Autoimmune Thyroid Disease

An Unfortunate and Lengthy Adventure in Misdiagnosis

Dermatitis and oxalates

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I happened on this very old article by a dermatologist, written in 1929.

All sorts of dietetic regulations have been laid down as part of the treatment of acne and seborrhoea, mostly useless. The patient must of course avoid overeating and drinking, food which upsets the stomach, and food containing much oxalates. The importance of the latter restriction is not generally appreciated. I may mention the ease of a dermatological colleague who suffered from seborrhoea. In conversation with him over a case, he laughed at my fad in telling the patient to avoid altogether rhubarb, spinach, pineapple, and to only take moderate amounts of beans, cauliflower, and tea. Last summer he told me he was converted to my opinion, as he had personally found that after eating rhubarb he had an exacerbation of his seborrhoeic troubles. My attention was first directed to this many years ago. I was consulted about an epidemic of skin trouble in a large school for girls. The cases were so numerous that it was thought to be some infectious disease; the school infirmary was overflowing with cases. I found them to be all acute seborrhoeic dermatitis. Of course, this is not uncommon among adolescent girls, but in this school it was beyond all normal proportions. I was a little puzzled to account for this but when I left the infirmary by the back door, I came upon one of the biggest plantations of rhubarb I had ever seen. Investigations about the diet demonstrated that the school authority had a theory that lots of rhubarb was good for health. The girls had rhubarb jam for breakfast and tea, rhubarb pies or stewed rhubarb for dinner and supper. Acne and seborrhoea were common in the school at all times. I advised a no-rhubarb diet, with almost immediate good results, and the great rhubarb plantation was scrapped. After clinical experience and observation, my opinion is amply confirmed. Always investigate what oxalic foods the patient is taking, and if much oxalate of lime is found in the urine, treat your patient for a time with small doses of hydrochloric acid with meals and magnesia between meals. SOME DERMATO-THERAPEUTIC NOTES by A. W. WILIAMS, Can Med Assoc J. 1930 June; 22(6): 821–825 [PDF]

An interesting and amusing anecdote!

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Written by alienrobotgirl

18 July, 2006 at 11:32 am

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