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Skin Signs as the Presenting Manifestation of Severe Nutritional Deficiency
Report of 2 Cases
John Kuhl;
Mark D. P. Davis, MD;
Amer N. Kalaaji, MD;
Patrick S. Kamath, MD;
Jennifer L. Hand, MD;
Craig J. Peine, MD
Arch Dermatol. 2004;140:521-524.
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REPORT OF CASES
CASE 1
A 17-month-old girl was brought by her parents and grandparents for a further opinion regarding her 3-month history of an itching skin eruption, thinning of scalp hair with hair "falling out in clumps," swelling of her extremities, and lack of weight gain. One year earlier, her rate of growth slowed and reached progressively lower percentiles on a normal growth curve. Although she had started walking at 10 months of age, she stopped in the previous 3 months and was unsteady on her feet.
She had a history of chronic atopic dermatitis managed with topical corticosteroids, emollients, and topical 0.1% tacrolimus, previously with reasonable control. Four months earlier, her dermatologist had performed radioallergosorbent testing (RAST), which showed positive results for multiple foods including green beans, strawberries, wheat, green . . . [Full Text of this Article] CASE 2
DIAGNOSTIC CHALLENGE
COMMENT
From the Mayo Clinic, Rochester, Minn (Drs Davis, Kalaaji, Hand, and Kamath), and Hennepin County Medical Center, Minneapolis, Minn (Dr Peine). Mr Kuhl is a visiting medical student from Creighton University, Omaha, Neb.
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