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Cutaneous Signs of Nutritional Disturbances

»	When do skin abnormalities occur in association with nutritional disturbances?
»	Do nutritional disturbances involve the skin exclusively?
»	Which skin changes are seen with protein and calorie deprivation in adults?
»	What is marasmus?
»	What is kwashiorkor?
»	Describe the skin findings in kwashiorkor.
»	How can I remember the differences in skin findings associated with kwashiorkor and marasmus?
»	Do skin abnormalities occur with fat deficiency?
»	Are any skin findings associated with fat excess?
»	Which water-soluble vitamin abnormalities have skin findings?
»	What is beriberi?
»	Name the four “Ds” of pellagra.
»	Describe the dermatitis in pellagra.
»	Does scurvy still exist?
»	Do deficiencies of the fat-soluble vitamins occur?
»	What abnormalities occur with vitamin A deficiency?
»	Is vitamin A excess toxic?
»	What is acrodermatitis enteropathica?
»	Has the gene responsible for inherited acrodermatitis enteropathica been identified?
»	How is acrodermatitis enteropathica diagnosed and treated?
»	Can zinc deficiency be acquired?
»	What is carotenoderma?
»	Has supplementation with micronutrients or homeopathic remedies been associated with any cutaneous disorders?

Which water-soluble vitamin abnormalities have skin findings?

Nearly all of the water-soluble vitamins demonstrate skin findings in deficiency states. There is considerable overlap in the skin findings, especially among the B-complex deficiencies, which is expected because they all function as coenzymes or cofactors in redox, carboxylation, or transamination reactions. Common clinical findings in riboflavin (B2), pyridoxine (B6), cobalamin (B12), and biotin deficiencies include angular cheilitis, periorificial dermatitis, and glossitis.

Barthelemy H, Chouvet B, Cambazard F: Skin and mucosal manifestations in vitamin deficiency, J Am Acad Dermatol 15:1263–1274, 1986.