Bypass phrynoderma. Vitamin A deficiency associated with bowel-bypass surgery

Area of Science:

• Dermatology
• Nutritional Science
• Gastroenterology

Background:

• Bowel-bypass surgery is a procedure for morbid obesity.
• Nutritional deficiencies can occur post-bariatric surgery.
• Skin manifestations are potential complications of malabsorption.

Observation:

• A 41-year-old woman presented with multiple keratotic papules and nodules on her trunk and extremities.
• These lesions appeared four years after a bowel-bypass procedure.
• Microscopic examination revealed features consistent with perforating folliculitis.

Findings:

• Serum vitamin A levels were found to be extremely low in the patient.
• Administration of oral vitamin A therapy resulted in a dramatic improvement of the cutaneous lesions.

Implications:

• This case highlights a potential association between bowel-bypass surgery, vitamin A deficiency, and perforating folliculitis.
• Early detection and management of vitamin A deficiency may prevent or treat such dermatological complications.
• Further research is warranted to understand the prevalence and mechanisms of this condition in post-bariatric surgery patients.