Cutaneous signs of nutritional disorders

Abstract

This review article focuses on the dermatologic manifestations of selected nutrient deficiencies, including protein-energy and micronutrient-related malnutrition. The various nutrient deficiencies presented may share common features. However, distinctive cutaneous signs may prompt clinicians to consider a nutritional cause and help distinguish a nutrient deficiency from other common dermatologic conditions. The recent reemergence of forgotten nutritional deficiencies, such as scurvy and pellagra, in the context of predisposing risk factors that may uniquely affect women more than men makes this topic timely. Recognition of nutritional disorders is important because appropriate treatment may reverse cutaneous signs and prevent irreversible sequelae.

When to Worry It’s More than Atopic Dermatitis

“…65,66 Clinical manifestations include angular stomatitis, glossitis, cheilosis, perioral dermatitis, nasolabial dermatitis, genital dermatitis, and rarely, corneal vascularization. 67 Rarely do patients present with the full spectrum of symptoms. 67 Vitamin B3 (niacin) deficiency clinically presents as pellagra.…”

“…67 Rarely do patients present with the full spectrum of symptoms. 67 Vitamin B3 (niacin) deficiency clinically presents as pellagra. Most often, this condition affects those experiencing homelessness, alcohol use disorder, drug use, and those with anorexia.…”

Unveiling Skin Manifestations: Exploring Cutaneous Signs of Malnutrition in Eating Disorders

“…This resemblance can result in potential misdiagnosis if healthcare professionals do not carefully differentiate between manifestations of malnutrition and those of other unrelated conditions. Distinguishing between these overlapping presentations requires a nuanced understanding of dermatology and nutrition [ 46 ].…”

Skin Conditions and Movement Disorders: Hiding in Plain Sight

“…3A); 129 with vesicles or bullae in severe form termed wet pellagra. 130 Pellagra typically responds well to niacin or nicotinamide administered either orally or intravenously (300 mg/day divided into 3-4 doses, 3-4 weeks) and a diet enriched in niacin, as well as to supplementation of other group B vitamins (multivitamin deficiency is seen in majority of patients, especially alcohol abusers). 131…”

“…Pellagra dermatitis is a photosensitive eruption, typically bilateral, symmetrical, limited to sun‐exposed sites with a sharp line of demarcation from unexposed skin (dorsal hands and feet, face, neck/upper chest—collar‐like lesion on the neck is called “Casal's necklace“); reddish at the beginning and dry, dark, scaly and cracked later on (hyperpigmented, hyperkeratotic plaques, Fig. 3A); 129 with vesicles or bullae in severe form termed wet pellagra 130 . Pellagra typically responds well to niacin or nicotinamide administered either orally or intravenously (300 mg/day divided into 3–4 doses, 3–4 weeks) and a diet enriched in niacin, as well as to supplementation of other group B vitamins (multivitamin deficiency is seen in majority of patients, especially alcohol abusers) 131…”