Which physical findings are characteristic of chronic vitamin A toxicity?

Updated: Jun 01, 2020
  • Author: Mark Rosenbloom, MD, MBA; Chief Editor: Michael A Miller, MD  more...
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Chronic vitamin A toxicity affects the skin, the mucous membranes, and the musculoskeletal and neurologic systems. Skin and mucous membrane effects include erythema, eczema, pruritus, dry and cracked skin, angular cheilitis, conjunctivitis, palmar and plantar peeling, and alopecia.

Musculoskeletal effects include pain and tenderness, particularly in the long bones of the upper and lower extremities, which may be exacerbated by exercise. Neurologic effects include blurred vision and frontal headache, which is often the first sign of toxicity.

In addition, studies suggest that elevated levels of vitamin A may cause increased bone resorption and promote the development of osteoporosis. [5, 44]

Manifestations of chronic vitamin A toxicity also include the following:

  • Alopecia

  • Erythematous dermatitis

  • Skin desquamation

  • Brittle nails

  • Exanthema

  • Cheilitis

  • Conjunctivitis

  • Petechiae

  • Liver cirrhosis

  • Hepatosplenomegaly

  • Peripheral neuritis

  • Benign intracranial hypertension

  • Ataxia

  • Papilledema

  • Diplopia

  • Hyperostosis

  • Edema

  • Hepatic hydrothorax [45]

  • Hepatomegaly

  • Ascites

  • Migratory arthritis

  • Craniotabes (in children)

  • Bulging fontanelle (in infants)

  • Epiphyseal capping and premature epiphyseal closure

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