Fuchs J
Abteilung II, Johann-Wolfgang-Goethe-Universität, Frankfurt.
Ther Umsch. 1994 Jul;51(7):489-95.
Mucocutaneous changes occur in vitamin deficiency states and may be helpful in clinical diagnosis of the underlying disease. Substitution and therapy with vitamins can also cause skin problems, which may be of allergic of nonallergic origin. The skin and mucosal changes in pellagra and scurvy can be diagnostic; however, in other vitamin deficiencies, skin signs are rather unspecific. In most cases combined vitamin deficiencies occur that result in polymorphic and nonspecific mucocutaneous signs. Vitamin deficiencies are due to malnutrition, malabsorption or genetic defects. In industrialized countries alcoholism and gastrointestinal disorders are the main cause of vitamin deficiencies. Alcoholics or patients with malabsorption syndrome suffering from seborrheic dermatitis-like or ichthyosiform-like eruptions should be investigated for vitamin deficiency. Laboratory analysis of blood and urine vitamin levels can be misleading because of the poor correlation with tissue vitamin concentrations. Rapid clinical improvement following vitamin substitution frequently confirms the clinical diagnosis. In this overview we describe mucocutaneous signs of vitamin deficiencies. Excellent reviews of this topic are recommended for further reading [1-5].
维生素缺乏状态下会出现皮肤黏膜改变，这可能有助于潜在疾病的临床诊断。维生素替代治疗也可能引发皮肤问题，这些问题可能源于过敏或非过敏因素。糙皮病和坏血病中的皮肤和黏膜改变具有诊断意义；然而，在其他维生素缺乏症中，皮肤体征往往缺乏特异性。大多数情况下会出现多种维生素联合缺乏，导致多形性和非特异性的皮肤黏膜体征。维生素缺乏是由营养不良、吸收不良或基因缺陷引起的。在工业化国家，酗酒和胃肠道疾病是维生素缺乏的主要原因。患有脂溢性皮炎样或鱼鳞病样皮疹的酗酒者或吸收不良综合征患者应进行维生素缺乏检查。由于血液和尿液中维生素水平与组织维生素浓度的相关性较差，实验室分析可能会产生误导。维生素替代治疗后临床症状迅速改善常常能证实临床诊断。在本综述中，我们描述了维生素缺乏的皮肤黏膜体征。推荐阅读关于该主题的优秀综述以获取更多信息[1-5]。
