Health Questions and Answers

Question: Is examination of the skin helpful in identifying the source of an upper GI bleed?

Answer:

The skin examination can be helpful for suggesting a potential source if certain stigmata are present. Lymphadenopathy or abdominal masses may suggest sources for intra-abdominal pathology

SKIN FINDINGS IN CONDITIONS THAT CAUSE GI BLEEDING

Disease Associated skin findings
Peutz-Jeghers Pigmented macules on lips, palms, soles
Malignant melanoma Melanoma
Hereditary hemorrhagic telangiectasias Telangiectasias on lips, mouth, palms, soles (Osler-Weber-Rendu)
Blue
rubber bleb nevus
Dark,
blue soft nodules
Bullous pemphigoid Oral
and skin bullae
Neurofibromatosis Café-au-lait spots, axillary freckles, neurofibromas
Cronkhite-Canada Alopecia; hyperpigmentation of creases, hands, and face
Cirrhosis Spider angiomata, Dupuytren’s contracture
Neoplasm Acanthosis nigricans
Kaposi’s sarcoma Cutaneous Kaposi’s sarcoma
Ehlers-Danlos Skin
fragility, keloids, paper thin scars
Pseudoxanthoma elasticum Yellow “chicken fat” papules and plaques in flexural areas
Turner’s Webbing of neck, purpura, skin nodules

Reference: From Berger T, Silverman S: Oral and cutaneous manifestations of gastrointestinal disease. In Sleisenger MH, Fordtran JS (eds): Gastrointestinal Disease, 5th ed. Philadelphia, W.B. Saunders, 1994, pp 268-285.

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