Folic acid deficiency is closely associated with the development of anemia. The condition is often caused by inadequate consumption of folic-acid containing foods, but may also result from cirrhosis of the liver or systemic malabsorption. Symptoms of the deficiency are typically the same as occur with other types of anemia, frequently encompassing redness and cracking of the skin around the mouth, soreness of the tongue, diarrhea, and stomach and intestinal ulcers. Abrupt improvement generally occurs when folic acid is administered orally to sufferers of the vitamin deficiency, a treatment that also results in dramatic improvement to those afflicted with tropical spruce disease.