Pellagra: A Non-Eradicated Old Disease

Abstract

We report a case of a 50-year old homeless male who presented with pellagra and pellagrous encephalopathy. The characteristic - if not pathognomonic - skin lesions of pellagra support its diagnosis on solely clinical grounds. Clinicians should keep a high index of suspicion, in certain patient groups, in order to early diagnose and cure this potentially fatal but treatable disease.

Metabolomic Alteration in the Mouse Distal Colonic Mucosa after Oral Gavage with Oxalobacter formigenes

“…It is worth mentioning that NA can be synthesized to some extent in vivo from tryptophan [ 27 ], meaning cases of NA malnutrition are rarely seen in developed nations and have historically afflicted mainly poverty-stricken populations with low-protein diets [ 28 ]. Dietary deficiency of NA causes Pellagra, a disease commonly associated with the “4 D’s”, which are diarrhea, dermatitis, dementia, and death [ 13 , 29 ]. This pathology is believed to arise due to the disruption of a variety of metabolic pathways involving nicotinamide adenine dinucleotide, which requires NA as a biosynthetic precursor [ 30 ].…”

Scaly Erythematous Acral Eruption

“…1,3 In developing countries where the bread and flour are not enriched with niacin or the diet is mainly corn or maize, pellagra remains prevalent. 1,4 Pellagra is exceedingly rare in developed countries because of food supplementation. The patient presented above had severe malabsorption secondary to multiple abdominal surgeries including a gastric bypass and Rouxen-Y bariatric surgery.…”

“…3 Early pellagra can manifest with weakness, appetite loss, digestive problems, and psychiatric symptoms (anxiety, depression, and irritability). 4 Cutaneous findings include a bilateral symmetrical eruption at sites of sunlight exposure, most commonly the dorsum of the hands. The dermatitis typically starts as a well-demarcated, tender, erythematous area of acute or intermittent onset and eventually becomes brown and exudative with pruritus and burning.…”

Vitamin B3 in der kosmetischen Dermatologie

“…Es kann sich auch eine Glossitis ausbilden bis hin zu einer Lingua villosa nigra. Die Pellagra ist bei weitem nicht ausgestorben und weiterhin abhängig von der Ernährungslage [4]. In unsere differenzialdiagnostischen Überlegungen sollten wir diese Mangelerkrankung bei schuppenden bis rhagadiformen hyperpigmenierten Dermatosen einschließen (▶ Tab.…”

“…Es senkt das LDL-Cholesterin und Triglyceride, führt jedoch zu einem Flush über Prostaglandin-Freisetzung. Bei Gicht darf es nicht gegeben werden, da es die Harnsäure-Werte erhöht [4].…”