What Are the Cutaneous Stigmata (Skin Symptoms) of Cirrhosis?

Rashes, colour changes, and paper-money skin are examples of skin symptoms that people with cirrhosis may encounter. You must visit a physician if you are encountering these signs.

Skin, hair, and nail symptoms are common in patients with liver illnesses such as cirrhosis.

Cutaneous stigmata, or skin symptoms, could be the initial sign of a liver issue.

But in its early stages, cirrhosis frequently exhibits no symptoms. Skin and other signs might not appear until your liver has sustained significant damage.

When the majority of the good tissue in your liver is replaced by scar tissue, cirrhosis results. Cirrhosis can develop from liver damage brought on by situations like:

long-term alcohol use
hepatitis
nonalcoholic fatty liver disease

Even though cirrhosis causes irreversible liver damage, medication and lifestyle modifications may help stop more damage.

Here are a few cirrhosis-related skin symptoms along with treatment options.

Pruritus (itching)

A common side effect of chronic liver disease is pruritus or itchy skin.

Your body may itch all over or only one specific area may be affected. The skin that is irritated may be rough, bumpy, or cracked. It may also be red.

The itch might not go away if you scratch certain spots. Itching might keep you awake at night and cause sleep disturbances.

Some treatments might be able to ease your skin's itch. Among them are:

putting a cold compress on the irritated region
soaking in a warm, oatmeal-filled bath
Using over-the-counter (OTC) ointments or skin creams containing corticosteroids
antihistamines over-the-counter
phototherapy, also known as light therapy

It's advisable to refrain from picking at your irritated skin. Wearing cosy clothes and limiting your exposure to intense heat may be helpful.

Jaundice

The dangerous ailment known as jaundice discolours the whites of your eyes and skin. It happens when your blood contains an excessive amount of the yellowish material bilirubin.

After red blood cells degrade and pass through your organs, including your liver, bilirubin is produced. Through your urine, you eliminate them from your body. Bilirubin can accumulate in your bloodstream due to liver damage caused by cirrhosis, which prevents it from being eliminated.

Itching is one of the signs of jaundice, albeit it can be eased as previously said.

Xerosis (dry skin)

If you have cirrhosis, you could get extremely dry skin (xerosis). This could be the result of your liver's inability to metabolise vitamin A, which is necessary for good skin.

Ninety-three percent of 125 cirrhosis patients in a 2021 study showed a vitamin A deficit.

To relieve your dry skin in addition to the pruritis therapies mentioned above, try the following:

Consume foods high in nutrients, such as fruits, vegetables, and lean meat, in your diet.
Use an oil-based moisturiser regularly.
Reduce the amount of time you spend in pools and hot tubs and take shorter showers or baths to prevent overexposure to water.
If you want to help moisturise your skin, drink lots of water.
To avoid having dry air in your house, use a humidifier.

Spider angioma

A spider angioma is a tiny skin lesion that resembles a spider and is characterised by a red area that is encircled by tiny blood vessels that branch out from it.

These painless lesions form in approximately 33 percent of cirrhosis patients. You may have more than one.

Because ethanol promotes the growth of new blood vessels, cirrhosis brought on by excessive alcohol consumption may result in spider angiomas.

Spider angioma is linked to cirrhosis as well as the following conditions:

rheumatoid arthritis
severe malnutrition
pregnancy

You might have electrocauterization to eradicate lesions for aesthetic purposes, but the lesions might reappear later.

Xanthelasma

A discoloured fatty deposit under the skin around your eyes is called a xanthelasma. People with cirrhosis may experience it as a result of elevated cholesterol.

Xanthelasma can also occur in those who have excessive blood pressure or diabetes. Individuals who identify as Asian or Mediterranean in origin and women are more prone to encounter it.

Despite being innocuous, xanthelasma may be eliminated for aesthetic purposes.

Paper money skin

On your upper body, you might grow slender capillaries that resemble the red and blue threads found in dollar bills. This ailment is known as "paper money skin" for this reason.

It can be brought on by bleeding into your skin, which is a possibility when you have cirrhosis. It resembles spider angiomas.

Skin symptoms specific to alcoholic liver cirrhosis
Specific skin signs associated with alcohol-induced cirrhosis include the following:
spider angioma
paper money skin
Dupuytren's contracture is a disorder in which one or more fingers may bend towards your palm as a result of thickening and forming nodules in the tissue beneath the skin of your palms and the base of your fingers.
diffuse superficial porokeratosis, a condition that results in tiny, dry patches on your arms and legs that are brown in colour

Hair and nail changes

Your nails and hair may be impacted by cirrhosis in these ways:

thinning hair
loss of facial or pubic hair in individuals born with male sex assigned due to elevated oestrogen levels
Clubbing is a condition where increased blood flow causes your fingernails or toenails to change shape.
ridged or thickened nails
A disorder known as "Terry's nails" causes your fingernails to turn white with a brown or red band at the tips.

Hyperpigmentation

The tops of your feet and shins may get grey spots due to hyperpigmentation, which affects 47% of cirrhosis patients.

One possible cause of hyperpigmentation is an imbalance in hormones that leads to an excess of melanin, the pigment responsible for skin colour. Topical retinoids and prescription drugs like hydroquinone can help lessen the spots.

Other rashes and lesions

Additionally, the following unusual skin signs might appear in people with cirrhosis:

Redness in your palms, the base of your thumbs, and your little fingers are known as palmar erythema.
blue lumps on your head and neck called arteriovenous haemangiomas
caput medusae, or the palm tree sign, are enlarged veins that radiate from your navel
sores, ulcers, or open wounds on your legs that could hurt

When to contact a doctor

Consultation with a physician is necessary if you have cirrhosis and experiencing any skin problems. It can be a sign that the illness is getting worse.

A doctor may be able to treat and relieve your skin complaints if they are seriously impairing your quality of life.

Takeaway

Individuals with cirrhosis and other liver illnesses frequently experience skin problems. Common symptoms include dry skin, itching, and skin sores. Certain skin conditions, such as paper money skin, are more common in patients with cirrhosis linked to alcohol.

Treatable symptoms include some of these. Your symptoms can be diagnosed, and a doctor can decide on the best course of action.