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November 17, 2008

Follicular Eruption on Arms and Legs—Diagnosis

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Arch Dermatol. 2008;144(11):1509-1514. doi:10.1001/archderm.144.11.1509-e

Findings from the patient's skin biopsy demonstrated distention of the upper follicular ostia with prominent keratotic plugging. The patient's multivitamin supplementation had been recently changed to omit vitamin A. Two-month supplementation increased his serum vitamin A level to 67 μg/dL and resolved his eruption and vision abnormalities.

Phrynoderma is classically thought to result from severe vitamin A deficiency,1-5 although deficiencies in vitamins B6 and E7 essential fatty acids and severe malnutrition8 have also been implicated. Severe vitamin A deficiency may also result in conjunctival and corneal lesions and nyctalopia (night blindness).1

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