title: [Phrynoderma secondary to vitamin A deficiency in a patient with biliopancreatic diversion].
abstract: Biliopancreatic diversion (BPD) is a malabsorptivebariatric procedure can lead to the development of several nutritional complications, including fat-soluble vitamins deficiencies. Routine supplementation with vitamins and trace elements and a close follow-up long-term can prevent these nutritional risks. Vitamin A participates in ocular metabolism, epithelial differentiation, growth, and embryogenesis. Have been described several cases of ophthalmological and fetal complications associated with vitamin A deficiency in patients who have undergone BPD. Few information exists in literature about dermatologic manifestations that may occur in these patients. Phrynoderma is a type of follicular hyperkeratosis located on the extensor surfaces of the extremities whose main cause is vitamin A deficiency. We report an exceptional case of severe cutaneous and ocular complications in a patient who had undergone BPD with poor adherence to treatment and postoperative follow-up. Our patient presented simultaneously the characteristic skin lesions of phrynoderma with nytalopia and xerophthalmia in a setting of low serum levels of vitamin A. Treatment with high doses vitamin A obtained the resolution of both processes. We review and discuss the relationship between phrynoderma, malnutrition and vitamin A deficiency.
authors.affiliation: Unidad de Nutrición Clínica y Dietética, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España. mjocon@salud.aragon.es
authors.forename: J
authors.initials: J
authors.lastname: Ocón Bretón
authors.forename: M C
authors.initials: MC
authors.lastname: Cabrejas Gómez
authors.forename: J
authors.initials: J
authors.lastname: Altermir Trallero
mesh_terms: D015904:Biliopancreatic Diversion / Q000009:adverse effects*; D005128:Eye Diseases / Q000209:etiology*; D006801:Humans; D007642:Keratosis / Q000209:etiology*; D008286:Malabsorption Syndromes / Q000209:etiology; D008297:Male; D044342:Malnutrition / Q000209:etiology; D008875:Middle Aged; D010349:Patient Compliance; D011183:Postoperative Complications / Q000473:pathology / Q000628:therapy; D012867:Skin / Q000473:pathology; D014801:Vitamin A / Q000627:therapeutic use; D014802:Vitamin A Deficiency / Q000150:complications* / Q000209:etiology*; D014815:Vitamins / Q000627:therapeutic use; D014985:Xerophthalmia / Q000209:etiology / Q000473:pathology
chemical_list: D014815:Vitamins; D014801:Vitamin A