Question

A 45 year old man presents with following skin changes. What relevant history will you take to diagnose this condition?

• A. H/o dietary pattern, dementia, diarrhea
• B. Dietary history
• C. Dementia
• D. Depression

Answer 1

The Correct Option is A

To diagnose the condition presented by the 45-year-old man, it is crucial to gather a comprehensive history that could point towards a deficiency syndrome or a nutritional disorder. The presence of specific skin changes, coupled with other potential symptoms, can guide us toward an accurate diagnosis. Here are the relevant history components you should focus on:

• H/o dietary pattern: Understanding the patient's diet is essential. This includes asking about food intake, any significant restrictions, and specific dietary habits that may lead to deficiencies.
• Dementia: Enquire if there have been any cognitive changes, such as memory loss or confusion, which may indicate a deficiency related to the central nervous system.
• Diarrhea: Chronic diarrhea can both be a symptom and a cause of nutritional deficiencies due to malabsorption.

Collecting a history specific to these components can help identify conditions like pellagra, which is characterized by the classical triad of dermatitis, dementia, and diarrhea, often due to niacin (Vitamin B3) deficiency. Hence, the comprehensive history-taking involving dietary pattern, dementia, and diarrhea is crucial for diagnosis.