Dermatologic Manifestations of Pellagra Follow-up

  • Author: Vladimir Hegyi, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jul 1, 2010
 

Further Inpatient Care

Patients with acute pellagra require bedrest during the initial phase of treatment. Patients with severe glossitis require a liquid or a soft solid diet to overcome dysphagia. Ensure that the patient has a balanced diet that is rich in protein and niacin. The topical treatment of skin lesions with topical emollients may reduce discomfort.

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Deterrence/Prevention

Primary prevention is as follows:

  • The primary prevention of pellagra involves an adequate diet.
  • Food sources of niacin and/or tryptophan include nutritional yeast, eggs, bran, peanuts, meat, poultry, fish with red meat, cereals (especially fortified cereals), legumes, and seeds.
  • The recommended daily allowance of niacin for infants is 5-6 mg; for children, 9-13 mg; for adults, 13-20 mg; for pregnant women, 17 mg; and for breastfeeding women, 20 mg.
  • Optimal supplementation is 20-30 mg daily.

Secondary prevention is as follows:

  • Patients should avoid sun exposure during the active phase of the disease.
  • Patients should follow a convenient dietary regimen.
  • Close dietary follow-up after the patient's recovery helps prevent the recurrence of pellagra.
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Complications

Dermatitis of pellagra can be distressing and disfiguring. Denudation of the vesiculated and blistered skin lesions can potentially become infected secondarily. Severe glossitis causes dysphagia. GI tract involvement leads to a malabsorptive state. Depression, anxiety, delusions, hallucinations, and coma are the neuropsychiatric complications observed in patients with pellagra. The malnourished state associated with pellagra results in death if untreated.

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Prognosis

If pellagra is diagnosed and treated appropriately, the prognosis for recovery is excellent.

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Contributor Information and Disclosures
Author

Vladimir Hegyi, MD, PhD  Associate Professor, Department of Pediatric Dermatovenereology, School of Medicine, Comenius University, Bratislava

Vladimir Hegyi, MD, PhD is a member of the following medical societies: European Academy of Dermatology and Venereology, European Dermatology Forum, and Slovak Dermatovenereological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

James Fulton Jr, MD, PhD  Center for Cosmetic Dermatology; Consultant, Vivant Pharmaceuticals, LLC

James Fulton Jr, MD, PhD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American Society for Laser Medicine and Surgery, Dermatology Foundation, International Society of Cosmetic and Laser Surgeons, and Skin Cancer Foundation

Disclosure: Vivant Pharmaceuticals Grant/research funds Consulting

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD  Associate Professor of Dermatology, Penn State University College of Medicine; Staff Dermatologist, Penn State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Professors of Dermatology, North American Hair Research Society, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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