A clinical study of 125 patients with phrynoderma

Phrynoderma is a type of follicular hyperkeratosis. Various nutritional deficiency disorders have been implicated in the etiology of phrynoderma.

To determine clinical features of phrynoderma and its association with nutritional deficiency signs.

A cross-sectional descriptive study of 125 consecutive patients with phrynoderma attending the outpatient department (OPD) of dermatology was conducted in a tertiary care hospital. In all patients, a detailed history was taken and cutaneous examination findings such as distribution, sites of involvement, morphology of the lesions, and signs of nutritional deficiencies were noted.

The proportion of patients with phrynoderma attending the OPD was 0.51%. There were 79 males and 46 females. Age of the patients was in the range of 3-26 years with a mean of 10 ± 4.3 years. The lesions were asymptomatic in 114 (91.2%) patients. The distribution of lesions was bilateral and symmetrical in 89 (71.2%) patients. The disease was localized (elbows, knees, extensor extremities, and/or buttocks) in 106 (84.8%) patients. The site of onset was elbows in 106 (84.8%) patients. The lesions were discrete, keratotic, follicular, pigmented or skin colored, acuminate papules in all patients. Signs of vitamin A and vitamin B-complex deficiency were present in 3.2% and 9.6% patients, respectively. Epidermal hyperkeratosis, follicular hyperkeratosis, and follicular plugging were present in the entire biopsy specimen.

Phrynoderma is a disorder with distinctive clinical features and can be considered as a multifactorial disease involving multiple nutrients, local factors like pressure and friction, and environmental factors in the setting of increased nutritional demand.