Seeing a skin doctor isn’t just about checking for moles or getting a cream for acne or wrinkles. Dermatologists may see early signs of everything from celiac diseases to diabetes.
More than skin deep
Your next dermatologist visit could reveal important health information that you may not expect. Some 30 to 40 percent of issues dermatologists see may be related to underlying chronic conditions, estimates Lisa Grandinetti, MD, assistant professor of dermatology at the University of Pittsburgh Medical Center. “Skin is the window to your health,” says Wilma Bergfeld, MD, senior dermatologist in the department of dermatology in the Cleveland Clinic. Medical dermatologists are seeing more and more skin issues, especially related to immune system problems, including lupus, rheumatoid arthritis, and inflammatory bowel disease. In many cases, dermatologists might help discover conditions during routine visits—before a specialist would—which can ensure patients get treated in earlier stages of illness. Here are some important conditions your skin doctor has her eyes on. Here are some more details on how to identify common rashes and skin conditions.
Diabetes is very common—almost 10 percent of Americans have it. Dr. Grandinetti estimates that about half have some kind of skin disease. The main one is called acanthosis nigricans, a velvety thickening of the skin that occurs around the neck and in the underarms. Usually patients with these dark patches don’t know they have diabetes when we see them, says Dr. Bergfeld. “In dermatology, they tend to be younger, so we pick up these cases early.” Skin tags are another sign, but they’re not an automatic red flag. “Everybody gets skin tags under their arms every now and then, or in the groin area just from rubbing,” says Dr. Grandinetti. “If somebody has no other risk factors for diabetes—they aren’t overweight, there’s no family history, and they only have one or two skin tags, there’s really no evidence to support further testing. But if someone has multiple skin tags around the neck, in the underarms, and in the groin and they also have acanthosis nigricans, then I usually test their blood glucose levels or A1C levels.” Here are some more silent signs of diabetes you might be missing.
Super itchy clusters of blisters called dermatitis herpetiformis, which commonly occur on the elbows, knees, buttocks, and sometimes the scalp, are a clear sign of one disease: celiac. “If you have this condition, you have celiac, although not everyone with celiac will have dermatitis herpetiformis,” says Dr. Grandinetti. She says patients who have this skin issue who don’t have any GI concerns are often shocked to learn they have celiac. And when they begin a diet free of gluten—the protein found in wheat, rye, and barley that triggers an immune system response in celiac patients—their skin gets better too. Be on the lookout for these symptoms of celiac disease.