الفهرس 
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Abstract
Chronic liver diseases (early cirrhosis) represent an important public health problem. Infections with hepatitis B or C viruses and non alcoholic fatty liver disease represent the majority of liver diseases. Cirrhosis is the main long term complication of chronic hepatopathies.
Patients with liver disorders present a wide variety of cutaneous manifestations. The objective of this study was to determine the prevalence of cutaneous manifestations and their distribution among patients with liver diseases in Sohag governorate and to determine the sociodemographic factors related to the presence of dermatological conditions in those patients. Out of the 800 patients with liver disease included in this study, 490 (61.25%) were males and the remaining 310
( 38.75%) were females. In this study, cutaneous manifestations were detected in 752/800 (94%) of patients with liver diseases.
In this study, 64% of patients with liver diseases who had cutaneous manifestations were between 40- 60 years old and 72.6% of them were farmers. The majority ( 87%) of patients with cutaneous manifestations came from rural areas and most of them were cirrhotic (72.07%). There was past history of bilharaziasis in more than one third of patients (36.97%). In this study, nail changes were the most common cutaneous manifestation in patients with liver diseases and accounted for 86.87%. White nails were the commonest abnormality (25%). Vascular changes were detected in 83.12% of patients. palmar erythema was the commonest vascular change and accounted for 54.5% among patients with liver diseases.
In this study, facial hyper pigmentation was found in 56.37% of patients. Diffuse pattern of hyper pigmentation (Muddy face) was the most common one was detected in about one third of patients. Jaundice was found in 23.88% of patients. Pruritus accounted for 17. 38% of patients with liver diseases. Coagulation defects in the form of purpura and ecchymoses were detected in 15.37% of patients. Lichen planus was detected in 11.25% of patients with liver diseases and acquired ichthyosis in 5.5% of patients with liver diseases.
In our study, feminine hair distribution as a hormonal change among male patients with liver diseases (490) was found in 46.12% and
oral mucosal lesions detected in 10.62% of patients with liver disease, OLP was the commonest accounted for 4.25%. In this study, we reported other skin diseases among patients with liver diseases such as: vitiligo vulgaris, lichen simplex chronicus, cutaneous vasculitis, idiopathic guttate hypomelanosis, necrolytic acral erythema, psoriasis vulgaris, seborrheic dermatitis, pityriasis versicolor, prurigo nodularis, herpes zoster and alopecia totalis. The potential relationship between these disorders and liver diseases requires further research.
In conclusion, this study highlights the patterns of cutaneous manifestations of liver diseases in Sohag governorate. Based on the results of this study, liver diseases are commonly associated with various dermatological disorders and patients with liver cirrhosis are at higher risk of developing skin lesions. The finding of skin affection in patients with liver diseases was significantly correlated with age above 40 years, past history of bilharaziasis and history of previous operation.