Physical signs of selected nutritional deficiency states

	Signs	Deficiencies
Hair	Alopecia	Severe undernutrition, zinc deficiency
	Brittle	Biotin, severe undernutrition
	Color change	Severe undernutrition
	Dryness	Vitamins E and A
	Easy pluckability	Severe undernutrition
Skin	Acneiform lesions	Vitamin A
	Follicular keratosis	Vitamin A
	Xerosis (dry skin)	Vitamin A
	Perioral and perianal bullous dermatitis (wet, flaming-red plaques)	Zinc
	Ecchymosis	Vitamin C or K
	Intradermal petechiae	Vitamin C or K
	Erythema (especially where exposed to sunlight)	Niacin
	Hyperpigmentation	Niacin
	Seborrheic dermatitis (nose, eyebrows, eyes)	Vitamin B2, vitamin B6, niacin
	Scrotal dermatitis	Niacin, vitamin B2, vitamin B6
Eyes	Angular palpebritis	Vitamin B2
	Corneal revascularization	Vitamin B2
	Bitot spots	Vitamin A
	Conjunctival xerosis, keratomalacia	Vitamin A
Mouth	Angular stomatitis	Vitamin B2, vitamin B6, vitamin B12
	Atrophic papillae	Niacin
	Bleeding gums	Vitamin C
	Cheilosis	Vitamin B2, vitamin B6
	Glossitis	Niacin, folate, vitamin B1, vitamin B2, vitamin B6, vitamin B12
	Magenta tongue	Vitamin B2
Extremities	Genu valgum or varum, metaphyseal widening	Vitamin D
Extremities	Loss of deep tendon reflexes of the lower extremities	Vitamins B1 and B12

Vitamin B1: thiamine; vitamin B2: riboflavin; vitamin B3: niacin; vitamin B6: pyridoxine; vitamin B12: cyanocobalamin.

Adapted from: Bernard MA, Jacobs DO, Rombeau JL. Nutrition and Metabolic Support of Hospitalized Patients. WB Saunders, Philadelphia 1986.

Graphic 78426 Version 8.0