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Pellagra

Overview

A chronic wasting nutritional disease, caused due to deficiency of vitamin B3 (niacin).It can develop in only 8 weeks on diets very deficient in niacin and tryptophan.


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Causes

It is a chronic wasting nutritional disease, caused due to deficiency of vitamin B3 (niacin).


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Signs & Symptoms
  • It is typically associated with dermatitis, dementia and diarrhoea.
  • Skin symptoms appear first. Characteristically there is an erythema resembling severe sunburn, appearing symmetrically over the parts of body exposed to sunlight and especially on neck.
  •  In acute cases it may progress to vesiculation, cracking, exudation and crusting with ulceration and sometimes secondary infection.In chronic cases the dermatitis occurs as a roughening and thickening of skin with brown pigmentation.
  • Dermatitis of vulva, perineum and perianal area is usually present.
  • There may be anorexia, nausea and dysphagia. Glossitis is an early symptoms and may precede skin lesions.
  • Mouth is sore and often shows angular stomatitis and cheilosis.
  • This non infective inflammation extends throughout the gastrointestinal tract and accounts for diarrhoea which is usually present. 
  • In severe cases delirium is most common mental disturbance in the acute form of disease and dementia in chronic form.

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Prevention

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Treatments
Conservative treatment Modern Medicine

Nicotinamide is given in doses of small quantity.Response is usually rapid; within 24 hrs erythema of skin diminishes and the diarrhoea ceases and often there is intense improvement in patient’s behaviour and mental attitude.

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