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Background <p>Anorexia nervosa (AN) is a severe psychiatric disorder associated with extreme malnutrition and multi-organ complications, including cutaneous manifestations.</p> Case presentation <p>We report an 11-year-old girl with restrictive-type AN who presented with a critically low BMI (7.7–9.0&#xa0;kg/m<sup>2</sup>), who presented with striking cutaneous findings. These included widespread striae distensae with a translucent, “cellophane-like” appearance, desquamative lesions reminiscent of the “flaky paint” dermatosis seen in kwashiorkor, and sacral pressure ulcers. Laboratory findings revealed severe protein-energy deficiency, anemia, electrolyte imbalance, and endocrine alterations. A structured refeeding program with close monitoring led to substantial clinical improvement. Over 8 weeks, her weight increased by 6&#xa0;kg, and the skin gradually regained thickness, elasticity, and integrity.</p> Discussion <p>This case highlights the interplay of nutritional deficiency, catabolism, cortisol elevation, and mechanical stress in producing rare dermatoses in anorexia nervosa. The co-occurrence of glassy striae and flaky desquamation suggests a marasmic–kwashiorkor phenotype of malnutrition. The reversibility of these lesions further underscores the remarkable regenerative capacity of the skin under restored nutritional conditions.</p>

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Extensive striae and cellophane-like skin in an adolescent case of restrictive anorexia nervosa: a rare dermatologic manifestation of extreme malnutrition

  • 期刊论文

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  • 发表日期：

    2025年12月5日

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  • Peihua Song,
  • Chao Chen,
  • Lei Yang,
  • Xiaoyu Wang,
  • Xiaotong Sun,
  • Xueni Li,
  • Xiao Zhang

摘要

Background

Anorexia nervosa (AN) is a severe psychiatric disorder associated with extreme malnutrition and multi-organ complications, including cutaneous manifestations.

Case presentation

We report an 11-year-old girl with restrictive-type AN who presented with a critically low BMI (7.7–9.0 kg/m2), who presented with striking cutaneous findings. These included widespread striae distensae with a translucent, “cellophane-like” appearance, desquamative lesions reminiscent of the “flaky paint” dermatosis seen in kwashiorkor, and sacral pressure ulcers. Laboratory findings revealed severe protein-energy deficiency, anemia, electrolyte imbalance, and endocrine alterations. A structured refeeding program with close monitoring led to substantial clinical improvement. Over 8 weeks, her weight increased by 6 kg, and the skin gradually regained thickness, elasticity, and integrity.

Discussion

This case highlights the interplay of nutritional deficiency, catabolism, cortisol elevation, and mechanical stress in producing rare dermatoses in anorexia nervosa. The co-occurrence of glassy striae and flaky desquamation suggests a marasmic–kwashiorkor phenotype of malnutrition. The reversibility of these lesions further underscores the remarkable regenerative capacity of the skin under restored nutritional conditions.