Dermatologic Findings in Anorexia and Bulimia Nervosa of Childhood and Adolescence

Schulze, Ulrike; Pettke-Rank, Claudia V.; Kreienkamp, Matthias; Hamm, Henning; Bröcker, Eva‐B.; Wewetzer, Christoph; Trott, Götz‐Erik; Warnke, Andreas

doi:10.1046/j.1525-1470.1999.00022.x

Cited by 94 publications

(53 citation statements)

References 16 publications

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“…This finding appears consistent with Harbauer [46]who describes nail-biting as a form of auto-aggressiveness that in some cases develops into an eating disorder later. This result also agrees with Schulze et al [47], who found onychophagia in 27% and scars in 12% of eating-disordered patients. Although nail-biting is described as an antecedent or comorbid factor of eating disorders [48], it does not appear to be specific for anorexia or bulimia nervosa, since our patients with PSD reported similarly high rates.…”

Section: Discussionsupporting

confidence: 93%

Childhood Body-Focused Behaviors and Social Behaviors as Risk Factors of Eating Disorders

Mangweth

Hausmann

Danzl

et al. 2005

Psychother Psychosom

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Background: The risk factors for adolescent eating disorders are poorly understood. It is generally agreed, however, that interactions with one’s body and interactions with others are two important features in the development of anorexia and bulimia nervosa. Therefore, we assessed a variety of childhood body-focused behaviors and childhood social behaviors in eating-disordered patients as compared to non-eating-disordered subjects. Method: We compared 50 female inpatients with eating disorders (anorexia or bulimia nervosa), 50 female inpatients with polysubstance dependence, and 50 nonpatient female control subjects with no history of eating or substance abuse disorders (all defined by DSM-IV criteria), using a semi-structured interview of our own design. We asked questions about (1) childhood body-focused behaviors (e.g. thumb-sucking) and body-focused family experiences (e.g. bodily caresses), and (2) childhood social behaviors (e.g. numbers of close friends) and family social styles (e.g. authoritarian upbringing). Results: Many body-focused measures, such as feeding problems, auto-aggressive behavior, lack of maternal caresses, and family taboos regarding nudity and sexuality, characterized eating-disordered patients as opposed to both comparison groups, as did several social behaviors, such as adjustment problems at school and lack of close friends. However, nail-biting, insecure parental bonding, and childhood physical and sexual abuse were equally elevated in both psychiatric groups. Conclusion: It appears that eating-disordered patients, as compared to substance-dependent patients and healthy controls, show a distinct pattern of body-focused and social behaviors during childhood, characterized by self-harm, a rigid and ‘body-denying’ family climate, and lack of intimacy.

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Section: Discussionsupporting

confidence: 93%

Childhood Body-Focused Behaviors and Social Behaviors as Risk Factors of Eating Disorders

Mangweth

Hausmann

Danzl

et al. 2005

Psychother Psychosom

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“…In accordance with the literature, xerosis, hair effluvium, acne, cheilitis, gingivitis, nail changes and acrocyanosis were the most frequently observed symptoms [2, 3, 5, 6, 7]. The pathogenetic mechanism responsible for the development of cutaneous signs in AN has been debated in many studies [9, 10, 11, 12, 13, 14, 15, 16].…”

Section: Discussionsupporting

confidence: 59%

“…Eating disorders are becoming an epidemic also in Europe, particularly among young women, but European studies concerning this topic are few [1, 2, 3]. Eating disorders mainly include anorexia nervosa (AN), bulimia nervosa (BN) and eating disorders not specified.…”

Section: Introductionmentioning

confidence: 99%

Skin Signs in Anorexia nervosa

et al. 2001

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Background: Eating disorders are becoming an epidemic in Europe, particularly among young women, but European studies concerning this topic are few. In eating disorders, significant medical complications occur in all of the primary human organ systems, including the skin. Objective: The purpose of this study was to improve the knowledge of skin signs in anorexia nervosa (AN) and verify whether cutaneous differences exist between the restrictive type and the bulimic type. Methods: A noncontrolled clinical study was performed in 24 consecutive patients with the restrictive and the bulimic types of AN in order to verify whether the cutaneous signs are different in the two types. The dermatological examination included the entire skin, oral cavity, hair and nails, with attention to skin pathologies prior to the development of AN. Results: In all the patients, the most frequent skin manifestations were xerosis (58.3%), hair effluvium (50%), nail changes (45.8%), cheilitis (41.6%), acne (41.6%), gingivitis (33.3%), acrocyanosis (29%), diffuse hypertrichosis (25%), carotenoderma (20.8%), generalized pruritus (16.6%), hyperpigmentation (12.5%), striae distensae (12.5%), factitial dermatitis, seborrheic dermatitis (8.3%), poor wound healing, melasma and Russell’s sign (4.1%). In the patients with the bulimic type of AN, hair effluvium, acne, gingivitis, nail changes and generalized pruritus were more frequent than in the patients with the restrictive type. Russell’s sign and seborrheic dermatitis were exclusively detected in the bulimic type. Hyperpigmentation, striae distensae, factitial dermatitis, poor wound healing and melasma were exclusively observed in the restrictive type. Cheilitis, diffuse hypertrichosis and carotenoderma were more represented in the restrictive type. Two patients with restrictive type of AN were followed up for a period of 3 years. In both, xerosis, cheilitis, acrocyanosis, hyperpigmentation and acne improved in relation to the increase in BMI. Hair effluvium and diffuse hypertrichosis appeared not to be linked to this parameter. Conclusion: Skin changes are prevalent among patients with AN. Some changes seem to depend on the type of AN or to be linked to the BMI.

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“…Die Hautveränderungen der Akne befinden sich v. a. fazial und am Rücken, verbunden mit Kratzexkoriationen [4]. Zur Akne kann es zum einen durch das Fasten und Hungern bei AN kommen, zum anderen sind Patienten mit AN meist jugendliche Mädchen -der Häufigkeitsgipfel liegt zwischen dem 14. und 16.…”

Section: Akneunclassified

Hautveränderungen bei Anorexia nervosa

2007

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Anorexia nervosa (AN) is one of the most dangerous psychiatric diseases; it bears a poor prognosis, marked addictive potential and a high risk of suicide. The earlier the eating disorder is diagnosed and treated, the better the prognosis of AN. A number of dermatological conditions may be associated with AN, although none are specific for AN. These findings include xerosis cutis, effluvium, gingivitis, cheilitis, acne and nail lesions. The cutaneous findings often observed in AN may be localized to the hands ("anorectic hand"), which should therefore always be examined if AN is suspected. The diagnosis of AN can thus be facilitated by knowledge of the cutaneous manifestations, which are generally plain to see. If AN is strongly suspected, the patient should be encouraged to consult a psychiatrist/psychotherapist.

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Dermatologic Findings in Anorexia and Bulimia Nervosa of Childhood and Adolescence

Cited by 94 publications

References 16 publications

Childhood Body-Focused Behaviors and Social Behaviors as Risk Factors of Eating Disorders

Childhood Body-Focused Behaviors and Social Behaviors as Risk Factors of Eating Disorders

Skin Signs in Anorexia nervosa

Hautveränderungen bei Anorexia nervosa

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