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Nihon Rinsho Men'eki Gakkai Kaishi =... 2015Niacin, also known as vitamin B3, is required for the synthesis of coenzymes, nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate... (Review)
Review
Niacin, also known as vitamin B3, is required for the synthesis of coenzymes, nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP). Niacin binds with G protein-coupled receptor (GPR) 109A on cutaneous Langerhans cells and causes vasodilation with flushing in head and neck area. Niacin deficiency due to excessive alcohol consumption, certain drugs or inadequate uptake in diet causes pellagra, a photosensitivity dermatitis. Recently several studies have revealed the mechanism of photosensitivity in niacin deficiency, which may pave a way for new therapeutic approaches. The expression level of prostaglandin E synthase (PTGES) is up-regulated in the skin of both pellagra patients and niacin deficient pellagra mouse models. In addition, pellagra is mediated through prostaglandin E₂-EP4 (PGE₂-EP4) signaling via reactive oxygen species (ROS) production in keratinocytes. In this article, we have reviewed the role of niacin in immunity and the mechanism of niacin deficiency-induced photosensitivity.
Topics: Animals; Dinoprostone; Humans; Intramolecular Oxidoreductases; Keratinocytes; Langerhans Cells; Mice; Niacin; Pellagra; Prostaglandin-E Synthases; Reactive Oxygen Species; Receptors, G-Protein-Coupled; Receptors, Prostaglandin E, EP4 Subtype; Signal Transduction; Skin; Up-Regulation; Vasodilation
PubMed: 25765687
DOI: 10.2177/jsci.38.37 -
Photodermatology, Photoimmunology &... Mar 2021Pellagra is a clinical syndrome caused by a deficiency of niacin (nicotinic acid) and/or its precursor tryptophan. The cardinal manifestations are 4 D's: dermatitis,... (Review)
Review
Pellagra is a clinical syndrome caused by a deficiency of niacin (nicotinic acid) and/or its precursor tryptophan. The cardinal manifestations are 4 D's: dermatitis, diarrhoea, dementia and in worst case death. Increased use of isoniazid prophylaxis along with antiretroviral therapy in countries where latent tuberculosis is common has been associated with increased presentations with pellagra.
Topics: AIDS-Related Opportunistic Infections; Antitubercular Agents; HIV Infections; Humans; Isoniazid; Pellagra
PubMed: 33471377
DOI: 10.1111/phpp.12659 -
Hellenic Journal of Nuclear Medicine 2023The carcinoid syndrome (CS) is a constellation of symptoms attributed to hypersecretion of amines, prostaglandins and polypeptides. The cardinal symptoms of CS are...
The carcinoid syndrome (CS) is a constellation of symptoms attributed to hypersecretion of amines, prostaglandins and polypeptides. The cardinal symptoms of CS are flushing, diarrhea and bronchospasm; however, CS may present with various symptoms and signs, as: Skin: cutaneous flushes, cyanosis, pellagra, Gastrointestinal: diarrhea, nausea, abdominal cramps, vomiting, Heart: tricuspid and pulmonic valve thickening causing right heart failure, edema, Respiratory: wheezing, dyspnea.
Topics: Humans; Carcinoid Heart Disease; Malignant Carcinoid Syndrome; Diarrhea; Carcinoid Tumor
PubMed: 37658565
DOI: No ID Found -
Brain and Nerve = Shinkei Kenkyu No... Apr 2019Pellagra is a type of dietary deficiency disease caused by an insufficiency of niacin or tryptophan. Symptoms of pellagra include diarrhea, dermatitis, and dementia. It...
Pellagra is a type of dietary deficiency disease caused by an insufficiency of niacin or tryptophan. Symptoms of pellagra include diarrhea, dermatitis, and dementia. It is usually diagnosed based on a patient's dietary history and clinical symptoms. The diagnostic triad of pellagra includes symptoms of dermatitis, dementia, and diarrhea. Dermatitis is important for the diagnosis of this condition, because dementia and diarrhea show low specificity. In the modern era, pellagra rarely occurs in developed countries. However, pellagra should be considered in the differential diagnoses of dermatitis occurring on the sun-exposed areas of skin. Additionally, a hypoalimentation state with concomitant vitamin and/or zinc deficiency is observed in patients with pellagra. After checking the patient's overall nutritional status specifically with respect to pellagra, it is important to provide adequate food, supplemented with vitamins, zinc, and nicotinic acid to treat the patient's nutritional deficiencies.
Topics: Dermatitis; Humans; Niacin; Pellagra; Skin Diseases
PubMed: 30988221
DOI: 10.11477/mf.1416201276 -
Revue Medicale Suisse Nov 2019In elderly or chronically ill patients, nutritional deficiencies are common and the presence of related skin lesions is not unusual. Recognition of such cutaneous... (Review)
Review
In elderly or chronically ill patients, nutritional deficiencies are common and the presence of related skin lesions is not unusual. Recognition of such cutaneous involvement is important regarding the diagnosis essentially based on clinical elements. By using some clinical case reports, we will describe several pathologies related to nutritional deficiencies like scurvy, pellagra and acquired acrodermatitis enteropathica.
Topics: Acrodermatitis; Chronic Disease; Humans; Malnutrition; Pellagra; Scurvy; Skin Diseases
PubMed: 31746568
DOI: No ID Found -
The British Journal of Dermatology Dec 2019
Topics: Aged; Female; Humans; Niacinamide; Pellagra; Photography; Skin; Treatment Outcome
PubMed: 31432495
DOI: 10.1111/bjd.18366 -
Journal of Cosmetic Dermatology Oct 2022Pellagra caused by niacin deficiency in alcoholics can be easily misdiagnosed because of similar symptoms to other alcohol-related diseases and the lack of the classical...
BACKGROUND
Pellagra caused by niacin deficiency in alcoholics can be easily misdiagnosed because of similar symptoms to other alcohol-related diseases and the lack of the classical triad of signs.
AIM
This study aimed to define the clinical presentation of alcoholic pellagra for early diagnosis and timely treatment.
METHODS
The clinical data of 16 alcohol-dependent patients who had pellagra and treated in our hospital from January 2002 to December 2019 were retrospectively analyzed. The local medical ethics committee approval (Medical Ethics Committee of Affiliated Hospital of XuZhou Medical University, XYFY2020-KL247-02) for this study has been obtained.
RESULTS
The main complaints of the 16 patients were skin lesions (six cases), diarrhea (six cases), and mental disorders (four cases). Then, 13 cases had typical skin lesions, and 3 patients had a full spectrum of diarrhea, dementia, and dermatitis (3D). In terms of the main diagnosis, 2 patients had pellagra and Wernicke's encephalopathy, 3 patients had pellagra and alcohol-withdrawal syndrome, and the other patients had pellagra. After sufficient amounts of niacin and multivitamin B were given, clinical symptoms improved rapidly, and no sequelae were observed during follow-up.
CONCLUSIONS
Pellagra is rarely manifested as a full 3D spectrum, with only one or two characteristics, which lack diagnostic specificity, especially in individuals with alcoholism. Physicians should maintain a high degree of suspicion of niacin deficiency in alcoholics. Alcohol-dependent patients with pellagra may be accompanied by complications of Wernicke's encephalopathy and alcohol-withdrawal syndrome. Prompt identification and timely treatment with a sufficient amount of niacin in combination with other vitamins and a certain amount of Zn can achieve a good prognosis of pellagra.
Topics: Humans; Pellagra; Retrospective Studies; Niacin; Wernicke Encephalopathy; Alcoholism; Vitamins; Diarrhea; Skin Diseases; Ethanol
PubMed: 35500141
DOI: 10.1111/jocd.15036 -
Praxis Oct 2015We report on a 61-year-old patient who suffered from severe protein-energy malnutrition due to an inadequately treated exocrine pancreatic insufficiency. In this...
We report on a 61-year-old patient who suffered from severe protein-energy malnutrition due to an inadequately treated exocrine pancreatic insufficiency. In this context, a thiamine deficiency was not recognized and there were clinical manifestations of beriberi disease with decompensated biventricular heart failure. In the course of time, a manifest niacin deficiency (pellagra) with dermatitis, diarrhea and persistent delirium occurred, which was recognized and could be treated. We highlight differential diagnostic considerations about the consequences and the treatment of malnutrition, with special focus on the classical deficiency diseases beriberi and pellagra.
Topics: Beriberi; Diagnosis, Differential; Exocrine Pancreatic Insufficiency; Female; Heart Failure; Humans; Middle Aged; Pellagra; Protein-Energy Malnutrition
PubMed: 26463907
DOI: 10.1024/1661-8157/a002163 -
Dermatologic Clinics Oct 2019Cutaneous metastasis portends a poor prognosis. Therefore, a high clinical index of suspicion is necessary so that a clinician knows how to recognize the presentation of... (Review)
Review
Cutaneous metastasis portends a poor prognosis. Therefore, a high clinical index of suspicion is necessary so that a clinician knows how to recognize the presentation of a cutaneous metastasis, while the pathologist must know the appropriate stains to order. In this review, the authors summarize the common and uncommon ways that these tumors will present. Frequently a metastatic cancer will present as a firm red nodule or as a plaque, ulcer, or papule. Less commonly they will present with a clinical clue that can alert a clinician to a likely diagnosis; these manifestations include alopecic, vesicular, blue color, sclerodermoid, acrochordon-, or pellagra-like.
Topics: Biopsy; Breast Neoplasms; Colorectal Neoplasms; Female; Humans; Immunohistochemistry; Lung Neoplasms; Male; Prostatic Neoplasms; Skin Neoplasms
PubMed: 31466594
DOI: 10.1016/j.det.2019.05.012 -
The Journal of Dermatology Jan 2019Malnutrition-associated dermatoses including necrolytic migratory erythema (NME) and pellagra share common clinicopathological features; in particular, necrolytic...
Malnutrition-associated dermatoses including necrolytic migratory erythema (NME) and pellagra share common clinicopathological features; in particular, necrolytic changes in the upper epidermis. Here, we report the involvement of autophagy in the development of necrolysis in three patients with malnutrition-associated dermatoses. First, we examined an autophagy-specific molecule, microtubule-associated protein light chain 3 (LC3), using a monoclonal antibody. LC3 was strongly expressed in the granular layers of the active border, and less intensely observed in the perilesional areas. Little LC3 staining or only background levels were observed in control skin diseases including atopic dermatitis (n = 4), psoriasis vulgaris (n = 3), basal cell carcinoma with amyloid deposits (n = 3) and squamous cell carcinoma (n = 3). Electron microscopic observations revealed the presence of autophagosome-like structures in the necrolytic areas. No apoptotic signals were observed in the necrolytic lesion using the terminal deoxynucleotidyl transferase dUTP nick end labeling method. Epidermal Langerhans cells determined by anti-CD1a antibody were markedly decreased in number. Our observations suggest the possibility that malnutrition-associated necrolysis, as exemplified by NME and pellagra, may be induced by autophagy.
Topics: Adult; Aged; Autophagy; Biopsy; Female; Humans; Keratinocytes; Male; Malnutrition; Middle Aged; Nutrition Therapy; Skin; Skin Diseases
PubMed: 30379352
DOI: 10.1111/1346-8138.14694