Liver disease refers to a range of conditions that affect liver function, including hepatitis, cirrhosis, fatty liver disease, and liver failure. The liver plays a crucial role in metabolism, detoxification, and digestion, so its dysfunction leads to systemic complications.

Muehrcke’s lines are paired, white, horizontal bands that appear on the nails due to hypoalbuminemia (low albumin levels). They do not move with nail growth and are commonly seen in chronic liver disease, especially cirrhosis.

Terry’s nails are characterized by a white, opaque nail bed with a narrow pink or brown band at the tip. This condition occurs due to changes in vascular supply and is often linked to liver cirrhosis, chronic kidney disease, and diabetes.

Clubbing is the enlargement of the fingertips with increased curvature of the nails. It results from hypoxia and altered platelet-derived growth factor levels. Clubbing can be seen in liver disease, particularly in cases of hepatopulmonary syndrome associated with cirrhosis.

Ascites is the accumulation of fluid in the peritoneal cavity, leading to abdominal swelling. It occurs due to portal hypertension and low albumin levels in advanced liver disease. Severe ascites may cause respiratory discomfort and an increased risk of spontaneous bacterial peritonitis (SBP).

Caput medusae refers to visibly dilated veins radiating from the umbilicus, caused by portal hypertension. Blood is rerouted through collateral veins due to increased pressure in the portal circulation, leading to this classic sign of cirrhosis.

Varices are enlarged veins, commonly found in the esophagus and stomach, that develop due to portal hypertension. They pose a high risk of rupture, leading to life-threatening gastrointestinal bleeding. Patients may present with hematemesis (vomiting blood) or melena (black, tarry stools).

Palmar erythema is redness of the palms, especially around the thenar and hypothenar eminences. It is associated with increased estrogen levels in chronic liver disease and cirrhosis.

Spider nevi (spider angiomas) are small, red, vascular lesions with a central arteriole and radiating branches. They appear on the upper body and are caused by increased estrogen levels in liver disease.

Muscle wasting (sarcopenia) is common in chronic liver disease due to malnutrition and metabolic disturbances. It leads to weakness and poor physical function, significantly impacting quality of life.

Dupuytren’s contracture is a thickening and shortening of the palmar fascia, leading to finger contractures (especially the ring and little fingers). It is associated with liver disease, likely due to altered collagen metabolism and alcohol-related liver damage.

Hepatic encephalopathy (HE) is a neurological disorder caused by liver failure, leading to an inability to clear toxins like ammonia. Symptoms range from mild confusion and sleep disturbances to severe disorientation, asterixis (flapping tremor), and coma in advanced cases.

Jaundice is yellowing of the skin and sclera due to elevated bilirubin levels. It occurs when the liver cannot effectively process and excrete bilirubin, commonly seen in hepatitis, cirrhosis, and liver failure.

Easy bruising and bleeding result from reduced liver production of clotting factors and platelet dysfunction. Patients with liver disease often experience prolonged bleeding times and may develop petechiae or ecchymoses.

Liver disease prevention includes: