Clinical and forensic signs related to ethanol abuse: a mechanistic approach

Abstract

For good performance in clinical and forensic toxicology, it is important to be aware of the signs and symptoms related to xenobiotic exposure since they will assist clinicians to reach a useful and rapid diagnosis. This manuscript highlights and critically analyses clinical and forensic imaging related to ethanol abuse. Here, signs that may lead to suspected ethanol abuse, but that are not necessarily related to liver disease are thoroughly discussed regarding its underlying mechanisms. This includes flushing and disulfiram reactions, urticaria, palmar erythema, spider telangiectasias, porphyria cutanea tarda, “paper money skin”, psoriasis, rhinophyma, Dupuytren’s contracture, multiple symmetrical lipomatosis (lipomatosis Lanois–Bensaude, Madelung’s disease), pancreatitis-related signs, black hairy tongue, gout, nail changes, fetal alcohol syndrome, seborrheic dermatitis, sialosis and cancer.

• Ethanol
• black hairy tongue
• Dupuytren’s contracture
• fetal alcohol syndrome
• porphyria cutanea tarda
• psoriasis
• rhinophyma
• spider telangiectasias

Acknowledgements

The authors confirm appropriate permissions were obtained to publish all figures cited from other publications, and acknowledge sole responsibility for use of the figures.