RIBOFLAVINE 



Skin Lesions 



W. H. vSebrell and R. E. Butler ^ appear to have been the first to 

 study artificial riboflavine deficiency in man ; they found that ten out 

 of eighteen women developed lesions in the angles of the mouth, 

 described as cheilosis, whilst the mucosa of the lips became red and 

 shiny and seborrhoeic accumulations appeared on the face. The 

 symptoms were cured by riboflavine but not by nicotinamide. Volun- 

 teers maintained for nine to seventeen months on a diet which supplied 

 only 0-55 mg. of riboflavine per 2200 cals. developed angular stoma- 

 titis, seborrhoeic dermatitis, scrotal skin lesions and also diminished 

 ability to perceive flicker. ^^ V. P. Sydenstricker et al.^ relieved 

 cheilosis in five patients by treatment with riboflavine, nicotinic acid 

 being ineffective. 



V. P. Sydenstricker,* in fact, regarded cheilosis and glossitis as 

 diagnostic of riboflavine deficiency, although these symptoms were 

 often preceded or followed by seborrhoeic lesions of the ear, nose and 

 forehead. The skin lesions, as well as the eye lesions, might yield 

 Staphylococcus aureus or Streptococcus haemolyticus on culture, but the 

 organisms disappeared after administration of riboflavine.^ Cheilosis 

 and seborrhoeic filiform excrescences on the face were observed in 

 badly-nourished Chinese and cleared up on treatment with riboflavine.^ 

 Cheilosis was also noted as a usual symptom of riboflavine deficiency 

 in infants and children in districts of Alabama, U.S.A."' The children 

 of mothers given riboflavine during pregnancy and lactation showed 

 no s3miptoms of riboflavine deficiency. 



T. E. Machella,^ on the other hand, claimed that cheilosis was not 

 an essential manifestation of riboflavine deficiency, for he observed a 

 number of cases of apparent ariboflavinosis , with lesions of the lips, 

 cornea and tongue, in which the cheilosis failed to respond to treat- 

 ment with riboflavine. Some of the cases responded to pyridoxine 

 and nicotinic acid, and others to ascorbic acid. One of the few con- 

 ditions that can be ascribed mainly to riboflavine deficiency is kwashior- 

 koi,^ which occurs in West Africa . The clinical response to riboflavine 

 administration in this condition was, however, confined to the healing 

 of epithelial lesions of the tongue, lips and external genitalia, the mor- 

 tality being unaffected. The condition is regarded as due to ribo- 

 flavine deficiency complicated by intercurrent disease and general 

 inanition. 



Ocular Lesions 



According to V. P. Sydenstricker, ^^ lesions of the eye due to ribo- 

 flavine deficiency in man may take the form of photophobia and dim- 

 ness of vision at a distance or in poor light with, as one of the earliest 



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