Age: usually infants + children

Cause: overdosing vitamin A, 13-cis-retinoic acid (treatment for neuroblastoma)

• anorexia, irritability; jaundice, enlargement of liver
• loss of hair, dry skin, pruritus, fissures of lips
• separation of cranial sutures (coronal >lambdoid) ← hydrocephalus in children <10 years of age, may appear within a few days
• symmetrical solid periosteal new-bone formation along shafts of long + short bones (ulna, clavicle)
• premature epiphyseal closure + thinning of epiphyseal plates
• accelerated growth
• tendinous, ligamentous, pericapsular calcifications
• changes usually disappear after cessation of vitamin A ingestion

DDx: infantile cortical hyperostosis (mandible involved)