-
Body : b/l edema
pro-energy
-
Body : pitting edema; body edema; moon face
pro-energy, thiamine (also some meds, esp steroids)
-
Body : Body edema , round swollen moon face
Protein, thiamine
-
Eyes : papilledema (edema of optic disk)
**vit A excess
-
Eyes : pallor of everted eyelid
Fe, Folic H+, b12, B6, Cu
-
Eyes : Ring of fine blood bessels around cornea
General poor nutrition
-
Eyes : Xanthelesma (small yellowish lumps around eyes), circumferential arcus (white rings around iris in b/l eyes)
Hyperlipidemia (circumferential arcus may be nl in adults >45)
-
Eyes : Angular palpebritis (redness/fissuring of eyelids, red and inflamed conjunctiva, swollen eyelids
Niacin, riboflavin, Fe, B6
-
Eyes : Scleral icterus – yellow eye (jaundice), mild
pyridoxine
-
Eyes : Angular Blepharitis
Riboflavin, biotin, B6, Zn
-
Eyes : corneal vascularization
riboflavin, other B complex
-
Eyes : ophthalmoplegia (paralysis of eye)
Thiamin, Phosphorus may also be seen in rickets. (no nutritional differential: brain lesions, graves dx, stroke)
-
Eyes : Dull/soft cornea, dry conjunctiva; Bitot's spots (white or grey on conjunctiva), night blindness
vitamin A
-
Gastrointestinal : Anorexia, flatulence, diarrhea
B12, B6
-
Hair - Body : broken, coiled, unmerged swan neck hairs, perifollicular hemorrhages, follicular hyperkeratosis (also, see skin)
vit A and C
-
Hair- Head : Alopecia (thin, sparse, patch)
Fe, Zc, Biotin, Protein (non-nutrition: aging, chemo/rad to the head, stress hormonal changes, endo d/o, meds)
-
Hair- Head : easily and painessly pluckable
pro-energy, Zc
-
Hair- Head : Color changes, lacklustre. transverse depigmentation/flag sign(hair becomes red in Blacks; bleached in Caucasians)
Protein, malnutrition, EFAD (non nut) over processing/bleaching)
-
Head : Skin color loss, dark cheeks and under yes, scaling of skin around nostrils
Pro-energy, niacin, riboflavin, B6
-
Head : Shrunken anterior fontanelle
dehydration
-
Head : Pallor of skin on face
Fe, B12, folate, Vitamin C
-
Head : Enlarged parotid gland
Pro deficiency, bulimia (non nutr: mumps, cirrhosis, sjorgens syndrome)
-
Head : Bulging anterior fontanelle
Vitamin A excess
-
Head : Anterior fontanelle not closed (average 14 months, wide variation
Vitamin D
-
Lips and Mucous Membranes : Angular stomatitis/cheliosis (angular scars, cheilosis/vertical fissuring later complicated by redness)
Riboflavin, niacin, Fe, B6, B12 deficiencies, vitamin A toxicity
-
Lips and Mucous Membranes : swelling and ulceration. Soreness, burning, pale lips
excess salivation due to ill-fitting dentures)
-
Lips and Mucous Membranes : pallor of the lips ad mucous membranes
Fe
-
Lips and Mucous Membranes : vertical fissuring
riboflavin
-
Lips and Mucous Membranes : inflammation, loss of clear demarcation at mucoutaneous border,
Riboflavin (also caused by
-
Muscular : muscle pain
Biotin, vit D
-
Muscular : peripheral neuropathy , tingling, pins and needles
Folate, B6, pantothenic acid, phos, thiamine, B12 deficiencies, B6 toxicity
-
Muscular : muscle twitching, convulsions, tetany
Mag or B6 excesses or deficiency, Ca2+, vit D or mag deficiency
-
Muscular : weakness
Phos, K+, Vit C, Vit D, B6
-
Muscular : wasted appearance
Pro-energy
-
Muscular : calf tenderness, absent deep tendon reflexes, flaccid muscles, foot/wrist drop
thiamine
-
Nail : Capillary refill time > 2 seconds
Dehydration
-
Nails : black pigment (diffuse or vertical streak)
B12 (resolves w/ tx)
-
Nails : Central ridges
Fe, folate, protein (severa arterial dz)
-
Nails : pale, spoon shaped (koilonychia), ridging, brittle, easily broken, thin
Fe, protein (normal if on toenails only, also caused by hypothyroidism, raynauds)
-
Nails : Muehrcke’s lines (transverse white line
Malnutrition, hypoalbuminemia (chornic liver/renal dz, trauma)
-
Nails : Schamroth sign (clubbing)
poss Fe
-
Nails : splinter-type hemorrhages in nail bed, under nail plate
vit C (or endocarditis, vascular dz)
-
Nails : Beaus lines (transverse ridges, horizontal grooves)
Z, pro, hypocalcmiac
-
Neck : Thyroid enlargement/goiter
iodine
-
Nervous System : peripheral neuropathy with weakness and paraesthesia, ataxia and decreased tendon reflexes, fine tactile vibrator and position sense
B12, thiamine deficiency (Wernicke’s encephalopathy), Cu, B6
-
Nervous System : seizures/tetany, memory impairment, behavioural disturbances
Ca2+, Mag, zinc, vit D
-
Nervous System : increased weakness, impaired cognitive fx, irritability, anorexia
Folate, B12
-
Nervous System : dementia
Niacin, B12 deficiency, hypercalcemia, aluminium toxicity
-
Nervous System : listlessness
Pro-energy
-
Nervous System : inability to concentrate, defective memory, confabulation, disorientation
Thiamine deficiency (korsakoffs psychosis), B12
-
Nose : nasolabial seborrhea (greasiness)
pyridoxine
-
Nose : nasolabial dyssebacea (exfoliation, inflammation, excess oil production, fissuring of sebaceous glands which are most and red--may see at angles of eyes, ears, other sites)
riboflavin
-
Nose hyposmia (decr sense of smell)
Zc
-
Skeletal demineralization of bone
Ca2+, phos, Vit D deficiencies or excessive vitamin A
-
Skeletal : malar, temporal, somatic wasting;loss of subcutaneous muscle and/or fat
pro-energy
-
Skeletal : epiphyseal enlargement of wrist, legs and knees, bowed legs, rickets or osteomalacia, frontal bossing (prominent forehead)
Vit D
-
Skeletal : bone tenderness/pain
Vit D
-
Skin : Purpura ( Purple colored patches on the skin and in mucous membranes including in mouth)
Vit C, Vit K, excessive vit E
-
Skin : yellow pigmentation sparing sclerae
**carotene excess
-
Skin : slate gray/hemochromatosis
**Fe excess
-
Skin : dry, rough, sandpaper like withscaling, poss w/ headache complaint, diplopia, dizziness
**vit A excess
-
Skin : sunburn-like erythematous eruption
**vit A excess
-
Skin : lemon yellow pigment
B12
-
Skin : Yellow(lemon yellow) pigmentation
B12 deficiency
-
-
Skin : Seborrheic dermatitis (scaliness, waxy, oiliness, crusty plaques on scalp, lips, nasolabial folds)
Biotin, b6, zinc, riboflavin, efad, Vit excess or deficiency
-
Skin : Yellow-orange pigementation
Excessive beta carotene
-
Skin : Cutaneous flushing
niacin
-
Skin : inflammation of mucocutaneous junctions
Niacin
-
Skin : pigmentation and dry scaling when exposed to sunlight/sunburn appearance with erythema, blisters, peeling; necklace of Casals" in neckline exposed to sun
Niacin (non-nutr: AED meds)
-
Skin : Pellagra - thick and inelastic, dry and scaly where exposed to sun)
Niacin, tryptophan, B6
-
Skin : Acanthosis nigricans (velvety hyperpigmentation in body folds)
Obesity, insulin resistance (hypothyroidism,)
-
Skin : scaliness--becoming "crackled"
possibly biotin
-
Skin : flaky paint dermatosis
Pro
-
Skin : flaky paint dermatosis
Pro
-
Skin : hyperpigmentation
pro-energy, folic H+, B12
-
Skin : Lack of fat under skin, cellophane appearance (thin and inelastic)
Pro-energy, Vit C
-
Skin : seborrheic inflammation w/ fine scaling, itching--involving face and areas of friction betw 2 body parts
pyridoxine, possibly other B complex
-
Skin : Eczema
Riboflavin, Zinc
-
Skin : exfoliative dermatitis
vit A, C, folic H+, Zn, pro
-
Skin : Xerosis (abn dryness)
Vit A, EFAD
-
Skin : perifollicular hemorrhages
Vit C
-
Skin : Petechiae (purple/red spots d/t bleeding under the skin)
Vit C, K (non nutr: severe fever)
-
Skin : Follicular hyperkeratosis (goose flesh)
vit C, poss vit A
-
Skin : decubitus ulcers, delayed wound healing
vit C, Zn, pro, poss linoleic acid
-
Skin : reduced turgor, inelastic, "tenting"
water, fluids
-
Skin : Slow wound healing, decubitous ulcers
Zinc, Vit C, pro, malnutrition, inadequate hydration
-
Teeth : pitting and mottling, gray brown spots
fluoride excess
-
Teeth : Missing teeth or erupting abnormally
General poor nutrition
-
Teeth : edentulous
pro-energy
-
Teeth : malpositioned, hypoplastic line across primary upper incisors, which becomes filled w/ yellow-brown pigment: caries then occur and tooth may break
pro-energy
-
Teeth : caries
pro-energy, Vit D, B6, fluoride. Excessive sugar
-
Tongue : Pale tongue
B12, folate, Fe
-
Tongue : pallor and patchy atrophy resembling geographic tongue, reddened tip
biotin
-
Tongue : filiform papillary atrophy (pale, atrophic, smooth, slick)
Fe, Folic H+, B12, niacin, other B complex factors
-
Tongue : Sore, swollen, scarlet raw-beefy red tongue, surface may be partially to completely bald
Folate, niacin, B12
-
Tongue : lobulated w/ atrophy
folic H+
-
Tongue : apthous-like ulcers on dorsum or under surface; healing leaves depapillated area
Folic H+, poss B12
-
Tongue : fissuring, edema
niacin
-
Tongue : scarlet, raw, painful w/ atrophy
niacin, folic H+, possibly B12, and other B complex
-
Tongue : scalding sensation succeeded by reddening and hypertrophy of filiform papillae
pyridoxine
-
Tongue : Sorness, burning tongeue, purplish/magenta
Riboflavin
-
Tongue : Glossitis (sore, swollen, red and smooth tongue)
Riboflavin, niacin, B6, B12, folate, severe Fe deficiency (non nutr: chron’s, uremia, infection, malignancy, anticancer tx, trauma)
-
Tongue : pebbly or granular dorsum; erythematous, purplish red/magenta
riboflavin, poss biotin
-
Tongue : Hypoguesia/dysguesia
Zc (also meds like antineoplastic agents/sulfonylureas)
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