MD. Physician, Department of Pathology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil.
MD, PhD. Associate Professor with Tenure (Phased Retirement), Department of Dermatology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil.
Sao Paulo Med J. 2022 Sep-Oct;140(5):723-733. doi: 10.1590/1516-3180.2021.0616.R1.17022022.
The number of bariatric surgeries performed worldwide is growing. Among the main short, medium or long-term complications after surgery are nutritional deficiencies. Many of these, such as those of Zn, Cu and vitamins A, B1, B3, B6 and B12, are manifested by dermatological lesions before potentially fatal systemic disorders occur.
To identify the main dermatological manifestations associated with nutritional deficiencies after bariatric surgery, and the associated variables.
Integrative literature review carried out at a public university in Brazil.
This was a case report and a review of health research portals and databases of national and international biomedical journals, without publication date limitation. The descriptors used for searches followed the ideal methodology for each database/search portal: "bariatric surgery", "skin", "skin disease", "skin manifestation", "deficiency disease" and "malnutrition".
A total of 59 articles were selected, among which 23 were review articles or articles that addressed specific dermatological manifestations. The other 36 articles described 41 cases, which were organized into a table with the clinical variables.
Although nutritional deficiencies are expected as complications after bariatric surgery, few articles relating them to their dermatological manifestations were found. It is important to recognize skin changes caused by nutritional deficiencies in patients treated via bariatric surgery, as these may occur before systemic complications appear and are easier to diagnose when the patient does not have any systemic symptoms yet. However, there is generally a delay between the appearance of skin lesions and making the diagnosis of nutritional deficiency.
全球进行的减重手术数量正在增长。手术后的主要短期、中期或长期并发症之一是营养缺乏。其中许多，如锌、铜和维生素 A、B1、B3、B6 和 B12 的缺乏，在潜在致命的系统性疾病发生之前，会表现为皮肤损伤。
确定与减重手术后营养缺乏相关的主要皮肤表现，以及相关的变量。
在巴西的一所公立大学进行的综合文献回顾。
这是一个病例报告，对健康研究门户和国家及国际生物医学期刊数据库进行了回顾，没有出版日期的限制。用于搜索的描述符遵循了每个数据库/搜索门户的理想方法：“减重手术”、“皮肤”、“皮肤病”、“皮肤表现”、“营养缺乏病”和“营养不良”。
共选择了 59 篇文章，其中 23 篇是综述文章或专门讨论特定皮肤表现的文章。其他 36 篇文章描述了 41 个病例，这些病例被组织成一个表格，其中包括临床变量。
尽管预计减重手术后会出现营养缺乏并发症，但与这些并发症相关的皮肤表现的文章却很少。重要的是要识别接受减重手术治疗的患者的营养缺乏引起的皮肤变化，因为这些变化可能在出现系统性并发症之前发生，而且当患者尚未出现任何系统性症状时，更容易诊断。然而，皮肤损伤的出现与营养缺乏症的诊断之间通常存在延迟。
