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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Malabsorption (M) is characterized by absorption defect of one or several nutriments in small bowel. Its clinical expression is rarely obvious and biological signs are: anaemia, low serum protein, albumin and lipid rates, low serum calcium, phosphorus and potassium level, and hypoprothrombinaemia. But only 4 simple and reliable tests are needed for diagnosis: i. e.: daily faecal fat amount measurement, daily faecal nitrogen excretion, the xylose test and the Schilling's test. This syndrome is related to many conditions which can be divided into 2 groups with and without intestinal abnormalities. The relationships between M and skin diseases belong to 4 types (J. Marks and S. Shuster): 1) M is responsible for the cutaneous signs, 2) M is caused by a skin disease, 3) both M and skin disease are the result of a same cause, 4) M and skin disease are associated in an indirect way. Only the two first types are dealt with in this report. Skin manifestations occur as a complication in 10 p. 100 to 20 p. 100 of cases of M. They are mostly polymorphous or non-specific, as they are related to multiple vitamin or essential amino acid deficiencies and heal with the treatment of M. The main conditions encountered are diffuse pigmentation, acquired ichthyosis, follicular keratosis, nail brittleness and hair loss. Mucous membrane lesions, purpura and eczematoid or psoriasis-like dermatitis have also been described. More uncommon are clubbing of fingers, finger print abnormalities, kwashiorkor or acrodermatitis enteropathica-like eruptions. The dermatogenic enteropathy, i. e. a M syndrome due to a skin disease, occurs as a result of widespread involvement of the body for instance in psoriasis or eczema; its clinical expression is rarely obvious, the histological record of gut biopsy usually normal and the results of biological tests often dissociated, but steatorrhoea is frequently found. The pathogenesis of the condition is still unknown but its importance is related to the extent of the skin disease and it only improves with the treatment of the latter. All these features and others are discussed in the report with a comprehensive review of the literature.
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PMID:[Cutaneous manifestations of malabsorption diseases (author's transl)]. 38 Apr 45

In 13 patients with psoriasis a lower total cholesterol (TC) concentration was found compared to healthy controls of the same population. No differences in the concentration of serum triglyceride (TG) or phospholipids (PL) were detected between these two groups. In the same patients, serum triglyceride fatty acid analyses showed a reduced concentration of linoleic acid and a raised level of palmitoleic and myristic acids. No differences were detected in the major phospholipid fractions. The increase in plasma free fatty acids (FFA) following intravenous heparin was comparable in the psoriatic patient and in the controls. It is concluded that no basic abnormality of serum lipids exists and that the changes described were due to a selective loss via the scales or due to malabsorption.
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PMID:Serum lipids in patients with psoriasis. 115 10

Deficiency of nutritional iron represents a public health problem recognized throughout much of the world. The overall prevalence rate of patients with iron deficiency (ID) who need supplementary iron therapy ranges markedly from less than 10% to as high as 70% among various ethnic and socioeconomic groups. Dermatologically, the iron-deficit state can be a secondary condition or trigger a wide range of mucocutaneous alterations. Early appreciation of adverse cutaneous manifestations of ID seems to have commensurate significance not only in predicting the presence of undiagnosed ID, but also for providing specified avenues for rational therapeutic approaches to patients with ID. Dermatopathic anemia has attracted the attention of clinicians because ID was found to be a metabolic consequence of skin diseases such as erythroderma, exfoliative dermatitis, psoriasis, eczema, and many others. Previous studies had suggested that iron may be lost in accelerated turnover of the keratinocyte from scaling; currently, malabsorption of iron is accepted implication accounting for dermatopathic anemia. However, mucocutaneous affections adversely manifested by ID have not been extensively reviewed and published in the current dermatologic literature because of the potentially benign course of the adverse conditions and the limited degree of clinical expression. Therefore, changes in hair, nails, mucosa and tongue, pruritus, chronically sustained inflammation, dermatitis herpetiformis, and photodermatitis are among the adverse cutaneous sequelae whose relation to ID are highlighted and discussed in the present review. Because of their clinical and diagnostic importance, other extracutaneous physical signs of ID, such as blue sclerae and pica, are also included in this review.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Iron deficiency: structural and microchemical changes in hair, nails, and skin. 176 60

The psoralen derivative 8-methoxypsoralen (8-MOP) and to a lesser extent some other psoralens, including 5-methoxypsoralen (5-MOP) and 4,5',8-trimethylpsoralen (TMP) have acquired a place in the treatment of psoriasis and other dermatoses. They are only active when combined with long-wave ultraviolet light: PUVA therapy (Psoralen plus UVA). Successful PUVA therapy depends on sufficiently high psoralen concentrations coinciding with the time of irradiation. The use of oral or rectal pharmaceutical formulations with 8-MOP dissolved in liquid is preferable to conventional tablets or capsules. Since no formulation of 5-MOP with fast and predictable absorption is available 8-MOP should be preferred in PUVA therapy. The effectiveness of oral TMP is doubtful, because of low serum concentrations, probably due to malabsorption.
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PMID:Biopharmaceutics, pharmacokinetics and pharmacology of psoralens. 306 92

Vitamin A is necessary to maintain the integrity and the differentiation of epithelia of the skin and adnexa. Evident deficiency of vitamin A in chronic diseases, malabsorption and liver affections may result in skin xerosis, follicular keratosis, and metaplasia of mucous membranes. The remarkable toxicity of vitamin A in high doses does not recommend its usage in dermatology. On the contrary the employ of retinoids, synthetic derivatives of vitamin A, brings to excellent results. These vitamin A compounds are much more effective, even if they show important side-effects. Etretinate and isotretinoin are widely used in psoriasis, keratinization disorders, and severe acne. Vitamin E functions in skin biology are not totally known. Vitamin E is used in the treatment of dermolytic recessive epidermolysis bullosa, with controversial results.
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PMID:[Vitamin A and vitamin E in dermatology]. 391 47

The excretion in the urine of (58)Co after an oral dose of (58)Co vitamin B(12) given together with intrinsic factor has been found to be reduced in a number of patients with psoriasis, eczema, and other less common dermatoses. There is a correlation between the abnormality and the extent of the rash. A reduced glomerular filtration rate was found in a few of the patients in whom it was measured, and this must have been responsible, at least in part, for the reduced excretion of vitamin B(12) in these patients, but abnormal vitamin B(12) excretion also occurred in the absence of impaired renal function. Our evidence is insufficient to show whether malabsorption or increased tissue utilization of vitamin B(12) was the explanation in other cases. Certainly a number of patients had steatorrhoea, and in these it is most likely that malabsorption was the major factor. In patients without steatorrhoea a lone malabsorption of vitamin B(12) cannot be excluded. A decreased serum concentration of vitamin B(12) was found in only one of the patients.
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PMID:Vitamin B12 excretion in patients with various skin diseases. 547 89

Hypocalcemia occurs in patients with psoriasis vulgaris, pustular psoriasis of von Zumbusch, and impetigo herpetiformis. In most cases hypocalcemia is caused by accompanying hypoalbuminemia, yet reductions in ionized serum calcium concentrations due to hypoparathyroidism or malabsorption have been reported. We report the case of a patient with surgical hypoparathyroidism in whom hypocalcemia precipitated typical pustular psoriasis of von Zumbusch. The psoriasis rapidly cleared on two occasions when the patient's serum calcium was corrected by therapy with oral calcium and vitamin D or its analogues, and reappeared when treatment was discontinued. The patient's psoriasis cleared on a third occasion when her serum calcium level returned to normal with a calcium infusion. Hypocalcemia can precipitate pustular psoriasis of von Zumbusch in susceptible persons. These psoriatic flares are due not to abnormal circulating levels of parathyroid hormone or vitamin D metabolites but to hypocalcemia.
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PMID:Hypocalcemia-induced pustular psoriasis of von Zumbusch. New experience with an old syndrome. 654 44

Azathioprine is employed for its immunosuppressive properties, as a steroid-sparing agent or as monotherapy. Its most traditional clinical indications are connective tissue diseases, vasculitis, post-transplant, and immunobullous dermatoses. The main disadvantages of azathioprine therapy are a delayed onset of action (6-8 weeks), and rare profound bone marrow toxicity. Susceptibility to bone marrow toxicity is due to a genetically determined metabolic defect (1 in 300). Patients at risk of such toxicity may be identified by a Thiopurine methyltransferase enzyme assay. We have undertaken a retrospective study, looking at the use of azathioprine as monotherapy for non-bullous inflammatory dermatoses. We studied a total of 24 patients (10 male, 14 female). The dermatoses comprised: atopic eczema (10), pompholyx (6), plaque psoriasis (6), and chronic actinic dermatitis (2). All patients had severe refractory disease warranting systemic second line therapy. The mean age was 49.4 years (range 17-86 years). The starting dose of azathioprine was 100-150 mg/day, and the maintenance dose 50-100 mg/day. The mean duration of treatment was 33.5 months(range 1-132 months). Eighteen patients (75%) showed a good to excellent sustained clinical response to azathioprine. This response rate was evenly represented in the 4 dermatoses studied. The adverse reactions encountered were raised MCV (6), leucopenia (2), raised hepatic enzymes (6), and dyspepsia (4). Azathioprine had to be discontinued due to adverse reactions in 2 patients (dyspepsia, raised hepatic enzymes) followed by normalization. Other factors that potentially contributed to the observed adverse events were present in 5 patients: alcoholism (2), erythromycin toxicity (1), and malabsorption (2). Our study demonstrates the efficacy of azathioprine monotherapy for severe atopic eczema, pompholyx, plaque psoriasis, and chronic actinic dermatitis. Furthermore, azathioprine is a low cost and generally well tolerated drug.
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PMID:Azathioprine in dermatological practice. An overview with special emphasis on its use in non-bullous inflammatory dermatoses. 1059 68

The paper covers clinical, morphological and functional aspects of gastrointestinal tract condition in patients with psoriasis accompanied by chronic opisthorchosis (CO). The authors examined 150 patients with psoriasis accompanied by CO, 100 patients having psoriasis without helminthiasis, 100 patients with CO and 30 healthy people. The gastric secretion was evaluated by means of the fractional test (both phases) with histamine stimulation; other diagnostic procedures included carbohydrate absorption evaluation (5-gram D-Xylose absorption test) and Kamer test of fat absorption. The morphological condition of the gastric and intestinal mucosa was investigated by means of light and electron microscopy. The study revealed gastric secretory dysfunction and malabsorption in small and large intestines in patients with psoriasis and CO, clarified the relation between the duration of psoriasis and opisthorchosis and gastric secretory dysfunction and determined dependence of small intestine malabsorption on such factors as stage, severity, degree of skin involvement and duration of psoriasis. The authors also established interrelation between the above malfunctions and gastric and intestinal structural abnormalities.
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PMID:[Morphofunctional changes in gastrointestinal tract in patients with psoriasis accompanied by chronic opisthorchosis]. 1575 90

A hundred and thirty patients, including 60 patients with psoriasis concurrent with chronic opisthorchiasis, 40 with psoriasis without helminthiasis, and 30 with chronic opisthorchiasis, and 15 healthy individuals were examined. To evaluate the pancreas, its incretory and excretory functions were studied. In patients with psoriasis concurrent with chronic opisthorchiasis, the pancreatic level of hormones and enzymes was significantly lower than those in patients with psoriasis without helminthiasis. Twelve months after dehelminthization, a follow-up of the parameters of the incretory function revealed their significant increase in 43 patients. Following dehelminthization, the excretory function in terms of amylase and lipase was significantly greater than that before dehelminthization. By taking into account steatorrhea, pancreatic excretory dysfunction showed significantly less fecal fat losses after a course of anthelminthic therapy. Malabsorption diminished in patients after anthelminthic therapy, as confirmed by increased urinary D-xylose excretion. Pancreatic proteolytic activity improved after dehelminthization, as supported by a significant increase in urinary PABA excretion. No improvement was observed in patients receiving no anthelminthic therapy; on the contrary, deterioration was established in half of them. Therefore, a year after dehelminthization, helminthological cure in patients with psoriasis concurrent with chronic opisthorchiasis causes a significant improvement in pancreatic incretory and excretory functions and promotes regression of psoriatic manifestation.
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PMID:[Impact of dehelminthization on pancreatic incretory and excretory functions in patients with psoriasis concurrent with chronic opisthorchiasis]. 1827 17


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