Got HBV? What is Your Skin Trying to Tell You?

StephenW

http://wp.hepb.org/
Got HBV? What is Your Skin Trying to Tell You?                                                        Posted on October 11, 2011 by hepbtalk| Leave a comment                       
                                                               

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The liver is the largest solid organ in the body, and your skin is the largest organ.  It only makes sense that the skin may be a window into what is going on inside your body and your liver.  The problem is trying to figure out what your skin is trying to tell you!
The most common skin manifestation associated with “hepatitis” is the yellowing of the skin (jaundice) and the sclera, or white part of the eye.  Jaundice  may be associated with a newly acquired or acute hepatitis B infection.  It certainly gets your attention and gets you to the door of your doctor, which is a good thing.  However, keep in mind that HBV is often asymptomatic, with few or no obvious symptoms, and jaundice is a more severe symptom of an acute HBV infection. Jaundice may also occur in those with advanced liver disease, and a decompensated liver. Jaundice is due to an accumulation of bilirubin, a yellow pigment, in the blood and tissues.  Your liver is responsible for controlling the levels of bilirubin.  If your liver is having problems performing basic, yet essential functions, yellow skin, eyes, dark urine, and itching (pruritus) may all be due to an inability to filter excess bilirubin.  Please see your doctor immediately if you experience jaundice of the skin or eyes.

It is also not uncommon for those with more advanced liver disease such as cirrhosis to have palmar erythema, which presents like red palms –especially around the base of the thumb and little finger.  Keep in mind that there may be other reasons for experiencing red palms, such as high blood pressure, pregnancy, or elevated estrogen levels. Talk to your doctor if you have concerns.

Spider nevi or spider angioma are another indicator of more serious liver disease. These are not to be confused with spider veins. It is also important to note that 10-15% of healthy adults and children have spider nevi, with no underlying disease. They range in size from 0.5 to 1 cm in diameter, with a dark center, radiating out to fine, red lines. When the center is depressed with the finger, the radiating lines disappear, and then re-appear, when the finger is lifted. Spider nevi may be caused by an increased level of estrogen in the body.  Naturally these may also appear during pregnancy, and in women using oral contraceptives. Following pregnancy and the discontinuation of contraceptives, the spider angiomas will disappear on their own. Like so many basic, but essential functions, the liver is responsible for breaking down and removing excess estrogen. Spider nevi associated with liver disease tend to be large in number and appear on the upper part of the body, face, and neck – especially on the backs of the hands and arms. Once again, it is a good idea to point out these out to your doctor.

Gianotti-Crosti Syndrome is a rash associated with HBV and EBV (Epstein Barr Virus). This rash almost always occurs in children, with 90% of kids under the age of four. The rash may last from two to eight weeks. Basically, it’s just a response to a virus, and nothing to worry about – just an indicator. Kids often have a rash for one reason or another.  If the rash is excessively itchy, talk to your pediatrician about using a topical steroid. Every parent of a child with HBV is convinced their child has some sort of HBV associated rash. (Speaking from experience…) Even the pediatric liver specialist was unsure, so she got a consult with a pediatric dermatologist.  The rash was unrelated to HBV.

Wondering about your finger nails?  There’s a condition called Terry’s Nails which is present in many of those with cirrhosis. The nail appears mostly white, similar to the appearance of “ground glass”, and possibly with a little pink strip at the top of the nail bed.  This is due to a decrease in blood flow to the nail bed and an increase in connective tissue.  Remember that your doctor will not be able to see any of this if you wear nail polish to your appointment.

How about your basic rash that is associated with hepatitis B?  Rashes are most often associated with acute hepatitis B infections, although a recurring rash may occur in those chronically infected.  Talk to people living with HBV and they’ll tell you they have occasional rashes and annoying itching, even if their doctor may tell them they do not.  Could be totally unrelated, or it could be erythematous papular lesions, or palpable purpura.  In other words, your basic red or purplish, raised, bumpy rash. It’s not easy to find specific information linking your basic rash to HBV, but when you consider how the skin is a window to your general health, it makes sense that you may see skin manifestations that reflect your immune system response to your HBV infection as it cycles through various stages, phases and flares.
If you are living with HBV, you know the importance of monitoring your HBV status and your liver health.  Annual, bi-annual, or the schedule recommended to you by your liver specialist, will keep you on top of what is going on with your HBV and any associated liver disease.  However, it is good to take notice of any changes in the skin and nails as the liver is a non-complaining organ.  Sometimes we have to look for evidence that something is going on. That being said, I feel the need to rush to a mirror and check myself out after having researched and written this blog.  The skin may be a window to our general health, but it is not always easy to figure out what it’s trying to tell us. If you have any questions, don’t try to self-diagnose. Talk to your doctor and bring any of your concerns to his attention.
                                                       
                               

StephenW

肝脏是体内最大的实质器官，和你的皮肤是最大的器官。它不仅使感，皮肤可能会到什么是你的身体和你的肝脏内的窗口。问题是试图找出你的皮肤是想告诉你什么！

与“肝炎”相关的最常见的皮肤表现是皮肤（黄疸）和巩膜，或眼白部分变黄。黄疸可能与新收购或急性B型肝炎感染。这当然得到您的关注，并得到医生的门，这是一件好事。但是，请记住，常无症状乙型肝炎病毒是，很少或根本没有明显症状，黄疸是一个更严重的症状，急性HBV感染。黄疸也可能发生在那些先进的肝脏疾病，和失代偿期肝。黄疸是由于胆红素，一种黄色色素的积累，在血液和组织中。你的肝脏是负责控制胆红素水平。如果你的肝有问题，执行基本的，但基本职能，黄色的皮肤，眼睛，黑尿，和瘙痒（瘙痒），都可能是由于无法过滤多余的胆红素。如果您遇到黄疸皮肤或眼睛，请立即去看医生。

更先进的肝脏疾病，如肝硬化呈现像红色手掌，特别是围绕基地的拇指和小指掌红斑，它也并不少见。请记住，体验红色手掌，如高血压，妊娠，雌激素水平升高，可能有其他原因。向您的医生，如果您有任何顾虑。

蜘蛛痣或蜘蛛痣是另一种更严重的肝脏疾病的指标。这些都不是要混淆蜘蛛痣。同样重要的是要注意的10-15％的健康成人和儿童蜘蛛痣，有没有潜在疾病。它们的范围从0.5到1厘米直径大小，与一个黑暗的中心，辐射罚款，红线。中心是用手指当情绪低落，辐射线消失，然后重新出现，当手指抬起。蜘蛛痣可能导致在体内雌激素水平的提高。当然这些也可能出现在怀孕期间，使用口服避孕药的妇女。妊娠和避孕药停药后，蜘蛛状血管瘤会自行消失。像这么多基本的，但重要的功能，肝脏是负责打破和消除过剩的雌激素。与肝脏疾病相关的蜘蛛痣往往要大的数量和出现的身上，脸上，颈部上部 - 尤其是对的手和胳膊的背影。再次，它是一个好主意，指出了这些医生。

Gianotti Crosti综合症是与乙肝病毒和EB病毒（EB病毒）相关的皮疹。这种皮疹几乎总是发生在儿童，90％下，四岁的孩子。皮疹可能会持续两到八个星期。基本上，它只是一个病毒的响应，并且完全不用担心 - 只是一个指标。孩子们经常有皮疹或其他的原因之一。如果过度发痒的皮疹，谈谈你的儿科医生使用外用类固醇。乙肝病毒的儿童的父母都相信他们的孩子有某种HBV相关的皮疹。 （从经验上... ...）即使小儿肝病专家，是不确定的，所以她得到了一个儿科皮肤科咨询。皮疹是与HBV无关。

很想知道你的指甲吗？特里的指甲条件，这是目前在许多肝硬化。指甲出现多为白色，类似的“毛玻璃”的外观，并可能在甲床的上方一点点的粉红色地带。这是由于在甲床的血液流量减少，增加结缔组织。请记住，您的医生将无法看到任何本的，如果你穿你的约会指甲油。

如何与乙肝相关的基本皮疹，是吗？皮疹常与急性B型肝炎感染，虽然经常性的皮疹，可能会出现慢性感染者。生活与乙肝病毒的人，他们会告诉你他们偶有皮疹和恼人的瘙痒，即使他们的医生可能会告诉他们，他们不。可能是风马牛不相及的，或者它可能是红斑性丘疹性病变，或可触及性紫癜。换句话说，你的基本的红色或紫红色，提出，崎岖不平的皮疹。这并不容易找到连接您的基本皮疹乙肝的具体信息，但是当你考虑如何对皮肤是你的一般健康的一个窗口，它使意义，你可能会看到皮肤表现，反映了它你的免疫系统的反应你的乙肝病毒感染循环的各个阶段，阶段和耀斑。

如果你是乙肝病毒的生活，你知道监测HBV的地位和您的肝脏健康的重要性。年度，双年度，或肝病专家推荐给你的时间表，将继续与HBV和任何相关的肝脏疾病是怎么回事上你。但是，它是好采取任何变化在皮肤和指甲的通知，如肝是一个非抱怨器官。有时候，我们不得不去寻找证据的东西是怎么回事。话虽这么说，我觉得有必要急于一面镜子，检查自己出来后，研究和编写了这个博客。皮肤可能是我们一般健康的一个窗口，但它并不总是很容易弄清楚它试图告诉我们什么。如果您有任何问题，不要尝试自我诊断。向您的医生和您的关注带来了他的注意。

music000

关于指甲，是指的哪个区域啊？


是突起的断断续续的竖向点线么？

StephenW

是指甲的颜色。不是"突起的断断续续的竖向点线么". 患有严重糖尿病的人
也有,因血液循环不畅。

music000

我的指甲上有竖的线，手背上有一颗蜘蛛痣，胳膊肘关节处还有一颗蜘蛛痣。

StephenW

回复 music000 的帖子

"我的指甲上有竖的线" - 我也有。你的指甲颜色不是白色.
"手背上有一颗蜘蛛痣，胳膊肘关节处还有一颗蜘蛛痣" - 我敢打赌,他们不是蜘蛛痣.
他们看起来像这样:

This is called cherry angionma,common, bengin.这就是所谓的樱桃状血管瘤，常见的，良性的。

music000

没啥可赌的。就是SPIDER ANGIOMA.