Vitamin deficiency and the skin

At a glance

• Micronutrient deficiency is rare in Australia but clusters in predictable groups: alcohol use disorder, eating disorders, bariatric surgery, short bowel and IBD, parenteral nutrition without trace elements, older people living alone, and very restrictive diets.
• Three patterns are examined: pellagra (niacin, photosensitive), scurvy (vitamin C, perifollicular bleeding), and zinc deficiency (periorificial and acral).
• Deficiencies travel together. Treat the one you see and replace the rest, and give thiamine first when you start feeding a malnourished patient (see malnutrition and refeeding).