Skin disorders can serve as early markers of alcohol misuse. Florid facies and flushing are common. Psoriasis in men has been associated with alcohol abuse, and the treatment responsiveness of psoriasis is significantly reduced when daily alcohol use exceeds 80 g per day (Gupta, Schork, Gupta, & Ellis, 1993). Other early skin markers of excessive alcohol use include discoid eczema (coin-shaped, scaly lesions, usually on the lower legs), rosacea, and skin infections such as tinea pedis, pityriasis, and onychomycosis (Higgins & du Vivier, 1992).

Immunosuppression secondary to alcohol intake is the likely mechanism for the increased incidence of skin infections. Squamous cell carcinoma of the oral cavity is increased with heavy alcohol consumption (Smith & Fenske, 2000). Late stages of alcoholism may reveal cigarette burns, bruises, acne, and cutaneous stigmata of liver disease, such as spider nevi and palmer erythema.

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