Cutaneous manifestations of chronic liver disease

Background Hepatobiliary diseases are frequently associated with abnormalities of the skin, nails and hair. Objective This study was undertaken to determine the cutaneous manifestations of chronic liver disease (CLD) and particular pattern associated with aetiology of disease. Patients and methods Patients suffering from chronic liver disease of any aetiology presenting to department of gastroenterology Hayatabad Medical Complex, Peshawar from 1 st December 2004 to 30 th April 2005 were enrolled in the study. All the relevant details regarding history and clinical examination were recorded on a specially designed pro forma. Results A total of fifty patients, 32 males and 18 females were included. Thirty (60%) patients were suffering from chronic hepatitis C virus infection, 14 patients were suffering from  Chronic hepatitis B virus infection and 2 patients each were suffering from primary biliary cirrhosis and Wilson’s disease. In two cases the aetiology could not be ascertained. Different manifestations included pigmentation (82%), Terry’s nails (80%), xerosis and excoriations (72%), nonscarring hair loss from axilla and pubic region (64%), and spider naevi and palmar erythema (36%). Lichen planus was seen in 4%, vitiligo and hepatocutaneous syndrome in (2%) of patients each . Conclusion Cutaneous manifestations in chronic liver disease are non-specific and do not point towards specific aetiology. Physicians caring for patients with chronic liver disease should pay attention to its multisystemic nature.