Early symptoms are characterized by cheilosis (lesions of the lips and the angles of the mouth), angular stomatitis (inflammation of the mucous membrane of the mouth), glossitis (inflammation of the tongue), and seborrheic dermatitis. Ocular manifestations like photophobia, itching, burning, circumcorneal capillary engorgement, dimness of vision and a feeling a grittiness of the eyes are observed.
1) Skin
Seborrheic dermatitis is usually found in the nasolabial region (folds of the nose), near the inner the outer canthus of the eyes, behind the ears and on the posterior side of the scrotum. Fine scaly desquamation of the skin is present.
Scrotal dermatitis – redness, scaling or desquamation of superficial skin of scrotum (in male) and vulva (in female) are observed.
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2) Eyes
Corneal vascularisation- eyelids become rough, itching, watering and soreness of eyes, blurring of vision, sensitivity to light and the eyes are easily fatigued. An increased number of capillaries develop in the cornea and the eyes become bloodshot in appearance.
3) Mouth.
Angular stomatitis with cracking at the corners of the mouth. Cheilosis-The lips are inflammed.
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4) Changes in Tongue
Glossitis, atrophic papillae, (complete disappearance of filiform papillae giving the tongue an extremely smooth and purplish appearance).
5) Low levels of urinary excretion.
6) A failure of maturation of red blood cells in bone narrow.
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Treatment, Control and Prevention
Treatment of ariboflavinosis consists of administration of riboflavin with improvement of the diet.
For a normal healthy person the quantiative requirement of riboflavin is 0.6 mg/l000 cals. Therefore, the diet should be rich in milk and milk products (skimmed milk, butter milk, whey, curd cheese), organ meats, leafy vegetables, eggs, wheat germ, dried brown yeast, enriched and fortified flour and bread. The daily safe requirement is 0.7-2.2 mg. day depending upon age, physiological status and level of acitivity.
Synthetic riboflavin is available for both oral and parenteral adminsitration. This vitamin is given orally in doses of 5 mg three times daily and supplementation should continue until complete recovery. If a person fails to respond to oral medication it can be given intravenously. The deficiency symptoms disappear in a few weeks.
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Some of the steps which may be taken to prevent riboflavin deficiency are:
i. Distribution of milk in opaque bottles, brown glass bottles or paper containers avoids direct exposure to bright day-light or sunlight.
ii. The usual cooking procedures for vegetables do not contribute too much loss, but the addition of sodium bicarbonate to preserve the green colour of vegetables is destructive and hence should be avoided.
iii. Because it is water soluble, some of the vitamin is lost by discarding cooking water.
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iv. A void soaking vegetables or simmering them, for this may mean heavy loss of this vitamin.