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  In this article
    Telogen effluvium
    Pemphigus vulgaris
    Cutaneous vasculitis
    Oculocutaneous t...
    Idiopathic calci...
    Fish odour syndrome
    Toxic oil syndrome
    Aphthous ulcers
    Allergic contact...
    Acanthosis nigricans

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Year : 2003  |  Volume : 69  |  Issue : 2  |  Page : 196-197

Diet in dermatology

From the Department of Dermato-Venereology AIMS, New Delhi-110029

Correspondence Address:
From the Department of Dermato-Venereology AIMS, New Delhi-110029

How to cite this article:
Sirka C S, Dulte B. Diet in dermatology. Indian J Dermatol Venereol Leprol 2003;69:196-7

How to cite this URL:
Sirka C S, Dulte B. Diet in dermatology. Indian J Dermatol Venereol Leprol [serial online] 2003 [cited 2021 Jan 18];69:196-7. Available from:

To the editor
We read the article entitled "Diet in Dermatology" by H. Hanumanthappa[1] with great interest and would like to put forward few comments and additional diet related dermatoses to the list. At the outset we would like to enumerate few additional dermatoses having relation with diet.

   Telogen effluvium Top

Sudden reduction of food intake as observed in "crash dieters"[2] and in individuals on restrictive diets and starvation[3] is associated with telogen effluvium. It is possibly due to acute protein deprivation to the hair matrix formation and sudden entry of large percentage of hairs into the telogen phase and subsequently hair fall.[4]
Other dietary aberrations related to hair loss but not necessarily due to telogen effluvium are hypervitaminosis, often secondary to renal dialysis, anorexia nervosa,[5] deficiency of iron,[6] zinc,[7] biotin,[8] essential fatty acid, and lathyrism.[9]

   Pemphigus vulgaris Top

Many food substances containing thiols, thiocyanates, phenols and tannins in the form of fruits, leaves, roots, seeds, beverages and even water can go a long way in precipitating pemphigus in a genetically predisposed individual.[10]
Though the definite agent or cause is difficult to specify, the wide array of substances containing moderate to high contents of the incriminated substances are.[11]
Vegetables- garlic, onion, mustard, turnip, brocolli, radish, cabbage, cauliflower, brussel, sprouts, tomatoes, potatoes, leek, chive, shallots.
Fruits and nuts- Mango, pistachio, cashew, guarana, walnut, black walnut, raspberry, cherry, cranberry, black­berry, avocado, banana, pear, peach, persimmon.
Mosticatories and stimulants- Coffee, beans, dry tea leaves, betel nut, betel leaf, katha, cassava
Provisions- beer, wine, soft drink
Miscellaneous- Ice cream, candy spice (chillies mostly), baked foods, nutritional supplements and colouring substabces.
Endemicity of "Fogo selvageum" in Brazil i5 attributable to high tannin content in water from river and addition of chlorine in drinking water leads to formation of hypochlorite ions which neutralizes phenolic compoundss and aids in the control of fogo selvageum.

   Koilonychia Top

It can be prevented by intake of food rich in iror (liver, meat, poultry, jaggery, green leafy vegetables, cereals, dry fruits, fish.)

   Cutaneous vasculitis Top

Food additives like tartrazines dye are implicated in causing vasculitis, especially high coloured soft dirnks,[11] causes leucocytoclastic vasculitis following intake of ponceou and fades with abstinence.[12]

   Oculocutaneous tyrosinaemia Top

Ocular and neurological complications due to the disease oculocutaneous tyrosinaemic can be avoided or minimized by early initiation of low phenylalamine and tyrosine containing diet.[13],[14]

   Idiopathic calcification Top

Intake of diet low in calcium is helpful in the management of calcinosis universalis.[15]

   Bromhidrosis Top

Omission of food stuff like garlic improves the condition.

   Fish odour syndrome Top

Symptoms can be minimized by low choline and ornithine containing food intake like sea fish, eggs, liver, pear, and soyabean.

   Toxic oil syndrome Top

Rape seed oil (denatured with aniline) used as a cooking oil, has been known to cause multisystem involvement including cutaneous.[16]

   Aphthous ulcers Top

Some evidence exists to support the role of a gluten free diet in reducing the pain and frequency of aphthous ulcers.[17]

   Allergic contact dermatitis Top

Partial cross reactivity exists between latex and fruits like banans, chestnut and avocado. Hence a food allergy should be ruled out in latex sensitive persons and vice versa.[18],[20]

   Acanthosis nigricans Top

Fish oil supplementation has improved the cutaneous conditions in patients of acanthosis nigricans with lipodystrophic diabetes.[21]

   Xanthomatosis Top

Hypercholesteralemic xanthomatosis is benefited from strict dietary limitation of cholesterol.
Further we would like to comment about the conditions like dermatitis herpetiformis, where besides a gluten free diet, restriction of iodide, milk and an elemental diet intake[22] may favourably effect the course of the disease. Prevention of milk from coming in contact with the gut mucosa, prevent IgA production, which is responsible in the pathogenesis of dermatitis herpetiformis. Iodine containing food (fish, kelp, iodized salt and vitamin) may be removed from patients diet who are not responding to a gluten free diet, as iodides worsen dermatitis herpetiformis by local chemotaxis and stimulating neutrophil migration.
Finally, we would like to conclude with a few words on the mentioned dietary influences on two dermatoses viz acne vulgaris and vitiligo, where we tend to defer. The author has suggested restriction of ice creams, sweets, fats and chocolates for bringing improvement in acne patients. However there is no evidence to support the fact that these mentioned food items could alter sebum composition or affect the disease process. Severe reduction of food intake might reduce subum production, and thereby reduce acne,[23] but this is not recommended.
In vitiligo, avoidance of citrus fruits is now believed to play no role. Since standard textbooks do not recommend avoidance of the same, they can be safely consumed by the patients with vitiligo.
The dermatoses which are due to reduce intake or excessive. intake of diet, are mostly managed by altering the dietary habits of the patients, however appropriate suggestions are required for specific dermatoses or else it may cause some other dermatoses. 

   References Top

1.Hanumanthappa H. Diet in Dermatology. Indian J Dermatol Venereal Leprol 2001;67:284-286.  Back to cited text no. 1    
2.Coette DK, Odom RB. Alopecia in crash dieters. JAMA 1976; 235:2622-2623.  Back to cited text no. 2    
3.Kautmon JP T etogen effluvium secondary to starvation diet. Arch Dermatol 1976;112: 731.  Back to cited text no. 3    
4.Headington JT Telogen effluvium and review: New concepts. Arch Dermatol 1993;129:356-363.  Back to cited text no. 4    
5.Gumimer CL. Diet and hair loss. In Maibach H, Rook AJ, eds. Seminars in Dermatology, vol.4. New York. Thieme Stratton, 1985: 5364.  Back to cited text no. 5    
6.Coumaish JH. Metabolic disorders and hair growth. Br J Dermatol 1971; 84:83-85.  Back to cited text no. 6    
7.Weismann K. Zinc metabolism and skin. In: Rook A, Savin J, eds Recent Advances in Dermatology. Edinburgh: Churchill Livingstone 1980; 109-114.  Back to cited text no. 7    
8.Sweetman L, Such L, Baker H, et al. Clinical and metabolic abnormalities in a boy with dietary deficiency of biotin. Pediatrics 1981, 68:553-558.  Back to cited text no. 8    
9.Lopez NR, Gomex CR. 11. Probable etiologic de la alopecia in lo: enfermos lotiricos esponoies. Arch Neurobioi 1978;41: 461-486.  Back to cited text no. 9    
10.Ethel T, Sarah B. Diet and pemphigus. Arch Dermatol 1998; 134 1406-1410.  Back to cited text no. 10    
11.Creip LH. Allergic vascular purpura. J Allergy Clinic Immuno 1971; 48: 7-12.  Back to cited text no. 11    
12.Voion NK, Krogdshl S. Cutaneous vasculities induced by foot additives. Ada Derm Venereal 1991; 71: 73-78.  Back to cited text no. 12    
13.Zaleski WA, Hill A, Kuishniruk W. Skin lesions in tyrosinosis response to dietary treatment. Br J Dermatol 1973; 88: 335-340.  Back to cited text no. 13    
14.Ney D, Bay C, Schneilder JA. Dietary management o aculocutaneous tyrosinaemia in an 11 year old child. Am J Dis Chilc 1983;137:995-1000.  Back to cited text no. 14    
15.Marks J. Studies with calcium in patients with calcinosis cutis. Br. Dermatol 1970; 82:1-9.  Back to cited text no. 15    
16.Tabuenca JM. Toxic allergic syndrome caused by suspected of denatured with aniline. Lancet 1981; 11:567-568.  Back to cited text no. 16    
17.Walker DM, Dolby AE, Mead J, et al. Effect of gluten free diet or recurrent aphthous ulceration. Br. J Dermatol 1980; 103: 111.  Back to cited text no. 17    
18.Lavaud F, Cossart C, Reiter V, et al. Latex allergy in patients witl allergyto fruit. Lancet 1992; 339: 492-493.  Back to cited text no. 18    
19.Rodriguez M, Vega F, Carcia MT, et al. Hypersensitivity to latex chestnut and banana. Ann Allergy 1993; 70: 31-34.  Back to cited text no. 19    
20.De corres LF, Monco I, Munoz D et al. Sensitization from chestnut and bananas in patients with urticaria and anaphylaxis from contac with latex. Ann Allergy 1993; 70: 35-39.  Back to cited text no. 20    
21.Sheretz EF Improved acanthosis nigricans with lipodystrophic diabete during dietary fish oil supplementation. Arch Dermatol 1988; 124 1094-1096.  Back to cited text no. 21    
22.Rackett SC. Rothe MJ, Kels G. Diet and dermatology. J Am Acac Dermatol 1993; 29: 447-461.  Back to cited text no. 22    
23.Pochi PE, Downing Dt, Stranos JS. Sebaceous gland response it man to prolonged total calorie deprivation. J Invest Dermatol 1970; 55 303-309.  Back to cited text no. 23    


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