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Your Skin: A Window to Your Health

Your skin can be a window to your underlying health, says Wake Forest’s Joseph Jorizzo, MD, one of the experts who literally wrote the book on skin signs of internal disease. Many underlying health conditions — some very serious — first appear as skin problems.

Butterfly Rash

A butterfly rash across the face is often the first sign of lupus erythematosis. But don’t jump to conclusions. “It could be rosacea, it could be contact dermatitis. Unfortunately, sometimes it is a sign of lupus,” says University of Miami dermatologist Paolo Romanelli, MD. Only further tests can tell if it’s really lupus.

Velvet Plaques

Velvety plaques around the neck and/or armpit suggest diabetes. This condition — acanthosis nigricans — could be benign, or just from being obese. But it is very often a sign of diabetes, and may indicate an internal malignant cancer.

Leg Plaque: Red on Edge, Gold in Center

Doctors call it necrobiosis lipoidica diabeticorum. As the name suggests, it’s a distinctive sign of diabetes. And not a good sign. This skin condition suggests the underlying diabetes may have damaged eyes and kidneys.

Itchy, Violet Bumps on Wrist

Lichen planus is a rash made up of reddish-purple, flat-topped bumps that may itch like crazy. It usually appears on the wrists or ankles, but may be on the lower back, neck, legs, and genitals. The cause isn’t known — but if you have it, you’ll need to get liver tests. It could be a sign of hepatitis C.

Flesh Colored, Orange-Peel Patches on Back

Shagreen patches are flesh-colored lesions on the lower back that have the texture of an orange peel. They often occur with other skin signs: red or brown acne-like bumps spreading across the cheeks and nose; and ash-leaf spots of under-pigmented skin, most often on the trunk, that are oval at one end and pointy at the other. These are signs of a rare genetic disease called tuberous sclerosis that causes benign tumors to grow in the brain and other vital organs.

Tripe Palms

Tripe palms describes a skin condition in which the skin of the palm becomes thick and velvety-white with pronounced folds in the lines of the hand. The skin resembles boiled tripe. It’s a sign of cancer. If only the palms are involved, it’s most likely lung cancer. If tripe palms is accompanied by acanthosis nigricans, it’s most likely gastric cancer.

Hardening of Skin in Extremities, “Wooden” Hands and Feet

First described in 1997, nephrogenic systemic fibrosis starts as a brown discoloration and indentation of the lower arms and legs. Very soon, the hands and feet become brown and like wood. Sometimes there’s also a small yellow spot in the eye. Researchers only recently found that the gadolinium contrast agent used during MRI exams triggers this condition in some patients with kidney failure.

Scaly Rash on Buttocks, Red Tongue

Fortunately, necrolytic migratory erythema is pretty rare. It’s a red, scaly rash, sometimes with small erosions of the skin, usually seen in elderly patients. It tends to start in the fold of the buttocks or palms but can be elsewhere on the body. A bright red, painful tongue is common. The condition usually signals a pancreatic tumor, usually a glucogenoma.

Not All Skin Conditions Scary

Many skin conditions do not indicate that anything else is wrong with you. For example, granuloma annulare is raised, reddish or flesh-colored bumps forming ring patterns on the hands and feet. They usually go away within two years, and don’t mean anything is wrong with you.

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