Godara Shashi K, Thappa Devinder M, Pottakkatt Biju, Hamide Abdoul, Barath Jagadisan, Munisamy Malathi, Chiramel Minu J
Department of Dermatology, Jawaharlal Institute of Medical Education and Research, Puducherry, India.
Department of Medical Gastroenterology, Jawaharlal Institute of Medical Education and Research, Puducherry, India.
Indian Dermatol Online J. 2017 Jan-Feb;8(1):9-15. doi: 10.4103/2229-5178.198760.
Hepatobiliary diseases are associated with various mucocutaneous changes that are directly and indirectly associated with these diseases. There is a dearth of studies from India dealing with cutaneous manifestations in liver disorders.
This study was conducted to know the spectrum of cutaneous changes and their correlation with liver function tests in patients with disorders of hepatobiliary system.
This was a descriptive study conducted among in patients and outpatients with primary hepatobiliary disorders at a tertiary care center in South India. Detailed history taking and examination was done. Visual analog score (VAS) and 5D itch score was employed to quantify pruritus. Correlation of liver function tests with pruritus and comparison of skin changes in the major disease groups was attempted.
A total of 303 patients were recruited. Hepatic mass/malignancy followed by nonalcoholic liver disease were the most common diagnoses. Icterus followed by pruritus were the most common cutaneous complaints. The mean VAS and 5D itch scores among the patients with pruritus were 4.7 ± 1.9 and 13.6 ± 4.9. The most common mucocutaneous findings observed were icterus (241 patients; 79.5%), ichthyosis/xerosis (172 patients; 56.7%), pallor (131 patients; 43.2%), excoriations (118 patients; 38.9%), hyperpigmented palmar creases (118 patients; 38.9%), clubbing (113 patients; 37.2%), and pedal edema (85 patients; 28%). There was statistically significant correlation between serum bilirubin levels and pruritus.
The common mucocutaneous manifestations associated with primary hepatobiliary disorders were icterus, ichthyosis/xerosis, pallor, excoriations, hyperpigmented palmar creases, clubbing, and pedal edema.
肝胆疾病与多种皮肤黏膜改变相关，这些改变与这些疾病直接或间接相关。印度缺乏关于肝脏疾病皮肤表现的研究。
本研究旨在了解肝胆系统疾病患者皮肤改变的范围及其与肝功能检查的相关性。
这是一项在印度南部一家三级医疗中心对原发性肝胆疾病住院患者和门诊患者进行的描述性研究。进行了详细的病史采集和检查。采用视觉模拟评分（VAS）和5D瘙痒评分来量化瘙痒。尝试了肝功能检查与瘙痒的相关性以及主要疾病组皮肤改变的比较。
共招募了303名患者。肝肿物/恶性肿瘤其次是非酒精性肝病是最常见的诊断。黄疸其次是瘙痒是最常见的皮肤主诉。瘙痒患者的平均VAS和5D瘙痒评分分别为4.7±1.9和13.6±4.9。观察到的最常见皮肤黏膜表现为黄疸（241例患者；79.5%）、鱼鳞病/皮肤干燥（172例患者；56.7%）、苍白（131例患者；43.2%）、抓痕（118例患者；38.9%）、掌纹色素沉着（118例患者；38.9%）、杵状指（113例患者；37.2%）和足部水肿（85例患者；28%）。血清胆红素水平与瘙痒之间存在统计学显著相关性。
与原发性肝胆疾病相关的常见皮肤黏膜表现为黄疸、鱼鳞病/皮肤干燥、苍白、抓痕、掌纹色素沉着、杵状指和足部水肿。
