Alcohol intake and other skin disorders

Abstract

The classical cutaneous stigmata of alcoholism have been well recognized for over a century. Most stigmata are in fact manifestations of the end stage of cirrhosis, rather than of alcohol itself, and as such are discussed in more detail in chapter 18. Over the past decade alcohol has become recognized as a causal or aggravating factor in a wide variety of skin diseases, particularly those of inflammatory origin. The exacerbation of psoriasis by alcohol has received greatest attention of late (see chapter 12), but many other chronic dermatoses may also be associated with excess drinking.1–3 However, these are not always widely appreciated and can be easily overlooked. A careful history is often required to elucidate the patient’s alcohol consumption, as these patients are often regular heavy drinkers (alcohol misusers) rather than alcoholic, and in particular will not exhibit any features of dependency. In fact, they may be quite surprised when it is suggested that drinking could have a pivotal role in their skin disease, as they would not personally consider themselves to be “at risk” or drinking to excess. Having a high level of awareness of the role of alcohol in skin disease is important for the clinician, as clues are rarely gleaned from standard screening tests, biochemical and hematological parameters being usually normal in these patients.3