Out of the following, the clinical skin manifestation of cirrhosis of the liver is?

Appeared in: HSSC Staff Nurse - 2015

Explanation

Palmar erythema is a classic cutaneous sign of chronic liver disease, including cirrhosis.
It presents as a blotchy redness over the thenar (thumb side) and hypothenar (little finger side) eminences of the palms.
The underlying cause is believed to be altered hormone metabolism, specifically elevated estrogen levels, which leads to vasodilation.
This sign, along with others like spider angiomas, helps in the clinical diagnosis of liver dysfunction.

Option B: Generalized erythema of the face is not a specific sign of liver cirrhosis. While patients may experience flushing, it is not considered a classic stigma of the disease.
Option C: Similar to facial erythema, generalized redness of the neck is not a characteristic sign of liver cirrhosis.
Option D: Erythema on the shoulders is not a recognized clinical manifestation of liver cirrhosis.

Clinical Relevance

Nursing practice connection: Knowing Cutaneous manifestations of liver cirrhosis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing palmar erythema and other stigmata of chronic liver disease is a crucial nursing assessment skill that can prompt further investigation and early intervention.
Nurses should correlate physical findings like palmar erythema with laboratory results (e.g., elevated liver enzymes, low albumin, prolonged prothrombin time) to build a comprehensive clinical picture.
What if? If a patient with palmar erythema also presents with confusion and a change in sleep patterns, the nurse should immediately suspect hepatic encephalopathy, a serious complication of cirrhosis, and escalate care.

How to Approach the Question

First, identify the core concept of the question, which is the specific skin signs associated with liver cirrhosis.
Review the options provided, noting that they all relate to erythema (redness) but in different body locations.
Recall the classic cutaneous manifestations of chronic liver disease taught in nursing curricula.
Recognize that palmar erythema is a well-documented and specific sign of cirrhosis.
Eliminate the other options (face, neck, shoulder erythema) as they are not considered classic or specific indicators of this condition.

Concept Tested & Keywords

QKp71CjEiCBJeixTPJ665u

E6 Medicine Harrison 22e Part 2 pp. 613-615, 533-535

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 222-224

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