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| • | liver disease or fat malabsorption may lead to deficiency |
| • | found in: fish, milk, eggs, green leafy vegetables, liver |
| • | reduces morbidity and mortality in measles (mnemonic: 4 C’s and an A) |
| • | oral and topical vitamin A reverses the adverse affects of steroids on wound healing |
| • | beta carotene: quenches free radicals; used to treat EPP |
| • | deficiency = Phrynoderma: “toad skin” (follicular hyperkeratosis) |
| • | PRP and psoriasis: can treat with vitamin A and vitamin A derivatives (retinoids) |
| • | Used in conjunction with vitamin E to treat Grover’s disease vitamin A 50,000 Units TID X 2 weeks, then 50,000 units QD for up to 12 weeks |
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Vitamin B1 (thiamine)
Vitamin B2 (riboflavin)
| • | found in cereals; 2/3 synthesized by tryptophan |
| • | pellagra = the clinical syndrome of niacin deficicency |
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| • | deficiency = periorificial dermatitis, pellagra-like rash, polyneuritis, glossitis, cheilosis |
| • | found in most classes of food |
| • | mnemonic: found in most foods and similar symptoms to most other vitamin deficiencies |
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| • | deficiency = hyperpigmentation at the neck, axillae, fingers (glossitis, megaloblastic anemia, ataxia, paresthesia) |
| • | causes – decreased intrinsic factor production, pernicious anemia, strict vegan, chronic alcoholism, ileal bypass, diphyllobothrium latum |
| • | found in animal products |
| • | vitiligo is associated with pernicious anemia ~ 8% of patients with vitiligo (and vice versa) |
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Vitamin C deficiency = scurvy
| • | psoriasis treated with vitamin D3 (calcipotriene): acts on epidermal proliferation |
Vitamin D analogues:
| • | calcitriol: the naturally occurring, active metabolite of vitamin D3 |
| • | calcipotriol: a synthetic analogue |
| • | receptor mediated effects on the growth and differentiation of keratinocytes and on the immune system |
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Vitamin K deficiency causes purpura (patients on long term antibiotics: alters gut flora)
Folic acid
Disease: Therapeutic vitamin:
| Grover’s disease | can treat with vitamin E and A (not clear how or if they work) |
| Dystrophic EB | treat sometimes with vitamin E (may work like dilantin: decreases collagenase activity) |
| Bullous Pemphigoid | niacinamide: a coenzyme; what nicotinic acid becomes in the body; used for its immunomodulatory properties (also used in GA) |
beta-carotene: as a photo-protective and anti-oxidant (e.g. EPP, hydroa vacciniforme)
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