What Is a Folate Deficiency?

Folic acid deficiency is a series of clinical manifestations of nutritional deficiencies such as skin pigmentation, megaloblastic anemia, stomatitis, and seborrheic dermatitis-like skin lesions caused by insufficient folic acid in the body. Pregnant women, lactating women, adolescents, and infants are all at high risk for this disease.

Basic Information

Visiting department

dermatology

Common causes

Due to inadequate folic acid intake, digestion, absorption, and utilization disorders, increased demand and excessive excretion

Common symptoms

Skin scaly pimples and plaques, cheilitis, glossitis, etc.

Contagious

no

Causes of folic acid deficiency

The disease can be caused by insufficient intake of folic acid, impaired digestion, absorption, and utilization, increased demand, and excessive excretion.
1. Congenital diseases that do not absorb folic acid, insufficient supply, lack of appetite, subtropical malabsorption syndrome, etc. can cause folic acid deficiency.
2. Pregnant and lactating women, infants and young people who have a large demand for folic acid.
3. Anemia, malignant tumor, parasitic infection, aseptic abscess, exfoliative dermatitis, etc. increase the consumption of folic acid.
4. Alcoholism and the use of certain drugs (such as anticonvulsants) affect folic acid absorption.

Clinical manifestations of folic acid deficiency

1. Folic acid deficiency skin damage occurs on the face, trunk, and extremities of the extremities. It is scaly pimples and plaques, and it shows seborrheic dermatitis-like changes. Gray-brown pigmentation can be seen in exposed areas and palms and palms. , Glossitis, tongue congestion, ulcers, filamentous nipples and mushroom nipples have shrunk and disappeared, the tongue surface is red and smooth, conscious pain, and oral diarrhea.
2. This disease can also cause megaloblastic anemia. Deficiency of folic acid in pregnant women can not only cause megaloblastic anemia, but also cause fetal malformations such as embryonic retardation, mental retardation, neural tube defects, and cleft lip (rabbit lip). Long-term deficiency of folic acid in the elderly can cause intellectual degenerative syndrome. Deficiency of folic acid in infants and young children can also lead to mental weakness and slow development.

Folic acid deficiency test

Folic acid concentration test, serum folic acid concentration <7 nmol / L can be determined as folic acid deficiency, red blood cell folic acid concentration <305 nmol / L is the standard for determining the deficiency of folic acid nutrition.

Folic acid deficiency diagnosis

Collect the patient's medical history, especially paying attention to the patient's history of folic acid deficiency and megaloblastic anemia. The disease should be suspected, and the diagnosis can be confirmed by measuring the concentration of folic acid.

Differential diagnosis of folic acid deficiency

1. Lille melanosis Lille melanosis is more common in middle-aged women. It occurs in exposed parts of the face, neck, forearm, and back of the hand. It is a flake-like gray-brown pigmentation spot without mucosal damage such as glossitis or cheilitis. No megaloblastic anemia occurred.
2. Exfoliative cheilitis Exfoliative cheilitis is characterized by redness, swelling, pain, dryness, cracks or ulcers on the lips, without skin pigmentation.
3. Seborrheic dermatitis folic acid deficiency has skin pigmentation and can be associated with mucosal damage such as cheilitis or glossitis, which can be identified.

Folic acid deficiency treatment

Consumption of foods rich in folic acid, oral or intramuscular injection of folic acid preparations can be combined with vitamin B12 or multivitamin B preparations to improve the therapeutic effect, calcium formyltetrahydrofolate acts quickly, and combined with vitamin B12 can treat malignant anemia. In addition, if there is a primary disease, the primary disease should be actively treated on the basis of folic acid supplementation. For skin pigmentation and mucosal damage such as glossitis and cheilitis, external medicine can be selected.

Folic acid deficiency prognosis

Folic acid deficiency can cause megaloblastic anemia, the prognosis of which is related to the degree of anemia, the presence of complications and treatment sooner or later. If the treatment is timely, the prognosis is good. If the anemia is severe, congestive heart disease can occur on the basis of anemia heart disease. Failure leads to death.

Folic acid deficiency prevention

Attention should be paid to eating folic acid-rich foods to prevent folic acid deficiency. Pregnant women should supplement folic acid within 28 days before and after pregnancy to prevent neural tube defects and other congenital abnormalities.