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ОглавлениеAriboflavinosis
Definition
Ariboflavinosis or vitamin B2 deficiency is an unusual disorder that usually occurs in combination with other vitamin deficiencies.
Etiology
Deficiency of vitamin B2 occurs due to dietary inadequacy, achlorhydria, malabsorption, alcoholic cirrhosis, hypothyroidism, and drugs.
Main Clinical Features
Oral Manifestations
•Angular cheilitis
•Atrophy of the filiform papillae resulting in a smooth red tongue
•Dry and cracked lips
Other Manifestations
•Skin lesions include perioral seborrheic dermatitis, scaly papules, fissures, and, rarely, ulcers
•Conjunctivitis and photophobia
•Anemia, mental disorders, and slowing of higher functions: weakness may occur
Diagnosis
The diagnosis is based mainly on the medical history and clinical features. Biochemical analysis of vitamin B2 status and measurement of erythrocyte glutathione reductase helps confirm the diagnosis.
Differential Diagnosis
•Pellagra
•Plummer-Vinson syndrome
•Other vitamin B complex deficiencies
•Zinc deficiency
•Angular cheilitis
Treatment
Basic Guidelines
•Improve or treat any underlying illness.
•Eat foods rich in vitamin B2 (meat, fish).
Suggested Therapies
•Treatment consists of riboflavin 5-15 mg/day taken orally until the clinical signs and symptoms are resolved. In severe cases 2-4 mg two times daily can be given parenterally.
•Topical antifungals such as nystatin or miconazole ointment may be used for the treatment of angular cheilitis.
•A high level of oral hygiene is necessary.
Barthelemy H, Chouvet B, Cambazard F. Skin and mucosal manifestations in vitamin deficiency. J Am Acad Dermatol 1986;15:1263.
Mataix J, Aranda P, Sanchez C, et al. Assessment of thiamin (vitamin B2) status in an adult Mediterranean population. Br J Nutr 2003;90:661–666.
Miller SJ. Nutritional deficiency and the skin. J Am Acad Dermatol 1989;21:1–30.
Roe DA. Riboflavin deficiency: Mucocutaneous signs of acute and chronic deficiency. Semin Dermatol 1991;10:293–7.
