Nutrition in dermatology

Question 1

What is a food allergy?

Answer 1

Adverse immune reaction to a food.

-Symptoms arise due to an IgE-mediated immune reaction (may be T-cell mediated)

Question 2

What is food intolerance?

Answer 2

A non-immune reaction to food (e.g. lactose intolerance)

Question 3

What are the adverse effects of obesity on skin physiology? (7)

Answer 3

1. Poor wound healing (insufficient collagen deposition)
2. Barrier failure (increased TEWL)
3. Apocrine and Eccrine glands - increased activity in skin folds
4. Increased skin blood flow contributes to hypertension
5. Lymphatic flow impeded by fat.
6. Increased endocrine hormone (e.g. testosterone) production by adipose tissue
7. Increased androgens stimulate sebaceous oil production

Question 4

How does obesity cause Lymphoedema?

Answer 4

1. subcutaneous fat reduces lymphatic drainage
2. swelling leads to inflammation and eventually fibrosis
3. reduced tissue oxygenation leads to infection
4. cellulitis causes further damage to lymphatics

Question 5

How does obesity lead to Chronic venous insufficiency?

Answer 5

1. Abdo obesity restricts venous return from legs
2. veins and valves become incompetent - varicose veins develop
3. increased pressure causes RBC leakage into tissues
4. chronic inflammation causes scarring
5. skin is prone to Venous ulceration

Question 6

Intertigo is…

Answer 6

…macerated red plaques developing in skin folds due to moisture, high pH, friction and impaired barrier (in obese patients).

Question 7

What direct skin manifestations of obesity are associated with insulin resistance (high circulating insulin)?

Answer 7

1. Acanthosis nigricans - pigmented and thickened skin folds

2. Skin tags - axillae and neck

Question 8

What direct skin manifestations of obesity are caused by hyper-androgenism?

Answer 8

1. Hirsutism (male hair distribution in females)
2. Acne
3. Androgenic alopecia
4. Hidradentis supprativa - boils & abscesses lead to scarring in apocrine gland areas

Question 9

Psoriasis is more likely to occur in obese patients (T/F)

Answer 9

True

Question 10

Vitamin __ deficiency presents with keratotic follicular papules in thighs and upper arms.

Answer 10

Vitamin A

Question 11

Deficiency of what vitamin causes Pellagra?

Answer 11

Vitamin B3 (Niacin)

Question 12

What is Pellagra? (4Ds)

Answer 12

Dermatitis - bilateral, symmetrical
Delirium - headaches, irritability, anxiety, depression, memory impariment
Diarrhoea
Death

Question 13

_____ deficiency predisposes to bruising and bleeding.

Answer 13

Vitamin K

Question 14

_____ and _____deficiencies causes anaemia, angular stomatitis, glossitis and hair depigmentation.

Answer 14

Folate and Vitamin B12

Question 15

What deficiency causes cheilosis, angular stomatitis and a pairful, red, dry tongue?

Answer 15

Vitamin B2 (Riboflavin) deficiency.

Question 16

Which vitamin is only found in foods of animal origin?

Answer 16

Vitamin B12

Question 17

____ deficiency causes neurological disorders.

Answer 17

Vitamin B12

Question 18

Inflamed gums, poor wound healing, and hyperkeratosis around hair follicles results from…

Answer 18

Vitamin C deficiency

Question 19

____ deficiency commonly arises due to increased elimination resulting from burns or infections.

Answer 19

Zinc