Dermatologic findings in anorexia and bulimia nervosa of childhood and adolescence

The cutaneous signs of anorexia nervosa (AN) and bulimia nervosa (BN) have been described previously in adult patients. For the first time, we present here dermatologic findings in children and adolescents suffering from eati ng disorders. Thirty consecutive young anorexic and bulimic inpatients (8 t o 17 years of age, mean 15.1 years) underwent a standardized dermatologic e xamination. Patients were checked for abnormalities of the skin including a topic stigmata, dermographism, hair, nails, and oral cavity. Serum was obta ined for hemoglobin, iron, zinc, GPT, thyroid, and sex-hormone levels. In 1 3 patients, the total serum IgE was determined, and a prick test was carrie d out with defined type 1 allergens. Findings in order of frequency include d xerosis of the skin, white dermographism, diffuse hypertrichosis, acrocya nosis, scars, diffuse effluvium, artifacts, brittle nails, and onychophagia . Significant correlations were found between the presence of hypertrichosi s and the existence of amenorrhea or a body mass index of less than 16. In 22 patients a low T3 level was found. In summary, children and adolescents suffering from AN or BN show dermatologic features similar to those reporte d in older patients. Special findings in this age group are extensive lanug o hair and signs of autoaggressive behavior.