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Blickdiagnose Hautkolorit

Visual diagnosis of skin color alterations

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Zusammenfassung

Die Beurteilung des Hautkolorits kann entscheidende Informationen über Kreislaufsuffizienz, Oxygenierung des Hämoglobins (Hb) und weitere Parameter liefern. So kann ein Ikterus auf eine Prozessierungsstörung des Bilirubins oder eine cholestatische Erkrankung hinweisen. Eine Zyanose hingegen ist Zeichen einer erhöhten Konzentration des Desoxyhämoglobins und zeigt eine erniedrigte Sauerstoffsättigung des Hb an. Ursachen können zyanotische Vitien, pulmonale Erkrankungen oder auch erworbene und kongenitale Methämoglobinämien sein. Blässe ist ein Zeichen für Anämie oder auch Kreislaufinsuffizienz. Zur Beurteilung des Kreislaufzustands wird allerdings die Bestimmung der „capillary refill time“ empfohlen. Hypo- oder Hyperpigmentationen können erworbene oder angeborene Ursachen haben. Differenzialdiagnostisch sollten immer assoziierte syndromale Erkrankungen bedacht werden.

Abstract

Assessment of a patient’s skin color can hold decisive information concerning the circulatory system, oxygenation of hemoglobin and other parameters. Jaundice indicates a disorder in bilirubin metabolism or cholestasis. In contrast, cyanosis reflects an increased concentration of deoxyhemoglobin and a decreased oxygen saturation of hemoglobin. Cyanosis can be the clinical manifestation of cyanotic heart disease, pulmonary diseases or acquired or congenital methemoglobinemia. Pallor is a sign for anemia or circulatory insufficiency. The capillary refill time is a valid tool to assess the state of the patient’s circulation. Hypopigmentation or hyperpigmentation can be caused by congenital or acquired disorders. Differential diagnostics should always take associated syndromal diseases into account.

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Authors and Affiliations

  1. Sektion Pädiatrische Gastroenterologie und Hepatologie, Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin, Johannes Gutenberg-Universität, Langenbeckstr. 1, 55131, Mainz, Deutschland

    D. Schreiner &  S. Gehring

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  1. D. Schreiner
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  2. S. Gehring
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Correspondence to S. Gehring.

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D. Schreiner und S. Gehring geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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F. Zepp, Mainz

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Schreiner, D., Gehring, S. Blickdiagnose Hautkolorit. Monatsschr Kinderheilkd 166, 856–866 (2018). https://doi.org/10.1007/s00112-018-0578-z

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