Pellagra and alcoholism: case report
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Abstract
Pellagra is mainly caused by a niacin deficiency or its precursor amino acid, tryptophan. We report a case of a male patient, 34 years old, a chronic alcoholic with delirium tremens and gastrointestinal symptoms (diarrhea, inappetence, and heartburn). He presented erythematous-brown, scaly, and well-defined plaques dispersed throughout the integument (photo-exposed areas) for 2 months that evolved with ulceration and hematic crusts. The case was diagnosed as pellagra associated with secondary bacterial infection and treated with rest, an unrestricted diet, B-complex replacement, abstention from alcohol, restriction of sun exposure, and broad-spectrum antibiotic therapy. The treatment allowed for significant improvement of symptoms in one week. Aspects of the pathophysiology and differential diagnoses of this condition are discussed, reinforcing the importance of considering pellagra in diagnosing patients with skin lesions associated with risk factors for malnutrition.
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References
2. Badawy AA. Pellagra and Alcoholism: A Biochemical Perspective. Alcohol and Alcoholism. 2014;49(3):238-50. https://doi.org/10.1093/alcalc/agu010
3. Prabhu D, Dawe RS, Mponda K. Pellagra a review exploring causes and mechanisms, including isoniazid-induced pellagra. Photodermatol Photoimmunol Photomed. 2021;37(2):99-104. https://doi.org/10.1111/phpp.12659
4. Morabia A. Joseph Goldberger's research on the prevention of pellagra. J R Soc Med. 2008;101(11):566-8. https://doi.org/10.1258/jrsm.2008.08k010
5. López M, Olivares JM, Berrios GE. Pellagra encephalopathy in the context of alcoholism: review and case report. Alcohol Alcohol. 2013;49(1):38-41. https://doi.org/10.1093/alcalc/agt070
6. Gupta Y, Shah I. Ethionamide-induced Pellagra. J Trop Pediatr. 2015; 61(4):301-3. https://doi.org/10.1093/tropej/fmv021
7. Piqué-Duran E, Pérez-Cejudo JA, Cameselle D, Palacios-Llopis S, García-Vázquez O. Pellagra: a clinical, histopathological, and epidemiological study of 7 cases. Actas Dermosifiliogr. 2012;103(1):51-8. https://doi.org/10.1016/j.adengl.2011.05.003
8. López D, Otero G. Pelagra: una enfermedad antigua en un mundo moderno. Nutr Hosp. 2021;38(3):667-70. https://doi.org/10.20960/nh.03513
9. Ng E, Neff M. Recognising the return of nutritional deficiencies: a modern pellagra puzzle. BMJ Case Rep. 2018;11(1):e227454. https://doi.org/10.1136/bcr-2018-227454
10. Matapandeu G, Dunn SH, Pagels P. An Outbreak of Pellagra in the Kasese Catchment Area, Dowa, Malawi. Am J Trop Med Hyg. 2017;96(5):1244-7. https://doi.org/10.4269/ajtmh.16-0423
11. Desai NK, Gable BP. Dermatitis as one of the 3 Ds of pellagra. Mayo Clin Proc. 2012;87(12):e113. https://doi.org/10.1016/j.mayocp.2012.08.018
12. Braverman ER. Medical history and holistic perspective. J Orthomol Med. 1988;3(4):191-6.
13. Noleto RS, Pinto NS, Godoy JSR. Pelagra: Correlação entre o diagnóstico e a apresentação clínica mais prevalente no Brasil. Res Soc Develop. 2021;10(9):e7210917787. https://doi.org/10.33448/rsd-v10i9.17787
14. Murga Y, Parra V, Aredes A, Alasino M, Torres A, Santolín L, et al. Manifestaciones cutáneas en el paciente alcohólico. Relación con la cirrosis. Dermatol Argent [Internet]. 2009 [cited 2022 Sep 3];15(4):255-259. Available from: https://test.dermatolarg.org.ar/index.php/dermatolarg/article/view/385