Dermatology Nutrition

Question 1

what are the most common food allergens for children?

Answer 1

wheat, milk, egg, soya, nuts, shellfish, fish

Question 2

what is the prevalence of food allergy in children?

Answer 2

6-8% of <3 year olds have an allergy. Most outgrow their allergy - so re-challenge them from 2yrs old onwards

Question 3

what is the prevalence of food allergy in adults?

Answer 3

1.5%

Question 4

explain how obesity can lead to lymphoedema?

Answer 4

• increased subcutaneous fat reduces lymphatic drainage and leads to swelling
• swelling gradually occurs and causes chronic inflammation leading to fibrosis
• reduced tissue oxygenation and swelling results in bacterial overgrowth
• cellulitis develops easily and leads to further damage
• downward spiral develops if left untreated and skin eventually becomes thick and warty and the lower leg and foot become permanently enlarged (often grossly)

Question 5

Coeliac disease is a food allergy/ food intolerance?

Answer 5

food intolerance

Question 6

Lactose intolerance is an example of food allergy/ food intolerance?

Answer 6

food intolerance

Question 7

list some foods that someone with coeliac disease can safely eat?

Answer 7

fruit, veg, rice, pasta, prescribed gluten-free breads and pastas, meat, fish, potatoes, lentils

Question 8

explain how obesity can lead to chronic venous insufficiency?

Answer 8

• abdo obesity resists venous return from legs
• veins dilate and valves become incompetent (varicose veins develop)
• the increased hydrostatic pressure in the vessels results in RBC leakage into tissue - resulting in swelling, haemosiderin pigmentation, and inflammation (due to breakdown products) - this is called venous (or stasis) dermatitis.
• chronic scarring eventually occurs
• the skin may ulcerate (venous ulcers)

Question 9

is coeliac disease a food allergy/ intolerance?

Answer 9

NEITHER

it’s an autoimmune disease

Question 10

one third of the world’s children are affected by protein malnutrition disorders. Name them and say the difference between them?

Answer 10

marasmus and kwashiorkor
In marasmus there is global nutrient deficiency, whereas in kwashiorkor there is reasonable carbohydrate intake but very low protein intake

Question 11

what is marasmus?

Answer 11

global nutrient deficiency
weight loss by fat breakdown
very thin child with muscle wastin
no oedema
skin is dry, wrinkled, loose due to loss of subcutaneous fat and muscle, thin, brittle hair which falls out - causing alopecia

Question 12

what is kwashiorkor?

Answer 12

caused by very low protein intake
there is reasonable carbohydrate intake
oedema - children develop a “pot bell2
skin has irregular or patchy discolouration caused by pigmentary change
dark, dry skin may split when stretched, revealing pale areas between the cracks (crazy paving dermatosis)