lichen planus
Image left: Necrotizing migratory erythema-like lesion in a patient with concurrent hepatitis C and HIV infection.
-Small vessel vasculitis
-Urticaria (hives)
-Porphyria cutanea tarda
-Lichen planus
Image left: Necrotizing migratory erythema-like lesion in a patient with concurrent hepatitis C and HIV infection.
Wilson's Disease
Copper-Brown Ring at Rim of Cornea - Fitzpatrick's Dermatology
Wilson's disease is an autosomal recessive genetic disease in which excess copper accumulates in the tissues, particularly the liver and CNS. Its hallmark feature is the Kayser-Fleischer ring. The two primary cutaneous findings in Wilson's disease are the following:
-Kayser-Fleischer ring - golden brown or green circle of pigment in periphery of cornea
-Blue lunulae - the semicircular feature at the base of the nail bed (normally white) takes on a bluish hue.
-Kayser-Fleischer ring - golden brown or green circle of pigment in periphery of cornea
-Blue lunulae - the semicircular feature at the base of the nail bed (normally white) takes on a bluish hue.