Biotin deficiency

Definition

In infants on biotin-free TPN, symptoms of biotin deficiency begin to appear within 3 to 6 months after initiation of the TPN regimen, which is earlier than that seen in adults, probably because of the increased biotin requirement related to growth. The associated rash appears first around the mouth, eyes, and nose. The rash and the unusual distribution of facial fat observed in these infants together are called biotin deficiency facies. As the rash progresses, the ears and perineal orifices are affected. In biotin-deficient infants, hypotonia, lethargy, and developmental delay, along with a peculiar withdrawn behavior, are all characteristic of a neurological disorder resulting from a lack of biotin.

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