Section : Alcohol (OH) and the Skin

Alcohol (OH) and the Skin – Malnutrition (For professionals)


  • Zinc
  • Clinically:
  1. erythematous crusting erosive sometimes bullous dermatitis
  2. periorificial: buccal, nasal, palpebral, anal, vulval, genital, flexural
  3. progressive alopecia
  • diagnosis and treatment: reduced blood Zn and alkaline phosphatase, sometimes also reduced non esterified essential fatty acids (linoleic and arachidonic acid). IV or oral by zinc salts (gluconate, sulfate) leads to spectacular cures.
  • Essential Fatty Acids
  1. sometimes associated with Zinc deficiency
  2. Clinically: leads to dry ichthyotic skin or eczema craquele and is associated with growth retardation.
  3. diagnosis and treatment: blood dosage. Treatment can be topical, IV or oral.
  • Vitamin PP
  • composed of nicotinic acid (niacin) and nicotinic amide (nicotinamide)
  • its precursor is tryptophane
  • its metabolism needs the vitaminic coenzymes B1, B2 and B6.
  • Clinically = pellagra
  1. dermatitis: dusky red erythema appearing quickly on exposed skin accompanied with edema, fine cracked skin followed by bullous hemorrhagic sloughings slowly resolving leaving behind thin, pigmented skin.
  2. diarrhea: often preceeded by stomatitis and glossitis.
  3. dementia: apathic, depression. Sensorial deficiency is present in severe cases
  • diagnosis and treatment: PP dosage can sometimes be normal despite symptoms. Treatment by Nicotinamide 500mg/d IV. Skin signs are the first to disappear, followed by the neurological and digestive ones.
  • Vitamin B6 (pyridoxin)
  1. Clinically = peri-orificial seborrhoeic dermatitis.
  2. diagnosis: charge test with tryptophane (measurement of urinary xanthurenic acid): efficient.
  3. Treatment with Vitamin B6 orally or IV (1g/d) leads to healing in a few months.
  • Vitamin B2 (riboflavin)
  • Clinically :
  1. oral: fissural cheilitis and perleche, angular stomatitis, glossitis.
  2. genital: peri-orificial erythema
  3. ocular: blepharitis and conjunctivitis
  • diagnosis: riboflavin dosage can’t be relied on.
  • Only Riboflavin IV (20-40mg/d) treatment followed by rapid improvement confirms the diagnosis
  • Vitamin A
  • Clinically
  1. rough dry scaly wrinkled skin
  2. hypohidrosis and sebaceous atrophy
  3. follicular hyperkeratosis (non specific)(=phrynoderma) of limbs, nape of neck, shoulders, trunk
  4. other systems: diminished night vision
  • Diagnosis and treatment: diagnosis by dosage of vitamin A or by proof treatment with vitamin A 50000 units/d (cured in a few months).
  • Vitamin C (ascorbic acid) (scurvy)
  • plays a role in collagen, iron, sulfur, tyrosine and folic acid metabolism
  • Clinical features of scurvy:
  1. follicular keratosis
  2. corkscrew hairs
  3. perifollicular hemorrhage
  4. extensive polychrome purpura with a sclerodermiform oedema. Sometimes hemorrhagic hypodermitis.
  5. glossitis
  6. hypertrophic and hemorrhagic gingivitis
  7. teeth fall
  • Diagnosis and treatment: Intraleucocyte dosage of Vit C can be normal in the beginning. Treatment with ascorbic acid orally or IV 1-2g/d
  • Vitamin K
  1. plays a role in the synthesis of coagulation factors II VII IX X.
  2. Clinically: purpura
  3. Treatment: intramuscular Vit K injection is sometimes followed by an inflammatory eczema-like reaction which can evolve to scleroderma-like plaques and necroses.
  • Iron (excess by intoxication or storage (hemochromatosis)):
  1. Clinically: melanoderma ; if diffuse associated with atrophic skin, hypopilosity, thin hair, leuconychia, koilonychias should lead to the suspicion of familial Hemochromatosis.

Bibliography: Dermatologie et Infections Sexuellement Transmissibles, 4th Edition

Category : alcohol - Modifie le 07.21.2010Category : alcohol dependancy - Modifie le 07.21.2010Category : alcoholism - Modifie le 07.21.2010Category : alcoolisme - Modifie le 07.21.2010Category : éthylisme - Modifie le 07.21.2010Category : introduction - Modifie le 07.21.2010Category : malnutrition - Modifie le 07.21.2010Category : OH - Modifie le 07.21.2010Category : peau - Modifie le 07.21.2010Category : skin - Modifie le 07.21.2010