Abstract

While the histopathologic features of nutritional deficiency related dermatoses can be non-specific, certain characteristic descriptors have been indoctrinated into dermatopathology despite only a few reports in the literature. Histopathologic features of nutritional deficiencies include pallor of the upper epidermis with ballooning degeneration, confluent parakeratosis, psoriasiform hyperplasia, loss of the granular cell layer, and the presence of necrotic keratinocytes. The presence or absence of any of these features can depend on the chronicity of the skin lesions. To better characterize the histopathologic features, we performed a retrospective review of all cases of nutritional deficiency-related dermatitis at our institution over the last four years. Only patients with confirmatory laboratory testing or those who underwent treatment for a nutritional deficiency with clinical improvement were included. The most consistent histopathologic finding reported was loss of the granular layer followed confluent parakeratosis. Traditionally epidermal pallor was acknowledged as the prototypical feature of nutritional deficiency related dermatoses. However, in our study confluent parakeratosis and hypogranulosis were found to be the most consistent findings.

Financial Disclosure:
No current or relevant financial relationships exist.