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Skin Signs of Gastrointestinal Disease

»List some of the hallmark skin signs seen with diseases of the digestive tract.
»What is jaundice (icterus) and when is it apparent in the skin?
»What can a jaundice color spectrum tell me about the types of liver disease in a patient?
»List the top ten skin findings suggestive of hepatic and biliary tract disease.
»What is the most common skin symptom associated with liver disease?
»What diseases associated with intestinal bleeding may also leave clues in the skin?
»What is pyoderma gangrenosum?
»A patient presents with anemia, blood in the stool, and red macules on his lips/tongue. What diagnosis should I first consider?
»What other diagnoses should I consider when seeing a patient with macules on the lips?
»What is the best treatment for patients with Peutz-Jeghers syndrome?
»What is pseudoxanthoma elasticum (PXE)? How does this cause GI bleeding?
»What is Gardner’s syndrome?
»How can cancer of the gastrointestinal tract present in the skin?
»What is “malignant” acanthosis nigricans (AN)?
»What is superficial migratory thrombophlebitis (SMT)?
»How is inflammation of the fat (panniculitis) associated with pancreatic disease?
»What chronic liver disease associated with photosensitivity causes blistering and scarring of the skin?
»What chronic skin disease is associated with a gluten-sensitive enteropathy?
»How is dermatitis herpetiformis treated?

 
 
 

What is the best treatment for patients with Peutz-Jeghers syndrome?

Surgery. The gold standard is prophylaxis and polypectomy of the entire small bowel. Treatment of patients with inhibitors of cyclooxygenase-2 (COX-2 inhibitors, celecoxib) may lead to a dramatic reduction in the burden of polyps and need for surgical resection. Ongoing research indicates that Rapamycin (sirolimus) shows promise for PJS treatment by binding to FKBP12, which results in antiproliferative effects and dramatic reduction of polyp production/size.

Kopacova M, Tacheci I, Rejchrt S, Bures J: Peutz-Jeghers syndrome: diagnostic and therapeutic approach, World J Gastroenterol 15(43):5397–5408, 2009.