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: |
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◦ 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. |
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