A red, itchy rash…little yellow bumps…extremely dry skin. The list of skin problems can go on and on. But did you know that a skin issue isn’t always just about your skin? It might be alerting you to an internal problem your doctor needs to know about and treat.
Plus, some skin conditions may mean that you have an increased risk for other health problems (for example, psoriasis has been shown to increase risk for cardiovascular disease), and you will want to take measures to reduce these risks.
EXTERNAL SIGNS, INTERNAL DISEASE
The following diseases are often accompanied by skin problems. If you notice any of the skin issues listed here, make an appointment with your primary care physician or dermatologist for an evaluation.
Cardiovascular disease (CVD). CVD is characterized by narrowed or blocked blood vessels that can cause heart attack or stroke. In many cases, chest pain, heart attack or stroke is the first recognizable sign of CVD. But several skin changes may indicate that you’re at increased risk for CVD…
• Yellow plaques on the eyelids. These waxy growths (known as xanthelasma) are found mostly on the upper eyelids. They may be a sign of elevated cholesterol levels, a risk factor for CVD. In some cases, use of cholesterol-lowering drugs will resolve these growths.
• Swollen and itchy legs and feet. Excess accumulation of fluid in patients with congestive heart failure can result in leg swelling (edema). If left untreated, stasis dermatitis, a condition characterized by itchy, red skin, may occur. Treatments that improve heart function, along with compression stockings and topical corticosteroids, help to alleviate symptoms and prevent recurrence.
Diabetes. Chronically high levels of blood sugar (glucose) dramatically increase the risk for heart disease, stroke, Alzheimer’s disease and many other problems, such as kidney failure, blindness and amputation. But millions of people are undiagnosed or have prediabetes (a precursor to full-blown diabetes). Be alert for these skin changes that might signal problems with blood sugar control…
• Yellow-red bumps on the arms and legs. Known as eruptive xanthomas, these bumps can pop up anywhere on the body but are especially common on the buttocks, shoulders, arms and legs. They’re caused by very high levels of triglycerides, a type of fat in the bloodstream that is common with insulin resistance, a condition that causes excess blood sugar and can result in prediabetes and diabetes. Once diabetes is treated, triglyceride levels often normalize and skin lesions resolve.
Hepatitis C. This liver infection, caused by the blood-borne hepatitis C virus, increases the risk for cirrhosis and liver cancer. New medications can cure the disease, but it’s symptomless in three out of four cases. However, the skin can sometimes provide an early clue…
• Blistered, fragile skin on the backs of the hands. This condition can be a sign of hepatitis C. Called porphyria cutanea tarda, it’s characterized by sensitivity to sunlight and is also seen in alcoholics and can occur as a drug side effect, particularly with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen (Motrin, Advil). When the hepatitis C is effectively treated, the skin issue goes away.
• Red, tender spots on the lower legs. This can be caused by inflammation of blood vessels, which occurs in some people who have hepatitis C. Like porphyria, it resolves when hepatitis C is treated.
Thyroid disease (Hashimoto’s thyroiditis). This autoimmune disease is one of the most common causes of hypothyroidism, a condition in which the thyroid gland doesn’t produce enough thyroid hormone. An estimated 14 million Americans may have the disease—and most don’t know it. But your skin may sound the alarm…
• Dry skin. Hypothyroidism can cause a wide range of symptoms, including fatigue, muscle and joint pain, depression, mental sluggishness, low libido, weight gain, constipation, cold hands and feet, dry, coarse hair—and dry skin, one of the most common red flags.
• Loss of eyebrow hair. People with hypothyroidism sometimes lose the outer third of their eyebrows.
When standard treatment for hypothyroidism (a thyroid replacement hormone) is given, skin problems typically resolve.
RISKS FROM SKIN CONDITIONS
If you have one of the following skin problems, you and your doctor need to be aware of the possible health risks that are linked to the condition…
Psoriasis. This inflammatory autoimmune disease attacks skin cells, producing scales of silvery, thick skin and raised red patches that can be painful as well as itchy. The inflammation associated with psoriasis can increase risk for high blood pressure, heart attack, stroke, peripheral artery disease (poor circulation in the legs) and diabetes.
What to do: Standard treatments for psoriasis include medications, such as steroids, light therapy and stress management. While there’s some evidence that treatments may lower CVD risk, it is best to work with your doctor to assess your CVD risk factors. You can then lower your risk by losing weight, exercising regularly, not smoking and, when necessary, using medication to control CVD risk factors such as high blood pressure and elevated cholesterol.
Lupus. Systemic lupus erythematosus (SLE) is an autoimmune disease in which the immune system attacks various tissues and organs, including the skin. Patients with SLE often develop a “butterfly rash”—a red rash that spreads across both cheeks in the shape of a butterfly’s wings. Other skin symptoms can include lesions that worsen when exposed to the sun.
People with lupus are at higher risk for many other health problems, including heart disease, stroke, cancer, kidney disease, bone disease and infections.
What to do: If you have lupus, you and your physician need to create a plan to minimize your risks of developing these other diseases. Elements of the plan should include controlling blood pressure and high cholesterol with lifestyle measures (such as regular exercise) and possibly medications…getting regular cancer screenings…and having regular checkups for kidney function and bone density.