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Biliopancreatic diversion: when a cure becomes a disease
Chiara Panetta1, Giovanni Paolino, Luca Muscardin
1Dermatopathological Laboratory "San Gallicano Institute of Rome," Roma, Italy.
The American Journal of Dermatopathology
|May 31, 2013
Summary
Phrynoderma, a skin condition, can occur after bariatric surgery due to vitamin A deficiency. Early diagnosis and nutritional management are crucial for preventing complications.
Area of Science:
- Dermatology
- Nutritional Science
Background:
- Phrynoderma is a follicular hyperkeratosis linked to malnutrition, primarily in Africa and Southeast Asia.
- In developed nations, it's rare and often arises from malabsorption issues, including after bariatric surgery.
Observation:
- A 51-year-old male presented with a year of asymptomatic, reddish-brown papules and follicular nodules.
- The patient also reported night blindness and had undergone biliopancreatic diversion surgery four years prior.
Findings:
- Skin biopsy revealed hyperkeratosis, irregular acanthosis, and follicular infundibula filled with keratin.
- Laboratory tests confirmed hypovitaminosis A, leading to a diagnosis of phrynoderma.
Implications:
- The rising rates of bariatric surgery necessitate awareness of potential nutritional deficiencies like hypovitaminosis A.
- A multidisciplinary approach is essential for managing post-bariatric surgery patients to prevent complications such as phrynoderma.
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