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5 Systemic Diseases with Dermatologic Involvement

Sometimes the first signs of serious conditions appear on the skin. Systemic diseases often have a wide range of cutaneous manifestations.[1] Here are the skin signs of 5 major systemic diseases.

1. Kidney Disease
Uremic pruritus is the most common symptom of chronic renal disease, which is also characterized by calcium deposits, purpura, plaques and hyperkeratotic papules or nodules (acquired perforating dermatitis), nail disorders, and bullous eruptions.

2. Hypothyroidism
Cold or pale color to the skin is a primary sign in hypothyroidism, but yellowing pseudojaundice is also common, as are edema of the hands and face, and hair loss or hair changes to various parts of the body. Nails may grow slowly and become brittle and dull. Telangiectasia and purpura may also be observed. The most serious skin symptom is myxedema, which in rare cases, can decompensate to a coma state.

3. Sarcoidosis
Sarcoidosis is a pulmonary disorder manifested by skin lesions in at least 25% of cases, which may accompany granulomatous involvement of the liver, spleen, eyes, lungs and lymph nodes. Skin involvement can take many forms: infiltrated or sometimes erythrodermic plaques, maculopapular eruptions, ulcerations, changes to scar tissue (sarcoidosis), Lupus pernio and Ichthyosiform lesions.

4. Systemic Lupus Erythematosus (SLE)
The “butterfly rash” (an erythematous rash that spreads across the nose and cheeks) is a signature sign of SLE, reported in 25-40% of cases. The rash can be colored from pale red to purple, raised or flat, but doesn’t usually cause discomfort other than possible itching. But the butterfly is not the only skin symptom. At least 80% of SLE patients experience some form of skin lesions that can be discoid or bulbar, vasculitis, alopecia, nail fold changes, oral erosions, hemorrhages and ulcers.

5. Liver Disease
Early signs of liver disease can include pruritus, spider angiomas, and porphyria cutanea. The latter can signal liver disease in general, but is often specific to hepatitis C.  A common presentation of cirrhosis is the combination of spider angiomas, palmar erythema, and Dupuytren contracture.

Last updated on 9/25/19.

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