General appearance

Wasting

Total calories

Skin

Rash

Many vitamins, zinc, essential fatty acids

Rash in sun-exposed areas

(pellagra)

Easy bruising

Vitamin C or vitamin K

Hair and nails

Thinning or loss of hair

Protein

Premature whitening of hair

Spooning (upcurling) of nails

Iron

Eyes

Impaired night vision

Corneal keratomalacia (corneal drying and clouding)

Mouth

Cheilosis and glossitis

, niacin

Bleeding gums

Vitamin C,

Extremities

Edema

Protein

Nervous system

Paresthesias or numbness in a stocking-glove distribution

Thiamin (beriberi)

Tetany

Calcium, magnesium

Cognitive and sensory deficits

Thiamin, vitamin B12

Dementia

Thiamin, , vitamin B12

Musculoskeletal system

Wasting of muscle

Protein

Bone deformities (eg, bowlegs, knocked knees, curved spine)

, calcium

Bone tenderness

Joint pain or swelling

Vitamin C

Gastrointestinal system

Diarrhea

Protein, , folate, vitamin B12

Diarrhea and dysgeusia

Zinc

Dysphagia or odynophagia (due to Plummer-Vinson syndrome)

Iron

Endocrine system

Thyromegaly

Iodine