Pellagra

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    Pellagra is a dermatitis resulting from niacin and/or tryptophane deficiency (in persons whose staple food is sorghum; patients with malabsorption, or during famine).

    Clinical features

    Classically, disease of the ‘three Ds’: dermatitis, diarrhoea and dementia.

    • Dark red plaques, well demarcated, symmetric, located on exposed areas of the body (forehead, neck, forearms, legs). The skin becomes very scaly, pigmented, sometimes with haemorrhagic bullae.
    • Gastrointestinal (glossitis, stomatitis and diarrhoea) and neuropsychiatric symptoms are seen in more serious forms.

    Treatment

    Children and adults: 100 mg 3 times daily, give with a diet rich in protein until the patient is fully cured.

    • In the event of an epidemic of pellagra, for example in a refugee camp, it is vital that the food ration be modified (add groundnuts or dry vegetables) in order to meet the daily requirements (approximately 15 mg daily for adults).

     

    References