Download PDF
CC BY-NC-ND 4.0 · Eur J Dent 2020; 14(01): 180-185
DOI: 10.1055/s-0040-1705073
Case Report

Anorexia Nervosa with Vomiting Episodes: Dermatological and Oral Complications

Elzbieta Paszynska
1   Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznań, Poland
,
Agata Dutkiewicz
2   Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
,
Agata Osinska
2   Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
,
Marta Mozol-Jursza
2   Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
,
Natalia Smalc
2   Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
,
Marta Tyszkiewicz-Nwafor
2   Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
,
Monika Dmitrzak-Weglarz
3   Department of Psychiatry, Psychiatric Genetics Unit, Poznan University of Medical S ciences, Poznań, Poland
,
Agnieszka Slopien
2   Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
,
Dorota Jenerowicz
4   Department and Clinic of Dermatology, Poznan University of Medical Sciences, Poznań, Poland
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

The aim of the study was to highlight the aspect of oral and cutaneous changes in anorexia nervosa (AN) as a purging type. On the basis of three clinical cases, a description has been made of the beginning and the possible course of the disease, teeth, oral mucosa, and skin changes resulting from the illness. The research method was based on the analysis of the available literature on AN supplemented by clinical experience of presented cases. On the basis of the interdisciplinary analysis, it was concluded that the appropriate diagnosis and treatment of AN are possible only with the collaboration of many specialists—psychiatrist or pediatric psychiatrist, general practitioner, dermatologist, dentist, and if necessary other medical specialists. In this context, psychotherapy is an integral aspect of treatment. Therefore, early intervention is essential to obtain good results of treatment.

Keywords

anorexia nervosa - vomiting - xerosis - dental erosion


Publication History

Article published online:
13 March 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Peat C, Mitchell JE, Hoek HW, Wonderlich SA. Validity and utility of subtyping anorexia nervosa. Int J Eat Disord 2009; 42 (07) 590-594
    CrossrefPubMedGoogle Scholar
  • 2 Casper RC, Eckert ED, Halmi KA, Goldberg SC, Davis JM. Bulimia. Its incidence and clinical importance in patients with anorexia nervosa. Arch Gen Psychiatry 1980; 37 (09) 1030-1035
    CrossrefPubMedGoogle Scholar
  • 3 Garner DM, Garner MV, Rosen LW. Anorexia nervosa “restricters” who purge: implications for subtyping anorexia nervosa. Int J Eat Disord 1993; 13 (02) 171-185
    CrossrefPubMedGoogle Scholar
  • 4 Clauwaert N, Jones MP, Holvoet L. et al. Associations between gastric sensorimotor function, depression, somatization, and symptom-based subgroups in functional gastroduodenal disorders: are all symptoms equal?. Neurogastroenterol Motil 2012; 24 (12) 1088-e565
    CrossrefPubMedGoogle Scholar
  • 5 Garfinkel PE, Moldofsky H, Garner DM. The heterogeneity of anorexia nervosa. Bulimia as a distinct subgroup. Arch Gen Psychiatry 1980; 37 (09) 1036-1040
    CrossrefPubMedGoogle Scholar
  • 6 Garner DM, Garfinkel PE, O’Shaughnessy M. The validity of the distinction between bulimia with and without anorexia nervosa. Am J Psychiatry 1985; 142 (05) 581-587
    CrossrefPubMedGoogle Scholar
  • 7 Pryor T, Wiederman MW, McGilley B. Clinical correlates of anorexia nervosa subtypes. Int J Eat Disord 1996; 19 (04) 371-379
    PubMedGoogle Scholar
  • 8 Halmi K, Brodland G, Loney J. Prognosis in anorexia nervosa. Ann Intern Med 1973; 78 (06) 907-909
    Google Scholar
  • 9 Deter HC, Herzog W. Anorexia nervosa in a long-term perspective: results of the Heidelberg-Mannheim Study. Psychosom Med 1994; 56 (01) 20-27
    CrossrefPubMedGoogle Scholar
  • 10 Romanos GE, Javed F, Romanos EB, Williams RC. Oro-facial manifestations in patients with eating disorders. Appetite 2012; 59 (02) 499-504
    CrossrefPubMedGoogle Scholar
  • 11 Lo Russo L, Campisi G, Di Fede O, Di Liberto C, Panzarella V, Lo Muzio L. Oral manifestations of eating disorders: a critical review. Oral Dis 2008; 14 (06) 479-484
    CrossrefPubMedGoogle Scholar
  • 12 Back-Brito GN, da Mota AJ, de Souza Bernardes LÂ. et al. Effects of eating disorders on oral fungal diversity. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113 (04) 512-517
    CrossrefPubMedGoogle Scholar
  • 13 Paszyńska E, Słopień A, Ślebioda ZS, Dyszkiewicz-Konwińska M, Weglarz M, Rajewski A. Macroscopic evaluation of the oral mucosa and analysis of salivary pH in patients with anorexia nervosa [article in Polish]. Psychiatr Pol 2014; 48 (03) 453-464
    PubMedGoogle Scholar
  • 14 Conviser JH, Fisher SD, Mitchell KB. Oral care behavior after purging in a sample of women with bulimia nervosa. J Am Dent Assoc 2014; 145 (04) 352-354
    CrossrefPubMedGoogle Scholar
  • 15 Uhlen MM, Tveit AB, Stenhagen KR, Mulic A. Self-induced vomiting and dental erosion–a clinical study. BMC Oral Health 2014; 14-92
    PubMedGoogle Scholar
  • 16 Willumsen T, Graugaard PK. Dental fear, regularity of dental attendance and subjective evaluation of dental erosion in women with eating disorders. Eur J Oral Sci 2005; 113 (04) 297-302
    CrossrefPubMedGoogle Scholar
  • 17 Johansson AK, Norring C, Unell L, Johansson A. Eating disorders and oral health: a matched case-control study. Eur J Oral Sci 2012; 120 (01) 61-68
    CrossrefPubMedGoogle Scholar
  • 18 Otsu M, Hamura A, Ishikawa Y, Karibe H, Ichijyo T, Yoshinaga Y. Factors affecting the dental erosion severity of patients with eating disorders. Biopsychosoc Med 2014; 8: 25
    CrossrefPubMedGoogle Scholar
  • 19 Hermont AP, Oliveira PA, Martins CC, Paiva SM, Pordeus IA, Auad SM. Tooth erosion and eating disorders: a systematic review and meta-analysis. PLoS One 2014; 9 (11) e111123
    CrossrefPubMedGoogle Scholar
  • 20 Robb ND, Smith BG, Geidrys-Leeper E. The distribution of erosion in the dentitions of patients with eating disorders. Br Dent J 1995; 178 (05) 171-175
    CrossrefPubMedGoogle Scholar
  • 21 Milosevic A, Dawson LJ. Salivary factors in vomiting bulimics with and without pathological tooth wear. Caries Res 1996; 30 (05) 361-366
    CrossrefPubMedGoogle Scholar
  • 22 Grippo JO, Simring M, Coleman TA. Abfraction, abrasion, biocorrosion, and the enigma of noncarious cervical lesions: a 20-year perspective. J Esthet Restor Dent 2012; 24 (01) 10-23
    CrossrefPubMedGoogle Scholar
  • 23 Altshuler BD. Eating disorder patients. Recognition and intervention. J Dent Hyg 1990; 64 (03) 119-125
    PubMedGoogle Scholar
  • 24 Fairburn CG. Cognitive Behavior Therapy and Eating Disorders. New York, NY: Guilford Press 2008
  • 25 Davis R, Olmsted M, Rockert W, Marques T, Dolhanty J. Group psychoeducation for bulimia nervosa with and without additional psychotherapy process sessions. Int J Eat Disord 1997; 22 (01) 25-34
    CrossrefPubMedGoogle Scholar
  • 26 Vella-Zarb RA, Mills JS, Westra HA, Carter JC, Keating L. A Randomized controlled trial of motivational interviewing + self-help versus psychoeducation + self-help for binge eating. Int J Eat Disord 2015; 48 (03) 328-332
    CrossrefPubMedGoogle Scholar
  • 27 Aranha AC, Eduardo CdeP, Cordás TA. Eating disorders part II: clinical strategies for dental treatment. J Contemp Dent Pract 2008; 9 (07) 89-96
    PubMedGoogle Scholar
  • 28 Kisely S, Baghaie H, Lalloo R, Johnson NW. Association between poor oral health and eating disorders: systematic review and meta-analysis. Br J Psychiatry 2015; 207 (04) 299-305
    CrossrefPubMedGoogle Scholar
  • 29 Milosevic A. Eating disorders and the dentist. Br Dent J 1999; 186 (03) 109-113
    CrossrefPubMedGoogle Scholar
  • 30 Schlagenhauf U, Kunzelmann K-H, Hannig C. et al. Impact of a non-fluoridated microcrystalline hydroxyapatite dentifrice on enamel caries progression in highly caries-susceptible orthodontic patients: a randomized, controlled 6-month trial. J Investig Clin Dent 2019; 10 (02) e12399
    CrossrefPubMedGoogle Scholar
  • 31 Glorio R, Allevato M, De Pablo A. et al. Prevalence of cutaneous manifestations in 200 patients with eating disorders. Int J Dermatol 2000; 39 (05) 348-353
    CrossrefPubMedGoogle Scholar
  • 32 Schulze UM, Pettke-Rank CV, Kreienkamp M. et al. Dermatologic findings in anorexia and bulimia nervosa of childhood and adolescence. Pediatr Dermatol 1999; 16 (02) 90-94
    CrossrefPubMedGoogle Scholar