The condition of the skin in patients with non alcoholic fatty liver disease and accompanying hypothyroidism: the view of the family doctor
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Abstract
The objective: is to study the frequency of skin changes in patients with NAFLD and accompanying hypothyroidism.
Materials and methods. There were examined 103 patients with NAFLD and accompanying hypothyroidism, including 91 with subclinical hypothyroidism. To diagnose internal diseases the anthropometric measurements were performed. Non invasive tests of steatosis, including the FLI (Fatty Liver Index) and LAP (Lipid Accumulation Product) were calculated by online calculators. The liver ultrasound and the laboratory examination were made also.
Results. Pathological changes of the skin were detected in 85 patients, who were being examined. Among them xanthelases were detected in 56 patients, nodular xanthomas – in 49, their combination were detected in 23 patients. The following changes were associated with accompanying dyslipidemia in 43 patients. Acne was diagnosed in 12 patients with NAFLD on the background of diabetes. Another 7 patients (5 – with diabetes and 2 – with prediabetes) noted acne in their anamnesis. In each of cases acne had been appeared long before the diabetes diagnosed. 7 patients noted furun culosis in anamnesis.
The skin of the most patients was dry, with a reduced turgor, often wrinkled. Facial puffiness (in 34 patients) is characteristic for the accompanying hypothyroidism and does not depend on the stage of the NAFLD. The tarnish and sparseness of hair, as well as early greyness and an excessive hair loss are revealed.
Conclusions. Phisical examination of patients and a detailed anamnes tic search are extremely valuable diagnostic methods in the practice of a family doctor, since internal illnesses are reflected on the condition of the skin.
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