Dermatological manifestations among inpatients with substance use disorders: a comparative study of individuals with alcohol and drug use.

BACKGROUND

Substance use disorders (SUD), encompassing alcohol use disorder (AUD) and non-alcohol psychoactive drug use disorder (DUD), are associated not only with psychiatric and systemic health outcomes but also with dermatological manifestations. Nevertheless, such cutaneous findings often remain under-recognized. The present study aimed to investigate and compare the prevalence and characteristics of dermatological findings among inpatients with AUD and DUD.

METHODS

This descriptive cross-sectional study was conducted at a tertiary psychiatric hospital. The 109 hospitalized patients were categorized into two groups based on their primary diagnosis: AUD (n = 33) and DUD (n = 76). Clinical data included sociodemographic features, substance use characteristics, and comorbidities. Dermatological diagnoses were established through physical examination and classified according to ICD-10.

RESULTS

Dermatological conditions were identified in nearly all participants (AUD:100%, DUD:94.7%). However, almost half (43.1%) reported no dermatological complaints beforehand, and a majority (60.6%) had never sought dermatological care. Xerosis (24.2%/7.9%), dermatophytosis (78.8%/57.9%), rosacea (36.4%/2.6%), and mucosal findings (100%/82.9%) were significantly more frequent in AUD. In contrast, hesitation marks (48.7%/9.1%), dermatitis artefacta (78.9%/51.5), sequelae of burns (0%/13.2%) and track marks/sooting tattoos (0%/22.4%) were significantly more common in DUD. Tattoos were more prevalent in patients with DUD (p = 0.018), and correlated with hesitation marks (p < 0.001). All cases of hepatitis B, C, and HIV occurred in the DUD group.

CONCLUSION

Dermatological conditions are common among inpatients with SUD and show distinct profiles between AUD and DUD, yet they are often overlooked in psychiatric settings. Integrating dermatological evaluations into routine care may enhance early detection, prevent complications, and support comprehensive treatment. CLINICAL TRIAL NUMBER: Not applicable.