FOLIC ACID DEFICIENCY IN PATIENTS WITH SKIN DISEASE

Thirty-three patients, 22 erythrodermic and 11 having psoriasis or eczema over more than half the body surface, were studied. Of these, 19/30 excreted increased amounts of formimino-glutamic acid (FIGLU) in the urine after an oral test-load of histidine. Twenty-one of 28 had low serum folate levels. Eleven of 25 in whom both FIGLU excretion and serum folate were measured showed abnormalities in both. Serum cobalamin levels were normal in all but one, as assayed by the Lactobacillus leichmannii method. Blood smears were abnormal in 2, and megaloblastic erythropoiesis was found in sternal marrow of 5/9. The serum folic acid levels did not correlate with hemoglobin concentrations, excretion of stearic acid in feces or serum Fe levels. Serum folate was measured as Lactobacillus casei factor; low levels were not due to an inhibitor, and the finding of megaloblastic erythropoiesis with normal cobalamin levels further indicates a true folic acid deficiency in these patients.