It may be time to rethink the words “skin deep.” According to board-certified dermatologist Susan Touma, MD, of Huntington Dermatology Inc., the skin has a greater role in our overall health than most people realize.

“Our skin is a window into our well-being,” Dr. Touma said. “Skin changes can sometimes point to a more serious health problem, and a number of internal diseases show their first signs on the skin.”

Certain changes in the skin may be more than skin deep, she said.

A rash may be more than skin deep.

A rash accompanied by joint or muscle pain or a fever could indicate an internal infection, such as hepatitis C. It could also indicate certain internal cancers, including ovarian cancer and kidney cancer.

“Dermatomyositis is an inflammatory muscle disease that is tied to several different cancers, and it usually starts as a purple rash around your eyelids, knuckles or nails,” Dr. Touma said. “If you see a rash in any of those areas, call your dermatologist. You don’t want to wait to find out what’s causing it.”

Most people know rashes can occur as an allergic reaction to medication, she said, but that doesn’t mean those reactions should go untreated. DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome is a serious condition that can occur weeks or even months after starting a new medication. The rash often looks the same as other, less serious drug reactions.

“DRESS can actually be fatal if the medication isn’t stopped soon enough,” said Dr. Touma. “Continuing to take the medication puts you at a higher risk for liver, kidney, lung and heart damage. If you think you’re experiencing a drug reaction, especially if the rash is accompanied by swelling in your face or neck, stop taking the medication and call your doctor.”

Several other internal diseases and infections cause rashes, Dr. Touma said. Yellow or orange bumps in the skinfolds or on the legs, arms or torso can indicate poor blood sugar control, a symptom of diabetes. A purple rash on the tops of the feet can be an early sign of hepatitis C. A common symptom of lupus is a rash on the bridge of the nose and cheeks. An autoimmune disease called reactive arthritis – usually caused by chlamydia or salmonella – can produce small sores on the palms and soles of the feet. In women, acne that appears along the jawline can be a sign of polycystic ovarian syndrome (PCOS).

“You are your own best medical detective,” Dr. Touma said. “Anytime you have a rash, keep a close eye on it and watch for other symptoms like swelling, fever or just a general ‘yucky’ feeling. You know your body better than anyone.”

Skin color and texture may be more than skin deep.

Many are aware that yellowing of the skin can be a sign of liver disease. However, Dr. Touma said, any change in skin color is worth noting.

“Darkening in the creases of your skin or in old scars can indicate an adrenal gland disorder like Addison’s disease,” she said. “Bronzing of the skin can be a sign of a genetic disorder called hemochromatosis. If hemochromatosis goes untreated, it can cause liver failure.”

Individuals should also look for changes in the texture of their skin. Dry, itchy skin can be evidence of an underactive thyroid. Acanthosis nigricans, an indicator of early diabetes, looks like velvety, darkened skin on the back of the neck and in the skinfolds. High blood pressure and kidney problems sometimes cause thickening of the skin, and an autoimmune disease called systemic sclerosis can cause swelling and hardening. Loose, silky skin can be a symptom of acquired cutis laxia, a rare disease linked to lymphoma and other blood cancers.

“The skin provides us with clues for many underlying medical problems,” Dr. Touma said. “Any time you have a skin change that you can’t explain, don’t wait. Call a dermatologist.”

Moles may be more than skin deep.

Of course, the most common reason to monitor changes in the skin is to look for possible skin cancer. About once a month, Dr. Touma said, men and women should check their skin for moles and growths that have changed in color, size, thickness or texture. Skin cancer is the most common cancer, but when diagnosed and treated early it’s also the easiest to cure.

“Many people believe that cancer located on the skin won’t directly involve their other organs,” Dr. Touma said. “But the skin is the largest organ in the body. Think about how likely it is that a cancer on your largest organ will spread to the rest of your body.”

If you have concerns about a change in your skin or to schedule a preventative skin exam with Dr. Touma, call Huntington Dermatology at 304.523.5100.