Signs of alcohol-associated liver disease

P1

P2

P3

P4

P5

• Skin: Spider angiomata, palmar erythema, leukonychia, ecchymoses

Yes

NA

No

Yes

NA

• Eyes: Icteric conjunctivae

Yes

Yes

Yes

Yes

Yes

• Musculoskeletal: Loss of proximal muscle mass, especially temporal wasting

NA

NA

NA

NA

NA

• Cardiovascular: Systemic hypotension; tachycardia suggests alcohol withdrawal syndrome*

Yes

Yes

No

No

No

• Abdominal: Ascites, hepatomegaly, splenomegaly, bruits, caput medusa

Yes

No

No

Yes

No

• Reproductive: Gynecomastia, gonadal atrophy in men

NA

NA

NA

NA

NA

• Neurological:

◦ Alcohol withdrawal syndrome*: Fine tremor, psychomotor agitation, transient hallucinations or illusions

Yes

No

No

Yes

No

◦ Hepatic encephalopathy: Coarse flapping tremor (asterixis), altered consciousness

Yes

No

No

Yes

No

◦ Wernicke-Korsakoff syndrome

Yes

No

No

No

NA

• Hands: Dupuytren’s contracture

NA

NA

No

No

NA

*Specific for alcohol; otherwise nonspecific.