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Dermatology > Nutritional deficiency and the skin > Flashcards

Nutritional deficiency and the skin Flashcards

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Dermatology Board Prep flashcards
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?

A

Measuring serum or urinary vitamin B6

24
Q

What are some sources of folate?

A
  • Liver
  • Green leafy veg
  • Beans
  • Nuts
  • Milk
25
Q

What are some sources of vitamin B12?

A
  • Meat
  • Milk
  • Fish
  • Eggs
26
Q

How will folate deficiency present on the skin?

A

Anaemia, angular stomatitis, glossitis, hair depigmentation and skin and mucous
membrane pigmentation

27
Q

How will B12 deficiency present?

A

Anaemia, angular stomatitis, glossitis, hair depigmentation and skin, mucous
membrane pigmentation and neurological symptoms due to demyelination

28
Q

What is the function of biotin?

A

Biotin is an essential co-factor for carboxylase enzymes

29
Q

What are some sources of biotin?

A
  • Cereals
  • Meat
  • Milk
  • Eggs
  • Pulses
  • Nuts
  • Produced by GI bacteria
30
Q

When are skin presentations usually found in biotin deficiency?

A

Only n severe malabsorptive states or cases of inadequate parenteral nutrition

31
Q

What are some skin presentations of severe biotin deficiency?

A

Facial dermatitis
Glossitis
Alopecia

32
Q

How is biotin deficiency diagnosed?

A

Measuring serum biotin

33
Q

What is the name of vitamin C?

A

Ascorbic acid

34
Q

What is the function of vitamin C?

A

Vitamin C is an essential co-factor in
collagen formation (e.g. hair, bone and teeth)

35
Q

What are some sources of vitamin C?

A
  • Citrus fruit
  • Strawberries
  • Blackcurrants
  • Tomatoes
  • Potatoes
36
Q

What are some skin presentations of vitamin C?

A

Hyperkeratosis around hair follicles, bent hairs, inflamed gums, poor wound healing, as well as fatigue, malaise, muscle and bone pain

37
Q

How is vitamin C deficiency diagnosed?

A

This is usually a clinical diagnosis, as vitamin C supplement brings rapid improvement

38
Q

What is the name given to vitamin C deficiency?

A

Scurvy

39
Q

What is the function of zinc in the skin?

A

It is required for structure and function of skin and is vital for wound healing

40
Q

What are some sources of zinc?

A
  • Meat
  • Fish
  • Milk
  • Eggs
  • Cereals
  • Nuts
  • Pulses
41
Q

What are the 2 types of zinc deficiency?

A

Genetic
Acquired

42
Q

What genetic condition leads to zinc deficiency?

A

Acrodermatitis enteropathica

43
Q

What is acrodermatitis enteropathica?

A

This is an autosomal recessive condition resulting in lack of zinc absorption

44
Q

How will infants present with acrodermatitis enteropathica?

A

Diarrhoea, alopecia, dry / brittle hair, perioral, facial and acral (i.e. hands and feet) dermatitis.

45
Q

What are some causes of acquired zinc deficiency?

A

Increased elimination of zinc secondary to burns or infection

46
Q

How will acquired zinc deficiency present?

A

Dermatitic rash of hands and feet mainly and growth retardation in children.

47
Q

How is acquired zinc deficiency diagnosed?

A

Serum zinc measurement

48
Q

How common is protein energy malnutrition (PEM)?

A

One third of the world’s children are affected by PEM

49
Q

How can protein energy malnutrition cause death?

A

Associated infection
Dehydration

50
Q

What are the 2 forms of PEM?

A
  • Marasmus
  • Kwashiokor
51
Q

What is marasmus?

A

This is a global nutrient deficiency causing weight loss by fat breakdown

52
Q

How will children with marasmus present?

A

Muscle wasting
No oedema
Dry, winkled, loose skin
Thin, brittle hair with alopecia

53
Q

What causes kwashiorkor?

A

Very low protein intake with reasonable carbohydrate intake

54
Q

How does kwashiorkor present in children?

A

Oedema
Enlarged abdomen (Pot belly)
Irregular or patchy skin pigment change
Dark, dry skin
Skin splitting when stretched revealing pallor (Crazy-paving dermatoses)

55
Q
A

Dermatology (38 decks)

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