Diet in dermatology

YS Marfatia, Pandya Asmi

 Department of Skin & VD, Medical College and S S S HospitaL, Vadodara, India

Correspondence Address:
Y S Marfatia
Department of Skin & VD, Medical College and S S S HospitaL, Vadodara
India

To the editor

The article ′Diet in Dermatology′ by H. Hanumanthappa in Indian J Dermatol Venereal Leprol: 284-286: Vol. 67, 2001 was quite interesting.

Hereby we are sending some additional and useful information on the same subject.

1. Pemphigus and diet

Exogenous factors play a role in the induction of pemphigus. These include well-established factors, such as drugs, in particular thiol drugs, and the newly described fool products containing similar chemical compounds. Generic predisposition is crucial for the development of pemphigus. Exogenous factors only affecting genetically predisposed individuals -both idiopathic and drug-induced pemphigus show the same HLA pattern.

Environmental factors were suggested to play a role in the etiopathogenesis of pemphigus vulgaris many years ago, whole evidence has only recently emerged. Certain possible nutritional products that might contribute to the induction of the diseases are:

(i) All over India, the habit of pan chewing is extensive.

(ii) In the Northern parts of India, large fields of mustard abound.

(iii) Mustard oil is commonly used on hair.

(iv) The food is very spicy.

(v) A large amount of fresh fruit is offered for sale.

(vi) There is high proportion of vegetarians among the Indian people.

(vii) Cassava (tapioca) is the main source of carbohydrates in the poorer section of Kerala.

2. Role of Iodide

Sea food and iodised salt are rich sources of iodine and iodide.

Iodide can precipitate pustular psoriasis and type II lepra reaction.

Restriction of iodide containing food results in improvement in patient of dermatitis herpetiformis not responding to dapsone and gluten free diet.

Acneiform eruptions are reported by iodine.

3. Dermatitis herpetiformis

A gluten free diet improves the enteropathy and protect patients with DH from malignancy.

Rice corn and potatoes are the main food articles which do not have gluten. DH patient should avoid wheat, rye and barley due to their gluten content.

Patient not responding to gluten free diet, should restrict iodide and milk in their diet.

Elemental diet (in which antigenic proteins are replaced by amino acid) decreases IgA production and improves skin lesions.

4. Pruritus

Some foods like banana and brinjal may cause pruritus with or without obvious urticarial lesion.

Low protein diet helps in reducing uraemic pruritus.

Patient of cholestatic jaundice may be benefited by diet rich in polyunsaturated fatty acid.

5. Allergic contact dermatitis

Exacerbation of dermatitis can occur after ingestion of nickel, cobalt, chromium and balsam of Peru in sensitive patients.

6. Fixed eruption

Legumes, lentils, strawberries and cheese crisps can cause fixed food eruptions.

7. Genetic disorders

• Avoid milk in galactosemia and lactose intolerance
• Avoid broad beans in glucose-6-phosphate deficiency

8. Psoriasis

Dietary fish oil given 60-75 g daily improves lesions moderately, it prevents cardiovascular disease in patients on retinoids and prevent nephrotoxicity in patients taking cyclosporin A.

9. Treatment

Those who are on steroid should be given more amount of milk, coconut water, banana and salt-restricted diet.

Patient on retinoid should have polyunsaturated fatty acids in their diert.

11. Fish Odour Syndrome

Patients are benefited form a diet low in choline and carnitine (sea fish, eggs, liver peas, soya beans)

12. Hyperhydrosis

Patients should avoid hot and spicy food.