Schulze U M, Pettke-Rank C V, Kreienkamp M, Hamm H, Bröcker E B, Wewetzer C, Trott G E, Warnke A
Department of Child and Adolescent Psychiatry, University of Würzburg, Germany.
Pediatr Dermatol. 1999 Mar-Apr;16(2):90-4. doi: 10.1046/j.1525-1470.1999.00022.x.
The cutaneous signs of anorexia nervosa (AN) and bulimia nervosa (BN) have been described previously in adult patients. For the first time, we present here dermatologic findings in children and adolescents suffering from eating disorders. Thirty consecutive young anorexic and bulimic inpatients (8 to 17 years of age, mean 15.1 years) underwent a standardized dermatologic examination. Patients were checked for abnormalities of the skin including atopic stigmata, dermographism, hair, nails, and oral cavity. Serum was obtained for hemoglobin, iron, zinc, GPT, thyroid, and sex-hormone levels. In 13 patients, the total serum IgE was determined, and a prick test was carried out with defined type I allergens. Findings in order of frequency included xerosis of the skin, white dermographism, diffuse hypertrichosis, acrocyanosis, scars, diffuse effluvium, artifacts, brittle nails, and onychophagia. Significant co-relations were found between the presence of hypertrichosis and the existence of amenorrhea or a body mass index of less than 16. In 22 patients a low T3 level was found. In summary, children and adolescents suffering from AN or BN show dermatologic features similar to those reported in older patients. Special findings in this age group are extensive lanugo hair and signs of autoaggressive behavior.
神经性厌食症（AN）和神经性贪食症（BN）的皮肤体征此前已在成年患者中有所描述。我们首次在此呈现患有饮食失调症的儿童和青少年的皮肤病学检查结果。连续30名年轻的厌食症和贪食症住院患者（年龄8至17岁，平均15.1岁）接受了标准化的皮肤病学检查。检查患者的皮肤异常情况，包括特应性体征、皮肤划痕症、毛发、指甲和口腔。采集血清检测血红蛋白、铁、锌、谷丙转氨酶、甲状腺和性激素水平。对13名患者测定了血清总IgE，并使用特定的I型变应原进行了点刺试验。按出现频率排序的检查结果包括皮肤干燥、白色皮肤划痕症、弥漫性多毛症、手足发绀、疤痕、弥漫性脱发、人为痕迹、指甲变脆和咬甲癖。发现多毛症的存在与闭经或体重指数低于16之间存在显著相关性。在22名患者中发现T3水平较低。总之，患有AN或BN的儿童和青少年表现出与年长患者报告的类似的皮肤病学特征。该年龄组的特殊发现是广泛的胎毛和自我攻击行为的迹象。
