Nutritional Deficiency and Acquired Ichthyosis

Excerpt

A 63-year-old man with a remote history of oropharyngeal cancer presented with a 1-year history of dysphagia, poor oral intake, and a 50-pound weight loss. On exam, he appeared cachectic with diffuse, symmetric scaling, most prominent over his lower extremities (Fig. 1a). He denied associated pain or pruritus. Laboratory testing revealed an undetectable vitamin C level and markedly reduced levels of A, E, B1, and B6. Given his malnourished state, enteral nutrition via a percutaneous gastrostomy tube was initiated. His skin findings were thought to represent a form of acquired ichthyosis (AI) related to nutritional deficiency. Over time, he gained weight and his skin findings progressively improved, with complete resolution by month 6 (Fig. 1b).

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