DEFICENCY-related diseases where the poor intake of food and lack of appetite or fanciful eating of selected items malabsorption  Phrynoderma  It presents as asymptomatic hard acuminate, follicular papules usually on the extensors of the knees, elbows and buttocks. it is believed to be due to deficiency of vitamin A and /or essentials fatty acids and occurs more frequently in children. the lessons are very tough to touch. usually, the patients are healthy and do not show evidence of any nutritional deficiency. however, occasionally other signs of vitamin A deficiency like dry skin with ichthyotic scales and bitots spots don't the conjunctiva may be present.