If skin were merely a sausage casing for the rest of you, it wouldn't be nearly so useful. An organ itself (your body's largest in terms of both weight and surface area), skin protects against invasive bacteria, regulates body temperature and picks up information from the stimulation of touch, pressure, pain, heat and cold. Little wonder, then, that when there's something wrong with you on the inside, your skin sometimes sends up the first warning flare.
"Diabetes, for example, is generally a silent disease, but it can lead to distinct changes to the skin. So the skin may in fact be the first indicator of what's happening," notes dermatologist Amy Newburger, M.D., of Scarsdale, N.Y., a spokesperson for the American Academy of Dermatology.
Here's the skinny on ten dermatologic oddities worth watching for in yourself or someone you love.
Yellowish skin, orange palms and soles
What it means: The cartoonish skin hues of carotenemia can be the unfunny result of an underactive thyroid gland—hypothyroidism—which causes increased levels of beta-carotene in the blood. Beta-carotene is an antioxidant, found in fruits and vegetables, that normally gets processed by the thyroid. When there's a thyroid problem, the gland doesn't metabolize the vitamins as quickly, so beta-carotene accumulates. You can also get Technicolor skin due to beta-carotene buildup thanks to a diet heavy on carrots, carrot juice, sweet potatoes and squash.
More clues: The skin of someone with hypothyroidism also tends to be dry and cold, and sometimes more pale than yellowed. Feeling tired, sluggish, weak or achy are the main symptoms, along with possible unexplained weight gain. Women over 50 most often develop hypothyroidism.
What to do: Carotenemia caused by a skewed diet isn't serious and resolves itself when a broader range of foods is consumed. Hypothyroidism, however, is a medical condition that can lead to such complications as heart problems, so a combination of skin changes plus fatigue warrants attention from a doctor.
Breaking out in hives in the sun
What it means: Being truly allergic to the sun is pretty rare (although this kind of immune system response can happen in some people). A more likely explanation for going outside on a sunny day and coming back with an itchy rash that looks like hives or eczema is having taken a photosensitizing drug. A chemical in the medication causes changes that increase the person's sensitivity to light.
"It's common in the Northeast to have no problem all winter long, and as soon as the weather gets nice and folks are outside less bundled up, the rash appears," says Newburger.
More clues: The rash is limited to sun-exposed areas, including the forearms, the neck and, less commonly, the face. It can feel worse and last longer than a sunburn. It doesn't matter whether you're fair-skinned or dark-skinned; anyone can have a photoreaction. One of the most common drug culprits: thiazide diuretics (Hydrodiuril, Dyazide), which are a first-line treatment for hypertension. Other meds that can produce this effect include antihistamines, tetracycline, the antiaging and antiacne drug tretinoin and tricyclic antidepressants. Two different people can react quite differently to the same drug. Or you may have no reaction one time but a severe reaction later.
What to do: Check the labels of your prescription medications. Look for phrases such as "May cause chemical photosensitivity." Use a high-SPF sunscreen or sunblock but know that this may not prevent the rash; the best advice is to wear sunglasses and a broad-rimmed hat, cover the skin and limit sun exposure. Tell your doctor, too; a switch in medicines may prevent further rashes.
Long dark lines in the palm
What it means: A palm-reading mystic might have her own interpretation, but to a physician, a deepening of the pigment in the creases of the palms or soles is a symptom of adrenal insufficiency, an endocrine disorder. Also known as Addison's disease, the name comes from its discoverer, physician Thomas Addison. Its two most famous victims include President John F. Kennedy and—it's thought—the writer Jane Austen.
More clues: Hyperpigmentation may also be visible around other skin folds, scars, lips and pressure points (knees, knuckles). Addison's sufferers have low blood pressure, which falls further when the person stands. Salt loss can lead to a craving for salty food. The disease affects men and women equally but is found most commonly between ages 30 and 50.
What to do: It's important to mention this visible symptom to a doctor, as skin changes may be the first symptoms seen before an acute attack (pain, vomiting, dehydration and loss of consciousness, a cascade known as an Addisonian crisis). Lab tests to measure cortisol (which is produced by the adrenal gland) provide a diagnosis.
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