Liver skin sign

Introduction

Liver damage or cirrhosis of the liver can lead to the appearance of so-called hepatic signs. These are different skin rashes that are directly related to the damage to the liver. These hepatic signs can be triggered, for example, by taking substances that are toxic to the liver, such as alcohol, drugs or some medicines.

Pathogens can also attack and damage the liver during a disease. In addition, a cardiac insufficiency can cause blood to be congested in the liver and thus affect the tissue. The signs of hepatic cirrhosis are often visible.

These liver skin signs exist

These types of skin changes are in most cases an indication of chronic liver disease.

  • Jaundice (icterus),
  • Palmarexanthem (red coloration of the palm)
  • White nails,
  • Vascular spiders (Spider naevi),
  • Caput medusae (dilation of the superficial veins around the navel)
  • Paint tongue
  • Paint lip
  • Belly Baldness
  • Dupuytren’s contracture (stiffening of the finger muscles with nodular thickening of the tendons)
  • Parchment skin (thinning of the skin layers so that the skin looks like parchment paper)

Causes

The liver is important for many different processes in the body and if its function is restricted, this can be shown by an equally large variability of symptoms. The liver produces vital clotting factors for the blood, i.e. blood components that enable a balanced blood consistency and prevent bleeding. If the liver is damaged by a disease, a toxic substance such as alcohol or other causes, it is possible that these very clotting factors can no longer be provided.

This can lead to small bleedings in the skin or later in other organs. Liver diseases also influence the appearance of the skin. Liver damage or liver cirrhosis means that the blood from the gastrointestinal tract can no longer flow properly through the liver, as it is remodeled into connective tissue, its function is restricted and it is reduced in size.

As a result, the blood in the portal vein circuit becomes congested and is referred to as portal hypertension. This congestion is visible as “caput medusae”, which are thickened veins in the area of the abdominal wall around the navel. Due to the disturbed metabolism and the missing detoxification function of the liver, hormones, toxins and the bile pigment bilirubin accumulate in the body.

The bilirubin causes the skin to turn yellow (jaundice or icterus). The nails turn whitish (white nails) and the insides of the hands are reddened (palmarexanthem). The tongue is strikingly red and shiny (varnished tongue).

Due to the changed blood pressure conditions, the so-called spider naevi also appear on the upper body and face. These are small, star-shaped extensions of small vessels. Belly baldness is the loss of abdominal hair in men.

Bald belly is a typical sign of liver skin, since the liver damage leads to hormonal disorders. Sex hormones can no longer be excreted through the bile and must be converted into female sex hormones, which increases the estrogen level. The estrogen in turn is responsible for the lack of abdominal hair.

Jaundice, known in medicine as icterus, is a sign of liver skin, which is a yellowing of first the eyes and then the skin. The liver plays an important role in the breakdown of hemoglobin, the dye from the blood, so that these breakdown products accumulate more in the body as soon as the liver can no longer perform all its tasks. This can happen, for example, through direct damage to the liver cells or through congestion in the outflow of bile acid, which is also produced in the liver and then concentrated in the gallbladder.

A palmarerythema, i.e. the red coloration of the palms, is also a typical hepatic sign that can occur in the context of liver damage. If the pressure in the liver vessels is increased, the vessels in regions of the body further away from the heart may dilate. This dilation of the blood vessels can then lead to the characteristic reddening of the skin.

In some cases, this can also affect the hollow side of the foot. From most of the abdominal organs, the blood flows together in the veins via the liver to the heart.If the blood vessels in the liver become more impermeable and the pressure in these vessels increases, the body can create alternative bypass circuits in which the blood then drains off to return to the heart. For example, superficial abdominal vessels are then used, which increase in volume over time and become clearly visible on the abdomen. This symptom pattern is called “Caput Medusae”.