Eating and weight disorders : EWD · 2025
Extensive striae and cellophane-like skin in an adolescent case of restrictive anorexia nervosa: a rare dermatologic manifestation of extreme malnutrition.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Song Peihua, Chen Chao, Yang Lei, Wang Xiaoyu, Sun Xiaotong, Li Xueni, Zhang Xiao
Аннотация
BACKGROUND: Anorexia nervosa (AN) is a severe psychiatric disorder associated with extreme malnutrition and multi-organ complications, including cutaneous manifestations.
CASE PRESENTATION: We report an 11-year-old girl with restrictive-type AN who presented with a critically low BMI (7.7-9.0 kg/m2), who presented with striking cutaneous findings. These included widespread striae distensae with a translucent, "cellophane-like" appearance, desquamative lesions reminiscent of the "flaky paint" dermatosis seen in kwashiorkor, and sacral pressure ulcers. Laboratory findings revealed severe protein-energy deficiency, anemia, electrolyte imbalance, and endocrine alterations. A structured refeeding program with close monitoring led to substantial clinical improvement. Over 8 weeks, her weight increased by 6 kg, and the skin gradually regained thickness, elasticity, and integrity.
DISCUSSION: This case highlights the interplay of nutritional deficiency, catabolism, cortisol elevation, and mechanical stress in producing rare dermatoses in anorexia nervosa. The co-occurrence of glassy striae and flaky desquamation suggests a marasmic-kwashiorkor phenotype of malnutrition. The reversibility of these lesions further underscores the remarkable regenerative capacity of the skin under restored nutritional conditions.
CASE PRESENTATION: We report an 11-year-old girl with restrictive-type AN who presented with a critically low BMI (7.7-9.0 kg/m2), who presented with striking cutaneous findings. These included widespread striae distensae with a translucent, "cellophane-like" appearance, desquamative lesions reminiscent of the "flaky paint" dermatosis seen in kwashiorkor, and sacral pressure ulcers. Laboratory findings revealed severe protein-energy deficiency, anemia, electrolyte imbalance, and endocrine alterations. A structured refeeding program with close monitoring led to substantial clinical improvement. Over 8 weeks, her weight increased by 6 kg, and the skin gradually regained thickness, elasticity, and integrity.
DISCUSSION: This case highlights the interplay of nutritional deficiency, catabolism, cortisol elevation, and mechanical stress in producing rare dermatoses in anorexia nervosa. The co-occurrence of glassy striae and flaky desquamation suggests a marasmic-kwashiorkor phenotype of malnutrition. The reversibility of these lesions further underscores the remarkable regenerative capacity of the skin under restored nutritional conditions.