Pellagra

Pellagra
The skin features of pellagra including peeling, redness, scaling, and thickening of sun-exposed areas.
SpecialtyDermatology
SymptomsInflammation of the skin, diarrhea, dementia, sores in the mouth[1]
TypesPrimary, secondary[1]
CausesNot enough niacin[2]
Diagnostic methodBased on symptoms[3]
Differential diagnosisKwashiorkor, pemphigus, photodermatitis, porphyria[3]
PreventionConsuming Niacin
TreatmentNiacin or nicotinamide supplementation.[1]
PrognosisGood (with treatment), death in ~ 5 years (without treatment)[3]
FrequencyRare (developed world), relatively common (developing world)[3]

Pellagra is a disease caused by a lack of the vitamin niacin (vitamin B3).[2] Symptoms include inflamed skin, diarrhea, dementia, and sores in the mouth.[1] Areas of the skin exposed to friction and radiation are typically affected first.[1] Over time affected skin may become darker, stiffen, peel, or bleed.[1][3]

There are two main types of pellagra, primary and secondary.[1] Primary pellagra is due to a diet that does not contain enough niacin and tryptophan.[1] Secondary pellagra is due to a poor ability to use the niacin within the diet.[1] This can occur as a result of alcoholism, long-term diarrhea, carcinoid syndrome, Hartnup disease, and a number of medications such as isoniazid.[1] Diagnosis is typically based on symptoms and may be assisted by urine testing.[3]

Treatment is with either niacin or nicotinamide supplementation.[1] Improvements typically begin within a couple of days.[1] General improvements in diet are also frequently recommended.[3] Decreasing sun exposure via sunscreen and proper clothing is important while the skin heals.[1] Without treatment death may occur.[3] The disease occurs most commonly in the developing world, often as a disease of poverty associated with malnutrition, specifically sub-Saharan Africa.[3]

  1. ^ a b c d e f g h i j k l m Ngan, Vanessa (2003). "Pellagra". DermNet New Zealand. Archived from the original on 9 April 2017. Retrieved 10 June 2017.
  2. ^ a b "Orphanet: Pellagra". orpha.net. Archived from the original on 17 April 2017. Retrieved 10 June 2017.
  3. ^ a b c d e f g h i Pitche P (2005). "Pellagra". Santé. 15 (3): 205–08. PMID 16207585.