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KMID : 0371620020170020183
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Journal of Wonkwang Medical Science
2002 Volume.17 No. 2 p.183 ~ p.189
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Clinclal features of 26 patients with pellagra
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Yoon Nyung-Hoon
Park Seok-Don
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Abstract
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Background : Pellagra is chronic disease affecting the skin, the gastrointestinal tract and the nervous system, which is caused by a deficiency of niacin or its precursor, the essential amino acid, tryptophan. In the developed countries, most cases of pellagra occur in alcoholics.
Objective : The purpose of this study was to elucidate the clinical and histopathological features of pellagra in Korea.
Methods : During 18-year-period from 1985 to June, 2002, the clinical charts, photographics and histopathological finding of 26 patients which was clinically diagnosed as pellagra were reviewed. And also age and sex distribution, clinical types of dermatitis associated symptoms and histopathological findings were evaluated.
Results :1. The male to female ratio was 3.3:1. The average age was 61 years old. 2. Chronic alcoholism (69%) and antituberculosis drug (isoniazid)(15%) were by far the most common etiologic factors. 3. The common clinical features were photosensitive eruption (100%), thickening and pigmentation over bony prominences (12%). 4. Gastrointestinal symptoms including diarrhea, anorexia, and constipation occurred in 5 patients (20%). Eight patients (32%) developed neurologic symptoms such as tremor, personality disorder, and delirium tremens. 5. The skin lesions occurred on the backs of the hands (88%), backs of the feet (58%), arms and face, in decreasing order of frequency 6. The frequent histopathologic findings were perivascular lymphocytic inflammatory infiltrate and telangiectasia (94%), hyperkeratosis (94%), vacuolar degeneration of the basal layer (47%), vacuolar change of the keratinocytes in the upper layer of the stratum malpighii (41%).
Conculsion : Most cases of pellagra occur in male farmer with alcoholics. The most characteristic skin lesion is the photosensitive skin eruption, which worsens in the summer and autumn.
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KEYWORD
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pellagra, clinical and histological features
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