A liver disease called cholestasis can result in a skin condition called cholestasis cutis, or simply cholestasis. This condition manifests as red, scaly patches on the skin that may itch and feel uncomfortable.

Strictly speaking, this is not a form of eczema but rather a symptom of another underlying problem. When it comes to rashes from liver disease, the most common culprit is alpha-1 antitrypsin deficiency (AATD).

This is an inherited genetic condition where your body produces a flawed protein that plays an essential role in keeping your blood lipid levels balanced.

In other words, if you are missing certain AATDs, your liver will struggle to process fats and fatty acids properly. The result? An imbalance of fats in the blood that leads to various health complications down the road.

In addition to the serious symptoms of liver disease, it can also cause skin rashes. This is because the liver filters blood and removes harmful substances from it.

If there are substances in the blood that the liver doesn’t know how to process, this can trigger a skin rash. The most common skin rashes seen with liver disease are cholestatic jaundice and Stevens-Johnson syndrome (SJS). Let’s explore what these rashes are, how they develop and how to treat them.

What is a Cholestatic Jaundice Skin Rash?

Cholestatic jaundice (or liver jaundice, for short) is caused by excessive leakage of bile pigment (bilirubin) from the liver. This is due to liver disease, medications, poor diet, certain diseases, or after childbirth.

The bile pigment is separated from the food once it enters the small intestine, so it can’t be absorbed back into the blood. Instead, it passes through the gut and is excreted in the stool. The body then recycles the pigment back into the blood, which is why a person with liver disease can experience jaundice.

When the pigment leaks from the liver, it combines with proteins and fats in the blood and changes colour, from yellow to a dark orange-red. This can be very severe and last for months, or even years. Jaundice can occur at any stage of liver disease, but it’s more common in people with advanced cirrhosis. It can also occur in people who have certain metabolic conditions such as hemolytic syndromes.

Stevens-Johnson Syndrome (SJS) Skin Rash

SJS is an extremely rare and serious skin rash caused by an intolerance to certain medications. SJS affects the skin, eyes, and internal organs. It’s a rapidly progressing rash that can be life-threatening.

The most common causes of SJS are drugs that are used to treat infections (such as ciprofloxacin, erythromycin, and penicillin), as well as drugs used to suppress a high immune response (such as azathioprine and mercaptopurine).

Other risk factors of SJS include a previous episode of SJS or another autoimmune disease, being older than 60, and taking immunosuppressant drugs for organ transplants.

Other Liver Disease Rashes

There are a number of less common rashes that can occur with liver disease. These include active cutaneous leishmaniasis, chronic idiopathic urticaria, and allergic skin reactions to medications. Active cutaneous leishmaniasis is a rare disease caused by a parasite.

ou can get it from a cut on the skin that’s already infected with the parasite, or from the mouth. The rash that occurs is red and itchy and it’s often in a symmetrical pattern.

The rash can be treated with anti-leishmanial drugs, but if left untreated, it can become complicated and cause permanent damage to the skin. Annoying skin rashes caused by other liver diseases are often transient and don’t require treatment.

How to Treat a Skin Rash From Liver Disease?

If you have a skin rash that’s caused by liver disease, it’s important to see a doctor. They can determine the health of your liver and give you the best possible treatment options. There are a few things you can do to help reduce the symptoms of a skin rash.

  • If your rash is itchy, apply calmative soaks, such as calendula soaks, to help relieve the itch.
  • Do your best to keep your skin hydrated by washing with lukewarm water, applying moisturizers, and keeping your skin out of the sun.
  • Use topical emollients such as petrolatum to help soothe your skin.
  • Avoid scratching your itchy skin, as this can make the rash worse.
  • Apply a cooling or soothing hydrocolloid bandage to your itchy skin to help relieve the itch.

Tips for Prevention

Although it’s rare, there’s a chance a skin rash could develop from liver disease. To prevent this, it’s important to see your doctor regularly and maintain a healthy lifestyle.

Follow a healthy diet, exercise regularly (at least 2 hours a day), do not abuse alcohol or medications, and maintain a healthy body weight.

Conclusion

If you have any concerns about your skin rash, don’t hesitate to visit your doctor. They can help determine the cause and offer treatment options.

And, if you suspect that you have liver disease, it’s essential to follow a healthy diet, maintain a healthy weight, and be screened regularly for liver disease.