Phrynoderma (Toad Skin)
A form of follicular hyperkeratosis historically linked to Vitamin A deficiency, though contemporary research suggests it may involve a complex interplay of multiple nutritional deficiencies (e.g., essential fatty acids, B-complex vitamins).
Key Clinical Features
- Appearance: Multiple, firm, discrete, hyperkeratotic papules that are follicularly centered.
- Texture: Gives the skin a rough, “toad-like” feel, particularly when stroked.
- Distribution: Most commonly found on the extensor surfaces of the extremities (elbows, knees) and the buttocks.
Diagnostic & Management Pearls
| Aspect | Details |
|---|---|
| Diagnosis | Primarily clinical, based on physical exam in the context of malnutrition. |
| Treatment | Correction of underlying nutritional deficiencies (balanced diet, vitamin supplementation). |
High-Yield Exam Pearl:
- Differential Diagnosis: Must be distinguished from Keratosis Pilaris, which is a common, often genetic condition rather than a sign of systemic malnutrition.
- Vitamin A: Classically associated with Vitamin A deficiency, which also presents with xerophthalmia (dry eyes) and night blindness.