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- Why it happens: Liver disease (especially cholestatic types like PBC or PSC) causes bile salts to build up in the blood, irritating nerve endings in the skin—often worse on the palms and soles, but can affect legs.
- What it feels like: Deep, burning itch that doesn’t improve with lotion—and may worsen at night.
3. Spider Angiomas or Red Palms (Palmar Erythema)
- Why it happens: Liver dysfunction leads to hormone imbalances and dilated blood vessels.
- On legs: Look for small, spider-like red blood vessels (spider angiomas) on thighs or calves.
- On palms: Bright red, warm palms that don’t fade when pressed.
4. Muscle Cramps or Weakness in the Legs
- Why it happens: Advanced liver disease can cause electrolyte imbalances (low potassium, magnesium) and toxin buildup, leading to painful cramps, twitching, or general leg fatigue.
- Often worse at night—disrupting sleep.
5. Easy Bruising or Purple Spots (Purpura) on Legs
- Why it happens: The liver makes clotting factors. When it’s impaired, you bruise easily or develop small purple spots (petechiae) from minor bumps or even pressure.
- Look for: Unexplained bruises on shins or thighs that take weeks to fade.
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