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October 1987

Dermatologic Signs in Anorexia Nervosa and Bulimia Nervosa

Author Affiliations

From the Departments of Psychiatry (Dr M. Gupta) and Dermatology (Dr A. Gupta), University of Michigan, Ann Arbor; and the Departments of Psychiatry (Psychodermatology Clinic) (Dr M. Gupta) and Dermatology (Dr Haberman), Toronto Western Hospital, University of Toronto.

Arch Dermatol. 1987;123(10):1386-1390. doi:10.1001/archderm.1987.01660340159040

• The dermatologic changes in anorexia nervosa and bulimia nervosa may be the first signs to give the clinician a clue that an eating disorder is present, as many of these patients either deny their symptoms or secretly refuse to comply with treatment. The dermatologic signs are a result of (1) starvation or malnutrition, eg, lanugolike body hair, asteatotic skin, brittle hair and nails, and carotenodermia; (2) self-induced vomiting, eg, hand calluses, dental enamel erosion, gingivitis, and a Sjögrenlike syndrome; (3) use of laxatives, diuretics, or emetics and their dermatologic side effects; and (4) other concomitant psychiatric illness, eg, hand dermatitis from compulsive handwashing. Further, as most of the cutaneous signs are not specific to anorexia nervosa and bulimia nervosa, failure to include eating disorders in the differential diagnosis may lead to misdiagnosis of the cutaneous symptoms.

(Arch Dermatol 1987;123:1386-1390)

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