World Health Day

Be in tune with your skin, the barometer of good health

On 7 April we very appropriately commemorate the World Health Organistion’s World Health Day. It is an annual celebration, but this year we specifically recognise the vital role that nurses and midwives play in keeping the world healthy. The world’s attention is rightfully focussed on the COVID-19 pandemic. While personally having been at the frontline of previous pandemics such as the SARS virus in 2003 and the H1N1 in 2009 I can sadly attest that the current pandemic is unlike anything our generation has ever experienced.

In general, people have been forced to think about their own health and to re-evaluate their priorities. The public is bombarded with medical advice; some backed by solid evidence and others more questionable health tips. When you Google how to boost your immune systems, how to protect yourself from the virus or what symptoms and signs to look out for, there is no shortage of information.

If we need to look for anything positive coming from this pandemic, it might be that people are more appreciative and focused on the things that really matter. Such as good general health.

As dermatologists, we are well-aware that the skin is a barometer of general health. The skin as the body’s largest organ should be viewed as a window and an external system that communicates directly with the internal organ environment. We see it all the time – the skin may show changes that reflect a disease that affects other parts of, or even the whole body. This is called a systemic disease.

Although modern medicine provides us with countless sophisticated ways of diagnosing internal disease, the skin is the only organ that is externally accessible to direct clinical examination. Therefore, the skin allows for clinical diagnosis. When we talk about signs of disease on the skin, we also include hair and nail pathology.

Examples of common systemic diseases that can present with skin problems are the following:

  • Many communicable viral infections, such as measles and influenza, may present with a rash.
  • Autoimmune and rheumatological disease is well known to present with skin, hair and nail signs. Dermatologists will often be involved in the diagnosis and treatment of these patients in collaboration with Rheumatology specialists.
  • Adverse reactions to systemic medication often show up as reactions on the skin. This can range from benign self-resolving rashes to life-threatening skin reactions that may require admission to an ICU.
  • Skin findings may raise the possibility of an underlying internal cancer and may serve as early warning signs that might require further investigations.
  • Hormonal abnormalities such as an over- or underactive thyroid gland as well as metabolic diseases, such as diabetes and high cholesterol, can present with very specific skin signs.
  • Some chronic infections, such as tuberculosis (TB), may trigger the immune system by resulting in skin lesions.
  • Even diseases of organ systems that you do not necessarily associate with the skin can cause skin disease. Examples of these might be sarcoidosis of the lung and inflammatory bowel disease.


On World Health Day, the best advice I can give is to ensure you are in touch with your body. If you experience any systemic symptoms and it coincides with skin lesions, one possibility to explore is that it might be a sign of internal disease. Your dermatologist might be the first to make the connection and initiate appropriate tests.

During this time while we self-isolate, we think of those on the frontline such as nurses and other health care workers while they tirelessly fight day in and day out to beat this pandemic. But I am also thinking of everyone who is exposed to enormous levels of stress brought on by the economic, mental and social impact that this pandemic will leave behind.

Now is the time to take extra care of our overall health and wellness.