chapter  45
Dermatological manifestations of serious gastrointestinal disorders
WithG. K. Singh, Kunal Ghosh
Pages 9

The skin can provide significant clues to screen, investigate, diagnose, and formulate management protocols with the help of gastroenterologists. These cutaneous manifestations are highly varied, diverse, and can include specific or nonspecific changes. Broadly these skin changes can be classified into four major categories: (1) Dermatological manifestations of disorders of the pharynx, esophagus, and stomach. Systemic sclerosis, Plummer-Vinson syndrome, and mechanobullous or immunobullous disorders that involve the upper gastrointestinal tract have distinct skin changes. Conditions such as acanthosis nigricans, acrokeratosis neoplastica (Bazex syndrome), seborrhoic keratosis (signs of Lese-Trelat), florid cutaneous papillomatosis (Schwartz-Burgess syndrome), Sister Mary Joseph nodule, and hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) give clues to underlying gastrointestinal malignancies. (2) Dermatological manifestations of disorders of intestinal involvement. Examples are dermatitis herpetiformis, Henoch-Schönlein purpura, inflammatory bowel disease (Crohn disease and ulcerative colitis), bowel-associated dermatitis arthritis syndrome (BADAS), Whipple disease, and hereditary intestinal polyposis have characteristic skin changes along with intestinal involvement. (3) Dermatological manifestations of liver and pancreas disorders. Lichen planus, Gianotti- Crosti syndrome, and cutaneous features of liver cell failure are examples of liver disorder due to various causes. Grey-Turner sign, migratory thrombophlebitis (Trousseau syndrome), and necrolytic migratory erythema may give clues to pancreatic disorders. (4) Dermatological manifestations of miscellaneous gastrointestinal disorders. These include, e.g., malabsorption, stomas, and drugs.