Cutaneous hyperpigmentation as a manifestation in acuteon chronic liver failure

Main Article Content

Jesús Sebastián Rodríguez-Gutiérrez http://orcid.org/0000-0003-4010-0797
Karen Montserrat Ramírez-Gómez http://orcid.org/0000-0002-6693-8005
Maricela Omaña-Domínguez http://orcid.org/0000-0001-7079-2320
Ana Lilia Ruelas-Villavicencio http://orcid.org/0000-0002-6886-2171

Keywords

Hyperpigmentation, Liver Diseases, Acute-On-Chronic Liver Failure

Abstract

Background: The acquired cutaneous pigmentation represents a little recognized clinical manifestation in liver disorders, both acute and chronic, and can occur in the exacerbation processes of preexisting hepatopathies, as in the context of acuteon chronic liver failure. Several hypotheses about the increase in pigment at skin and mucous membranes have been developed; some try to explain it as a defect in the degradation of melanin with secondary accumulation at tissues; others, on the other hand, describe it as a consequence of the release of fibroblast growth factors like endothelial growth factor and hepatocyte growth factor, which are produced under the stimulation of liver regeneration and cause a melanogenesis stimulation. The aim of this article is to describe pigmentary skin changes in the background of liver diseases.


Clinical case: We described two clinical cases of patients with acuteon chronic liver failure secondary to different clinical scenarios are presented, who have in common the development of acquired pigmentary skin changes.


Conclusion: In hepatopathies, the cutaneous hyperpigmentation is a sign with unknown etiology, so further studies are required to know the accurate pathophysiology. Reporting this finding is useful for physicians, since timely identification can help in the early diagnosis of underlying liver diseases.

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