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fat soluble vitamins = A,D,E,K are deficient in diseases of fat malabsorption = Crohn’s disease, celiac disease, cystic fibrosis, and cholestatic liver disease
in general:
| • | infants and children are particularly at risk |
| • | in developed countries, alcoholism is the main cause |
| • | many of the nutritional disorders have overlapping features, because nutrients are essential to overlapping metabolic pathways, and because often malnourished patients have multiple deficiencies |
| • | peri-orificial dermatitis |
while there is usually overlap, some vitamin deficiencies have classic characteristic features:
| Deficient Vitamin: | Dermatology: |
| Vitamin B2 (riboflavin) | angular cheilitis |
| zinc | periorificial dermatitis |
| essential fatty acid deficiency | periorificial dermatitis |
| kwashiorkor | periorificial dermatitis |
| folic acid | deficiency similar to B12 ~ B12 without the neurologic findings (?) (hyperpigmentation, glossitis, angular cheilitis, megaloblastic anemia) |
| Vitamin B1 (Thiamine) | may have either cardiac (wet beriberi), neurologic (dry beriberi) manifestations and Wernicke-Korsakoff encephalopathy |
Prescribe a multivitamin for patient’s with:
| • | “hair loss” but you can’t appreciate it clinically |
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