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Correspondence |

Acute Edema/Cutaneous Distention Syndrome Associated With Refeeding in a Patient With Anorexia Nervosa

Mari Kishibe, MD, PhD; Hiroyuki Sakai, MD, PhD; Hajime Iizuka, MD, PhD
Arch Dermatol. 2009;145(10):1202-1203. doi:10.1001/archdermatol.2009.240.
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We herein report a case of acute edema/cutaneous distention syndrome (AECDS) triggered by refeeding in a patient with anorexia nervosa. Patients with anorexia nervosa should be carefully monitored because nutritional therapy may induce AECDS.

Cox  NHChalmers  RJBhushan  M The acute edema/cutaneous distension syndrome. Arch Dermatol 2003;139 (2) 224- 225
PubMed Link to Article[[XSLOpenURL/10.1001/archderm.139.2.224]]
Bhushan  MChalmers  RJCox  NH Acute oedema blisters: a report of 13 cases. Br J Dermatol 2001;144 (3) 580- 582
PubMed Link to Article[[XSLOpenURL/10.1046/j.1365-2133.2001.04087.x]]
Bhushan  MCox  NHChalmers  RJ Eczéma craquelé resulting from acute oedema. Br J Dermatol 2001;145 (2) 355- 357
PubMed Link to Article[[XSLOpenURL/10.1046/j.1365-2133.2001.04357.x]]
Ishiguro  NHirohara  DHotta  MTakano  KKawashima  M Linear erythéma craquelé due to acute oedema in anorexia nervosa. Br J Dermatol 2001;145 (2) 357- 359
PubMed Link to Article[[XSLOpenURL/10.1046/j.1365-2133.2001.04358.x]]
Ishiguro  NKawashima  M Striaelike epidermal distension: a newly recognized cutaneous manifestation in acute leg edema. Arch Dermatol 2002;138 (5) 641- 642
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Figure 1

Lesions on the leg of our patient. A, Linear erythematous lesions, grayish bullae, and edema were seen on admission. B, Worsening of the linear erosions, erythema, and grayish bullae were noted 4 days after refeeding.

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Figure 2

Histopathologic analysis showed necrotic keratinocytes in the upper layers and spongiosis in the lower layers of the epidermis. Edema, dilated blood vessels, and extravasated erythrocytes are present in the underlying dermis.

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