390 RIBOFLAVIN 



Sydenstricker'^^ ' ^'^ noted an itching dermatitis of the scrotum or vulva in 

 patients with pellagra. Purcell'" described a scrotal dermatitis that im- 

 proved with riboflavin treatment. Mitra^^^ reported a urogenital lesion 

 among Indians which responded to riboflavin. Goldberger and Wheeler^^^ 

 showed that six of their eleven patients exhibited scrotal dermatitis before 

 any other lesions of pellagra appeared. In a recent study ^^^ scrotal dermatitis 

 was the most frequently observed symptom of riboflavin deficiency; twelve 

 of fifteen subjects had it, either mildly or severely. Typically, this began 

 as a patchy redness associated with scaling and desquamation of the super- 

 ficial epithelium of the anterior surface of the scrotum. The median com- 

 missure was uninvolved in most of the patients. The more prolonged and 

 severe cases showed a lichenification of the involved areas. The far-advanced 

 lesion became quite raw and extended up the shaft of the penis or to the 

 inner aspects of the thigh. The response to treatment with 6 mg. of ribo- 

 flavin per day was prompt, and in two cases with severe inflammation it 

 was dramatic. This recent study emphasizes the question of the role of 

 ariboflavinosis in the development of those scrotal and vulval lesions which 

 have been considered characteristic of pellagra. 



3. Ocular Manifestations 



In experimental animals vascularization of the cornea and involvement 

 of the lids are early and constant findings.^®' ^^' ^^" In man, ocular pathology 

 is not constant, but it may occur in a high percentage of cases. Conjuncti- 

 vitis, lacrimation, and burning of the eyes have been observed as manifesta- 

 tions which have been cured by riboflavin by sufficient investigators to be 

 non-controversial; corneal vascularization in human riboflavin deficiencies 

 has not been noted so often under controlled conditions. 



Spies and his associates^- "• ^^^ were among the first to note that the ocular 

 lesions were cured by riboflavin administration. Sydenstricker and co- 

 workers"'' reported that photophobia was associated with conjunctivitis. 

 Reduced visual acuity, itching, a sensation of roughness of the eyelids, 

 keratitis, and mydriasis have also been reported."^- ^'^' i^i-hs 



Rubeosis iridis has been suggested as a manifestation of deficiency which 



'36 V. P. Sydenstricker, Am. /. Public Health 31, 344 (1941). 

 "6 V. P. Sydenstricker, Ann. Internal Med. 14, 1499 (1941). 



137 F. M. Purcell, Trans. Ro^j. Soc. Trop. Med. Hyg. 35, 323 (1942). 



138 K. Mitra, Indian Med. Gaz. 78, 330 (1943). 



139 J. Goldberger and G. A. Wheeler, Public Health Service, Hygienic Lab. Bull. 120, 

 116 (1920). 



"" R. E. Eckardt and L. V. Johnson, Arch. Ophthalmol. 21, 315 (1939). 

 "1 H. C. Hou, Chinese Med. J. 59, 314 (1941). 



i'2 P. n. Pock-Steen, Geneesk. Tijdschr. Ned.-Indie 79, 1980 (1939). 

 I" P. R. Wilkinson, Lancet II, 055 (1944). 



