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Dermatology > Nutritional deficiency and the skin > Flashcards

Nutritional deficiency and the skin Flashcards

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1
Q

What are some mechanisms of nutritional deficiency?

A
  • Dietary insufficiency
  • Bowel malabsorption
  • Concomitant drugs affecting absorption
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2
Q

Who is most at risk of nutritional deficiency in modern society?

A

Food faddists
Those with eating disorders
Infants

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3
Q

What are the uses of vitamin A in the skin?

A

Epithelial proliferation, keratinisation and development

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4
Q

Wha are some sources of vitamin A?

A
  • Animal
    • Milk
    • Liver
    • Eggs
    • Oily fish
  • Plant
    • Green leafy veg
    • Bright yellow/orange fruit (E.g. mango)
    • Bright yellow/orange veg (E.g. Carrots)
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5
Q

What are some skin manifestations of vitamin A deficiency?

A

Keratotic follicular papules on the thighs and upper arms, with presence of dry skin

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6
Q

How is vitamin A deficiency diagnosed?

A

Serum vitamin A

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7
Q

What is the importance of vitamin K?

A

Production of several coagulation factors

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8
Q

What are some sources of vitamin K?

A
  • Green leafy veg
  • Liver
  • Legumes
  • Vegetable oils
  • GI tract bacteria (Produced in the GI tract)
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9
Q

What are some skin manifestations of vitamin K deficiency?

A

Bleeding tendency, presenting with purpura and easy bruising

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10
Q

How is vitamin K deficiency diagnosed?

A

Measuring coagulation and serum vitamin K

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11
Q

What is the name for vitamin B2?

A

Riboflavin

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12
Q

What are some sources of vitamin B2?

A
  • Milk
  • Liver
  • Meat
  • Eggs
  • Leafy green veg
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13
Q

How will vitamin B2 deficiency present in the skin?

A

Lesions on the margins of the lips (Cheilosis) and corners of the mouth (Angular stomatitis)

The patients tongue may also become painful, red and dry

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14
Q

How is vitamin B2 deficiency diagnosed?

A

measuring the activity coefficient of erythrocyte glutathione reductase (EGR)

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15
Q

What is the name of vitamin B3?

A

Niacin

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16
Q

What are some sources of vitamin B3?

A
  • Meat
  • Fish
  • Nuts
  • Coffee
  • Converted from dietary tryptophan in the body
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17
Q

What disease is caused by vitamin B3 deficiency?

A

Pellagra

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18
Q

Where is pellagra most commonly found?

A

Endemic in areas with high grain, low meat diet such as in Indo-China

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19
Q

How will pellagra (Vitamin B3 deficiency) present?

A

This presents with the 4Ds:

D - Dermatitis - Bilateral, symmetrical, itchy, red rash, worse on sun-exposed areas

D - Delirium - Headaches, irritability, anxiety, depression, memory impairment

D - Diarrhoea - With abdominal pain, nausea and vomiting

D - Death - In 4-5 years if not treated

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20
Q

How is vitamin B3 deficiency diagnosed?

A

It is difficult to measure niacin levels, however, diagnosis can be made with nicotinamide therapy, which will bring rapid improvement

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21
Q

What are some sources of vitamin B6?

A
  • Meats
  • Cereals
  • Milk
  • Potatoes
  • Bananas
  • Nuts
  • Pulses
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22
Q

How will vitamin B6 deficiency present on the skin?

A

Dermatitis of face, scalp, neck, shoulders, buttocks and perineum, with tongue inflammation (glossitis)

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23
Q

How is vitamin B6 deficiency diagnosed?

Study These Flashcards
A

Measuring serum or urinary vitamin B6

24
Q

What are some sources of folate?

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A
  • Liver
  • Green leafy veg
  • Beans
  • Nuts
  • Milk
25
What are some sources of vitamin B12?
- Meat - Milk - Fish - Eggs
26
How will folate deficiency present on the skin?
Anaemia, angular stomatitis, glossitis, hair depigmentation and skin and mucous membrane pigmentation
27
How will B12 deficiency present?
Anaemia, angular stomatitis, glossitis, hair depigmentation and skin, mucous membrane pigmentation and neurological symptoms due to demyelination
28
What is the function of biotin?
Biotin is an essential co-factor for carboxylase enzymes
29
What are some sources of biotin?
- Cereals - Meat - Milk - Eggs - Pulses - Nuts - Produced by GI bacteria
30
When are skin presentations usually found in biotin deficiency?
Only n severe malabsorptive states or cases of inadequate parenteral nutrition
31
What are some skin presentations of severe biotin deficiency?
Facial dermatitis Glossitis Alopecia
32
How is biotin deficiency diagnosed?
Measuring serum biotin
33
What is the name of vitamin C?
Ascorbic acid
34
What is the function of vitamin C?
Vitamin C is an essential co-factor in collagen formation (e.g. hair, bone and teeth)
35
What are some sources of vitamin C?
- Citrus fruit - Strawberries - Blackcurrants - Tomatoes - Potatoes
36
What are some skin presentations of vitamin C?
Hyperkeratosis around hair follicles, bent hairs, inflamed gums, poor wound healing, as well as fatigue, malaise, muscle and bone pain
37
How is vitamin C deficiency diagnosed?
This is usually a clinical diagnosis, as vitamin C supplement brings rapid improvement
38
What is the name given to vitamin C deficiency?
Scurvy
39
What is the function of zinc in the skin?
It is required for structure and function of skin and is vital for wound healing
40
What are some sources of zinc?
- Meat - Fish - Milk - Eggs - Cereals - Nuts - Pulses
41
What are the 2 types of zinc deficiency?
Genetic Acquired
42
What genetic condition leads to zinc deficiency?
Acrodermatitis enteropathica
43
What is acrodermatitis enteropathica?
This is an autosomal recessive condition resulting in lack of zinc absorption
44
How will infants present with acrodermatitis enteropathica?
Diarrhoea, alopecia, dry / brittle hair, perioral, facial and acral (i.e. hands and feet) dermatitis.
45
What are some causes of acquired zinc deficiency?
Increased elimination of zinc secondary to burns or infection
46
How will acquired zinc deficiency present?
Dermatitic rash of hands and feet mainly and growth retardation in children.
47
How is acquired zinc deficiency diagnosed?
Serum zinc measurement
48
How common is protein energy malnutrition (PEM)?
One third of the world’s children are affected by PEM
49
How can protein energy malnutrition cause death?
Associated infection Dehydration
50
What are the 2 forms of PEM?
- Marasmus - Kwashiokor
51
What is marasmus?
This is a global nutrient deficiency causing weight loss by fat breakdown
52
How will children with marasmus present?
Muscle wasting No oedema Dry, winkled, loose skin Thin, brittle hair with alopecia
53
What causes kwashiorkor?
Very low protein intake with reasonable carbohydrate intake
54
How does kwashiorkor present in children?
Oedema Enlarged abdomen (Pot belly) Irregular or patchy skin pigment change Dark, dry skin Skin splitting when stretched revealing pallor (Crazy-paving dermatoses)
55

Dermatology (38 decks)

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