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    Photosensitive disorders in HIV.
    South Afr J HIV Med 2017 31;18(1):676. Epub 2017 Aug 31.
    Wits University Donald Gordon Medical Centre, Johannesburg, South Africa.
    Photosensitive disorders are common, affecting up to 5% of HIV-positive patients. HIV itself induces photosensitivity but photoaggravated drug reactions, porphyria cutanea tarda and nutritional disorders such as pellagra are also more common in patients with HIV. In South Africa, actinic lichenoid leukomelanoderma of HIV is a unique photosensitive disorder which is associated with advanced HIV. Read More
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    Niacin.
    Adv Food Nutr Res 2018;83:83-149. Epub 2018 Feb 1.
    Utah State University, Logan, UT, United States. Electronic address:
    Nicotinic acid and nicotinamide, collectively referred to as niacin, are nutritional precursors of the bioactive molecules nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP). NAD and NADP are important cofactors for most cellular redox reactions, and as such are essential to maintain cellular metabolism and respiration. NAD also serves as a cosubstrate for a large number of ADP-ribosylation enzymes with varied functions. Read More
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    Prevalence of obesity and diabetes in the socioeconomic transition of rural Mayas of Yucatan from 1962 to 2000.
    Ethn Health 2018 Feb 20:1-7. Epub 2018 Feb 20.
    e Facultad de Medicina , Universidad Autónoma de Yucatán , Mérida , México . Yucatán PAA: mi tendencia a indicar primero la obesidad tiene raices en la fisiopatología de estas enfermedades, ya que la obesidad suele preceder el desarrollo de la diabetes del adulto.
    Background: The Mayas of the State of Yucatan in Mexico are the only aboriginal group with obesity and diabetes data before 1997.

    Objective: To analyze socioeconomic trends associated with the increase in obesity and diabetes seen in rural Yucatan from 1962 to 2000.

    Methods: Body weight, height and venous Fasting Blood Glucose (FBG) were measured in 263 rural Maya adults participating in a 2000 nutrition survey. Read More
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    Zinc and Skin Disorders.
    Nutrients 2018 Feb 11;10(2). Epub 2018 Feb 11.
    Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan.
    The skin is the third most zinc (Zn)-abundant tissue in the body. The skin consists of the epidermis, dermis, and subcutaneous tissue, and each fraction is composed of various types of cells. Firstly, we review the physiological functions of Zn and Zn transporters in these cells. Read More
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    Pellagra affecting a patient with Crohn's disease.
    An Bras Dermatol 2017 Nov-Dec;92(6):879-881
    Department of Gastroenterology and Hepatology, Jinling Hospital, China.
    Pellagra is a nutritional disease caused by a deficiency of niacin. It may lead to death if not identified and treated timely. We review the literature and report a female patient presented with clinical features of pellagra as a complication of Crohn's disease. Read More
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    Paleopathological rigor and differential diagnosis: Case studies involving terminology, description, and diagnostic frameworks for scurvy in skeletal remains.
    Int J Paleopathol 2017 Dec 25;19:96-110. Epub 2015 Nov 25.
    Department of Sociology and Anthropology, George Mason University, United States; Museo Nacional Sicán, Peru; Museo Nacional de Arqueología y Etnografía Hans Heinrich Brüning de Lambayeque, Peru. Electronic address:
    Diverse pathological processes can produce overlapping or even indistinguishable patterns of abnormal bone formation or destruction, representing a fundamental challenge in the understanding of ancient diseases. This paper discusses increasing rigor in differential diagnosis through the paleopathological study of scurvy. First, paleopathology's use of descriptive terminology can strive to more thoroughly incorporate international standards of anatomical terminology. Read More
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    Alcoholic Pellagra as a Cause of Altered Mental Status in the Emergency Department.
    J Emerg Med 2017 Oct 20;53(4):554-557. Epub 2017 Jul 20.
    Department of Emergency and Critical Care Medicine, Urasoe General Hospital, Okinawa, Japan.
    Background: Pellagra, which is caused by a deficiency of niacin and tryptophan, the precursor of niacin, is a rare disease in developed countries where alcoholism is a major risk factor due to malnutrition and lack of B vitamins. Although pellagra involves treatable dementia and psychosis, it is often underdiagnosed, especially in developed countries.

    Case Report: In Japan, a 37-year-old man presented to the emergency department with altered mental status and seizures. Read More
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    Necrolytic Acral Erythema in Seronegative Hepatitis C.
    Case Rep Dermatol 2017 Jan-Apr;9(1):69-73. Epub 2017 Mar 17.
    Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
    Necrolytic acral erythema (NAE) is a distinctive skin disorder. The exact cause and pathogenesis is still unclear. Most studies report an association of NAE with hepatitis C virus (HCV) infection. Read More
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    Meat Intake and the Dose of Vitamin B - Nicotinamide: Cause of the Causes of Disease Transitions, Health Divides, and Health Futures?
    Int J Tryptophan Res 2017 3;10:1178646917704662. Epub 2017 May 3.
    Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
    Meat and vitamin B - nicotinamide - intake was high during hunter-gatherer times. Intake then fell and variances increased during and after the Neolithic agricultural revolution. Health, height, and IQ deteriorated. Read More
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    Severe pellagra masked by concurrent plaque psoriasis: a case report of a hidden diagnosis.
    Dermatol Online J 2017 May 15;23(5). Epub 2017 May 15.
    Department of Dermatology, School of Medicine, University of California, Davis, Sacramento, California.
    Despite characteristic features, psoriasis can mimic other dermatologic conditions, such as seborrheic dermatitis, lichen simplex chronicus, and certain nutritional deficiencies such as pellagra. We present a patient with a longstanding history of severe plaque psoriasis who presented with disfiguring scaly plaques involving greater than 80% body surface area. The patient's disease was minimally responsive to multiple therapies. Read More
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    'Shrouded in a dark fog': comparison of the diagnosis of pellagra in Venice and general paralysis of the insane in the United Kingdom, 1840-1900.
    Hist Psychiatry 2017 Jun 1;28(2):166-181. Epub 2017 Feb 1.
    University of Leicester, UK.
    The debate on the causes and the nature of pellagra in Italy during the nineteenth century resembles and evokes the similar debate on General Paralysis of the Insane (GPI) that was growing at the same time in the United Kingdom. Pellagra and GPI had a massive and virulent impact on the populations of Italy and the UK, respectively, and contributed to a great extent to the increase and overcrowding of the asylum populations in these countries. This article compares the two illnesses by examining the features of their nosographic positioning, aetiology and pathogenesis. Read More
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    Depletion of Epidermal Langerhans Cells in the Skin Lesions of Pellagra Patients.
    Am J Dermatopathol 2017 Jun;39(6):428-432
    *Department of Dermatology, University of the Ryukyus, Okinawa, Japan; †Department of Dermatology, Tone-chuo Hospital, Numata, Japan; ‡Department of Dermatology, Gunma University, Maebashi, Japan; §Department of Dermatology, Wakayama Medical University, Wakayama, Japan; ¶Department of Dermatology, Nagasaki University, Nagasaki, Japan; and ‖Department of Dermatology, Saitama Medical University Saitama Medical Center, Kawagoe, Japan.
    Pellagra is a nutrient deficiency disease caused by insufficient niacin levels. Recent studies have shown that numbers of epidermal Langerhans cells decreased in other diseases caused by nutritional deficiencies, including necrolytic migratory erythema and acrodermatitis enteropathica. Epidermal Langerhans cells are capable of modulating or even halting the inflammatory reaction. Read More
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    An Outbreak of Pellagra in the Kasese Catchment Area, Dowa, Malawi.
    Am J Trop Med Hyg 2017 May 13;96(5):1244-1247. Epub 2017 May 13.
    Department of Family and Community Medicine, University of Texas Southwestern, Dallas, Texas.
    AbstractPellagra is a deficiency of niacin or its amino acid precursor, tryptophan, which presents with the classic four Ds: the characteristic dermatitis, diarrhea, dementia, and eventually death if left untreated. The incidence of pellagra is quite rare presently because of increased awareness and strategies such as vitamin fortification. However, the deficiency is still present in cultures that rely on maize as their primary source of sustenance. Read More
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    Diets derived from maize monoculture cause maternal infanticides in the endangered European hamster due to a vitamin B3 deficiency.
    Proc Biol Sci 2017 Jan;284(1847)
    Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France.
    From 1735 to 1940, maize-based diets led to the death of hundreds of thousands of people from pellagra, a complex disease caused by tryptophan and vitamin B3 deficiencies. The current cereal monoculture trend restricts farmland animals to similarly monotonous diets. However, few studies have distinguished the effects of crop nutritional properties on the reproduction of these species from those of other detrimental factors such as pesticide toxicity or agricultural ploughing. Read More
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    Photodermatoses: Kids are not just little people.
    Clin Dermatol 2016 Nov - Dec;34(6):724-735. Epub 2016 Jul 12.
    University of Connecticut School of Medicine, Department of Dermatology, Farmington, CT.
    Photodermatoses are a group of skin disorders caused by abnormal reaction to ultraviolet radiation. Photodermatoses are divided into four groups: (1) immunologically mediated photodermatoses; (2) chemical- and drug-induced photodermatoses; (3) photoaggravated dermatoses; and (4) hereditary photodermatoses. This contribution discusses differences in the approach and diagnosis of pediatric and adult patients with suspected photodermatoses, focusing on immunologically mediated photodermatoses and chemical- and drug-induced photodermatoses. Read More
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    Drug-induced photosensitivity: new insights into pathomechanisms and clinical variation through basic and applied science.
    Br J Dermatol 2017 Apr 28;176(4):902-909. Epub 2017 Feb 28.
    Betsi Cadwaladr University Health Board, Ysbyty Gwynedd, Penrhosgarnedd, Bangor, Gwynedd, LL57 2PY, U.K.
    Drug-induced photosensitivity occurs when a drug is capable of absorbing radiation from the sun (usually ultraviolet A) leading to chemical reactions that cause cellular damage (phototoxicity) or, more rarely, form photoallergens (photoallergy). The manifestation varies considerably in presentation and severity from mild pain to severe blistering. Despite screening strategies and guidelines in place to predict photoreactive drugs during development there are still new drugs coming onto the market that cause photosensitivity. Read More
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    Pellagra Secondary to Medication and Alcoholism: A Case Report and Review of the Literature.
    Nutr Clin Pract 2016 Dec 19;31(6):785-789. Epub 2016 Aug 19.
    2 Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
    Pellagra usually results from niacin deficiency and presents with the classic triad of dermatitis, diarrhea, and dementia. It is most commonly associated with malnutrition and poverty and is extremely rare in industrialized societies. Furthermore, pellagra can be induced by special clinical conditions that interfere with the intake, absorption, and metabolism of niacin. Read More
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    Hereditary lactate dehydrogenase M-subunit deficiency with late-developing pustular psoriasis-like lesions.
    J Dermatol 2016 Dec 23;43(12):1429-1432. Epub 2016 Jul 23.
    Department of Dermatology, Faculty of Medicine, Oita University, Yufu, Japan.
    Hereditary lactate dehydrogenase (LDH) M-subunit deficiency is very rare and we have found reports of close to a dozen cases in the published work, two of which were associated with pustular psoriasis-like lesions. We report a third case of pustular psoriasis-like eruptions associated with LDH M-subunit deficiency, which occurred 24 years after the diagnosis of LDH M-subunit deficiency. These cases indicate that abnormal activity of LDH can induce pustular psoriatic lesions in the long term. Read More
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    Nicotinamide Riboside Is a Major NAD+ Precursor Vitamin in Cow Milk.
    J Nutr 2016 05 6;146(5):957-63. Epub 2016 Apr 6.
    Department of Biochemistry, Carver College of Medicine, Interdisciplinary Graduate Program in Genetics, and
    Background: Nicotinamide riboside (NR) is a recently discovered NAD(+) precursor vitamin with a unique biosynthetic pathway. Although the presence of NR in cow milk has been known for more than a decade, the concentration of NR with respect to the other NAD(+) precursors was unknown.

    Objective: We aimed to determine NAD(+) precursor vitamin concentration in raw samples of milk from individual cows and from commercially available cow milk. Read More
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    Skin diseases among elderly patients attending skin clinic at the Regional Dermatology Training Centre, Northern Tanzania: a cross-sectional study.
    BMC Res Notes 2016 Feb 22;9:119. Epub 2016 Feb 22.
    Regional Dermatology Training Centre, Moshi, Tanzania.
    Background: As global population of the elderly continues to rise, a critical need to provide it with health services, including dermatology, will be significant, especially in developing countries like Tanzania. To adequately meet their dermatologic needs, knowledge of local patterns of skin conditions is vital. This study was aimed to describe the spectrum of skin diseases among elderly patients attending skin clinic at the Regional Dermatology Training Centre (RDTC) in Northern Tanzania. Read More
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    Wernicke encephalopathy and pellagra in an alcoholic and malnourished patient.
    BMJ Case Rep 2015 Oct 21;2015. Epub 2015 Oct 21.
    Department of General Internal Medicine, Tsukuba University, Mito, Ibaraki, Japan.
    Deficiency of multiple vitamins can be identified in alcoholic and malnourished patients. We report a patient with Wernicke encephalopathy, a B1 deficiency and pellagra, a niacin deficiency. A 61-year-old Japanese man presented with generalised weakness. Read More
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    [An Uncommon Diagnosis].
    Praxis (Bern 1994) 2015 Oct;104(21):1151-6
    1 Universitätsklinik für Endokrinologie, Diabetologie und Klinische Ernährung, Inselspital Bern.
    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. Read More
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    Niacin (Vitamin B3) Supplementation in Patients with Serotonin-Producing Neuroendocrine Tumor.
    Neuroendocrinology 2016 4;103(5):489-94. Epub 2015 Sep 4.
    Background/aims: Tryptophan is the precursor of serotonin and niacin (vitamin B3). The latter is critical for normal cellular metabolism. Tryptophan and niacin can be deficient in patients with serotonin-producing neuroendocrine tumors (NETs). Read More
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    Goose skin in a girl with Ehlers-Danlos syndrome.
    J Community Hosp Intern Med Perspect 2015 1;5(4):28216. Epub 2015 Sep 1.
    Department of Dermatology, Hospital Central Dr. Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, San Luis, México;
    Pellagra is a nutritional disorder secondary to niacin deficiency. The classical triad is dermatitis, diarrhea, and dementia. We report the case of a young girl with hypermobility-type Ehlers-Danlos syndrome who exhibited the classical pellagra symptoms, despite apparent adequate nutritional intake. Read More
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    Pellagra Pre-Goldberger: Rupert Blue, Fleming Sandwith, and The "Vitamine Hypothesis".
    Trans Am Clin Climatol Assoc 2015 ;126:20-45
    Columbia, South Carolina.
    The conquest of pellagra is commonly associated with one name: Joseph Goldberger of the US Public Health Service, who in 1914 went south, concluded within 4 months that the cause was inadequate diet, spent the rest of his life researching the disease, and--before his death from cancer in 1929--found that brewer's yeast could prevent and treat it at nominal cost. It does Goldberger no discredit to emphasize that between 1907 and 1914 a patchwork coalition of asylum superintendents, practicing physicians, local health officials, and others established for the first time an English-language competence in pellagra, sifted through competing hypotheses, and narrowed the choices down to two: an insect-borne infection hypothesis, championed by the flamboyant European Louis Westerna Sambon, and the new "vitamine hypothesis," proffered by Casimir Funk in early 1912 and articulated later that year by two members of the American Clinical and Climatological Association, Fleming Mant Sandwith and Rupert Blue. Those who resisted Goldberger's inconvenient truth that the root cause was southern poverty drew their arguments largely from the Thompson-McFadden Pellagra Commission, which traces back to Sambon's unfortunate influence on American researchers. Read More
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    A Nampt inhibitor FK866 mimics vitamin B3 deficiency by causing senescence of human fibroblastic Hs68 cells via attenuation of NAD(+)-SIRT1 signaling.
    Biogerontology 2015 Dec 2;16(6):789-800. Epub 2015 Sep 2.
    School of Nutrition, Chung Shan Medical University, Taichung, Taiwan.
    Vitamin B3 (niacin) deficiency can cause pellagra with symptoms of dermatitis, diarrhea and dementia. However, it is unclear whether the vitamin B3 deficiency causes human aging. FK866 (a Nampt inhibitor) can reduce intracellular NAD(+) level and induce senescence of human Hs68 cells. Read More
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    Niacin metabolism and indoleamine 2,3-dioxygenase activation in malnourished patients with flaky paint dermatosis.
    Nutrition 2015 Jun 31;31(6):890-2. Epub 2014 Dec 31.
    Internal Medicine Division - Clinics Hospital, Medical School of Federal University of Triangulo Mineiro, Uberaba, Brazil.
    Flaky paint dermatosis, characterized by extensive, often bilateral areas of flaking and pigmentation, mostly in sun unexposed areas is considered a feature of kwashiorkor in both children and adults, and must be differentiated from other dermatosis, including chapped and xerotica skin, and pellagra. In this case series we provide evidence that malnourished patients with flaky paint dermatosis and infection/inflammation shown laboratory data suggestive of indoleamine 2,3-dioxygenase (IDO) activation, besides decreased urinary excretion of N1-methylnicotinamide (N1 MN), a marker of pellagra. We study nine adult patients showing flaky paint dermatosis and clinical features of infection or inflammation, and increased serum C-reactive protein, characteristic of the presence of acute phase response syndrome. Read More
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    Generalised hyperpigmentation in vitamin B12 deficiency.
    J Assoc Physicians India 2014 Aug;62(8):714-6
    In developing countries like India, nutritional deficiencies are prevalent and hyperpigmentation due to protein energy malnutrition, zinc deficiency and pellagra are common. Indian women, especially vegetarian are prone to vitamin B12 deficiency. Vitamin B12 deficiency can present as anaemia, neurological defect, gastrointestinal symptoms or dementia. Read More
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    Ethionamide-induced Pellagra.
    J Trop Pediatr 2015 Aug 30;61(4):301-3. Epub 2015 Mar 30.
    Pediatric TB Clinic, B J Wadia Hospital for Children, Mumbai 400012, India Consultant in Pediatric Infectious Diseases and Pediatric Hepatology, Nanavati Hospital, Mumbai 400056, India
    Pellagra is a disorder characterized by dermatitis, diarrhea, dementia and eventually death, resulting from a deficiency of niacin or its precursor tryptophan. Ethionamide (a second-line antituberculosis agent)-induced pellagra is rarely encountered in clinical practice. Prompt diagnosis and treatment with nicotinamide can prevent life-threatening complications. Read More
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    [Niacin deficiency and cutaneous immunity].
    Nihon Rinsho Meneki Gakkai Kaishi 2015 ;38(1):37-44
    Swiss Institute of Allergy and Asthma Research, Davos, Switzerland.
    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. Read More
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    Louis Sambon and the Clash of Pellagra Etiologies in Italy and the United States, 1905-14.
    J Hist Med Allied Sci 2016 Jan 4;71(1):19-42. Epub 2015 Mar 4.
    University of Leicester, University Road, Leicester LE1 7RH, UK.
    This article explores the extent to which the bacterial concept of disease acted as an obstacle to the understanding of deficiency diseases, by focusing on explorations into the cause of pellagra in the early twentieth century. In 1900, pellagra had been epidemic in Italy for 150 years and was soon to become so in the United States, yet the responses of medical investigators differed substantially. To account for these, the article reconstructs the sharply contrasting reactions to a provocative theory proposed by Louis Sambon. Read More
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    Fortification and health: challenges and opportunities.
    Adv Nutr 2015 Jan 15;6(1):124-31. Epub 2015 Jan 15.
    Office of Dietary Supplements, NIH, Bethesda, MD; and.
    Fortification is the process of adding nutrients or non-nutrient bioactive components to edible products (e.g., food, food constituents, or supplements). Read More
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    Exploiting Nutritional Value of Staple Foods in the World's Semi-Arid Areas: Risks, Benefits, Challenges and Opportunities of Sorghum.
    Healthcare (Basel) 2015 Mar 30;3(2):172-93. Epub 2015 Mar 30.
    Food and Veterinary Toxicology Unit, Department of Veterinary Public Health and Food Safety, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
    Sorghum (Sorghum bicolor (L.) Moench) is a drought-resistant crop and an important food resource in terms of nutritional as well as social-economic values, especially in semi-arid environments. Cultivar selection and processing methods have been observed to impact on composition and functional and nutritional value of sorghum. Read More
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    Mechanisms of the pellagragenic effect of leucine: stimulation of hepatic tryptophan oxidation by administration of branched-chain amino acids to healthy human volunteers and the role of plasma free tryptophan and total kynurenines.
    Int J Tryptophan Res 2014 4;7:23-32. Epub 2014 Dec 4.
    Department of Psychiatry, University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA.
    The pellagragenic effect of leucine (Leu) has been proposed to involve modulation of L-tryptophan (Trp) metabolism along the hepatic kynurenine pathway. Here, we discuss some of the mechanisms suggested and report the effects in healthy volunteers of single doses of Leu (4.05-6. Read More
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    The biochemical pathways of central nervous system neural degeneration in niacin deficiency.
    Neural Regen Res 2014 Aug;9(16):1509-13
    Department of Physiology, M.S. Ramaiah Medical College, Bangalore, India.
    Neural degeneration is a very complicated process. In spite of all the advancements in the molecular chemistry, there are many unknown aspects of the phenomena of neurodegeneration which need to be put together. It is a common sequela of the conditions of niacin deficiency. Read More
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