Pellagra


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

– nicotinamide (vitamin PP) PO1
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

  1. World Health Organization, United Nations High Commissions for Refugees. Pellagra and its prevention and control in major emergencies. World Health Organization, 2000.
    http://www.who.int/nutrition/publications/en/pellagra_prevention_control.pdf [Accessed 23 May 2018]