title: Clinical and forensic signs related to ethanol abuse: a mechanistic approach.
abstract: For good performance in clinical and forensic toxicology, it is important to be aware of the signs and symptoms related to xenobiotic exposure since they will assist clinicians to reach a useful and rapid diagnosis. This manuscript highlights and critically analyses clinical and forensic imaging related to ethanol abuse. Here, signs that may lead to suspected ethanol abuse, but that are not necessarily related to liver disease are thoroughly discussed regarding its underlying mechanisms. This includes flushing and disulfiram reactions, urticaria, palmar erythema, spider telangiectasias, porphyria cutanea tarda, "paper money skin", psoriasis, rhinophyma, Dupuytren's contracture, multiple symmetrical lipomatosis (lipomatosis Lanois-Bensaude, Madelung's disease), pancreatitis-related signs, black hairy tongue, gout, nail changes, fetal alcohol syndrome, seborrheic dermatitis, sialosis and cancer.
authors.affiliation: IINFACTS -- Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, Advanced Institute of Health Sciences - North, CESPU, CRL , Gandra , Portugal .
authors.forename: Ricardo Jorge
authors.initials: RJ
authors.lastname: Dinis-Oliveira
authors.forename: Teresa
authors.initials: T
authors.lastname: Magalhães
authors.forename: Roxana
authors.initials: R
authors.lastname: Moreira
authors.forename: Jorge Brandão
authors.initials: JB
authors.lastname: Proença
authors.forename: Helena
authors.initials: H
authors.lastname: Pontes
authors.forename: Agostinho
authors.initials: A
authors.lastname: Santos
authors.forename: José Alberto
authors.initials: JA
authors.lastname: Duarte
authors.forename: Félix
authors.initials: F
authors.lastname: Carvalho
mesh_terms: D000437:Alcoholism / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D053593:Forensic Toxicology; D006801:Humans; D008297:Male