Oculo-Orogenital Syndrome — A Deficiency of Vitamins B2 and B6
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《新英格兰医药杂志》
A 48-year-old man presented with a six-month history of irritated mouth angles, irritated genital skin, and red, burning eyes. On physical examination, he had blepharoconjunctivitis (Panel A), angular stomatitis (Panel B), a bright red and atrophic tongue, and dermatitis of the pubic area (Panel C). Findings on the remainder of the examination were unremarkable. For several months, the patient had been consuming approximately 150 g of alcohol daily and large quantities of beef and pork, but hardly any cereals or vegetables. Ultrasonography showed an enlarged, fatty liver. On routine laboratory testing, the hemoglobin level was 16.4 g per deciliter, the white-cell count was 4700 per cubic millimeter with a normal differential count (59.0 percent neutrophils, 1.5 percent eosinophils, 0.4 percent basophils, 6.4 percent monocytes, and 32.7 percent lymphocytes). The serum levels of vitamins B2 and B6 were markedly reduced, at 2.3 μg per deciliter (61.1 nmol per liter) (normal range, 3.8 to 24.0 ) and 1.1 μg per deciliter (65.8 nmol per liter) (normal range, 3.0 to 8.0 ), respectively.
The patient was treated with 100 mg of riboflavin per day intravenously and 150 mg of pyridoxine per day orally. All the skin lesions disappeared within 10 days. Nutritional instructions were given, but the patient refused treatment for his alcoholism.
André Friedli, M.D.
Jean-Hilaire Saurat, M.D.
University Hospital of Geneva
1211 Geneva 14, Switzerland
The patient was treated with 100 mg of riboflavin per day intravenously and 150 mg of pyridoxine per day orally. All the skin lesions disappeared within 10 days. Nutritional instructions were given, but the patient refused treatment for his alcoholism.
André Friedli, M.D.
Jean-Hilaire Saurat, M.D.
University Hospital of Geneva
1211 Geneva 14, Switzerland