Search Our Scientific Publications & Authors

Clin Case Rep 2020 May 19;8(5):815-818. Epub 2020 Feb 19.

Gastroenterology B Department La Rabta Hospital Tunis Tunisia.

Isoniazid preventive therapy in malnourished patients with Crohn's disease has a potential of inducing pellagra but still a very rare situation. No cases of isoniazid-induced pellagra in patients with Crohn's disease were reported in the literature. Pellagra can be easily treated if timely diagnosed. Read More

JAMA 2020 05;323(20):2100

IDCases 2020 29;20:e00750. Epub 2020 Mar 29.

Infectious Diseases Institute, Kampala, Uganda.

Int J Tryptophan Res 2020 16;13:1178646920910159. Epub 2020 Apr 16.

School of Biomedical Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK.

Nicotinamide homeostasis is a candidate common denominator to explain smooth transitions, whether demographic, epidemiological or economic. This 'NAD world', dependent on hydrogen-based energy, is not widely recognised as it is neither measured nor viewed from a sufficiently multi-genomic or historical perspective. Reviewing the importance of meat and nicotinamide balances during our co-evolution, recent history suggests that populations only modernise and age well with low fertility on a suitably balanced diet. Read More

Pediatr Dermatol 2020 Apr 23. Epub 2020 Apr 23.

Department of Dermatology, Penn State College of Medicine, Hershey, PA.

Once a significant cause of morbidity and mortality, health care providers rarely see primary pellagra in developed countries where fortification of foods with niacin is commonplace and niacin-rich foods are generally widely available. We report a ten-year-old boy with autism spectrum disorder who presented with photosensitive dermatitis which resolved after vitamin supplementation and dietary changes. In this child, the pellagra developed as the result of a long-term pattern of selective eating. Read More

Clin Cosmet Investig Dermatol 2020 5;13:275-281. Epub 2020 Apr 5.

Department of Dermatology, Venereology and Leprosy, SN Medical College, Bagalkote 587102, Karnataka, India.

Necrolytic acral erythema (NAE) is now considered as a distinct clinical entity. It clinically presents as well demarcated hyperpigmented papules and plaques with thick adherent scales distributed symmetrically over dorsum of feet. It usually develops in patients with Hepatitis C virus (HCV) infection. Read More

Cureus 2020 Mar 5;12(3):e7186. Epub 2020 Mar 5.

Medical Education, Brookwood Baptist Health, Birmingham, USA.

Carcinoid syndrome (CS) is a paraneoplastic syndrome caused by the release of serotonin and other substances from well-differentiated neuroendocrine tumors (NETs). The hallmark symptoms of carcinoid syndrome are flushing and diarrhea; atypical signs and symptoms can include wheezing, abdominal pain, valvular heart disease, telangiectasias, pellagra, and the complications of mesenteric fibrosis, including ureteral obstruction, bowel obstruction, and bowel ischemia. These symptoms are mediated by the release of serotonin (5-HT), histamine, kallikrein, prostaglandins, and tachykinins. Read More

Med Clin (Barc) 2020 Mar 13. Epub 2020 Mar 13.

Dermatology Department, Hospital Quirón Málaga, Málaga, Spain.

Monogr Oral Sci 2020 7;28:59-67. Epub 2019 Nov 7.

Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA.

Vitamins are essential organic compounds that catalyze metabolic reactions. They also function as electron donors, antioxidants or transcription effectors. They can be extracted from food and supplements, or in some cases, synthesized by our body or gut microbiome. Read More

J Gastroenterol Hepatol 2019 Dec 4. Epub 2019 Dec 4.

Clinical Gastroenterology, Faculty of Medicine, Universidade de Caxias do Sul, Caxias do Sul, Brazil.

Int J Mol Sci 2019 Nov 26;20(23). Epub 2019 Nov 26.

Laboratory of Molecular and Cell Biology, IDI-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy.

Nicotinamide (NAM) is an amide form of vitamin B3 and the precursor of nicotinamide adenine dinucleotide (NAD+), an essential co-enzyme of redox reactions for adenosine triphosphate (ATP) production and for other metabolic processes. As NAD+ status is critical in maintaining cellular energy, vitamin B3 deficiency mainly affects tissues that need high cellular energy causing pellagra and skin sun sensitivity. In animal models, NAD+ deficiency leads to UV sensitivity of the skin, impairs DNA damage response, and increases genomic instability and cancer incidence. Read More

Rev Med Suisse 2019 Nov;15(672):2125-2130

Service de médecine interne, Département de médecine, CHUV, 1011 Lausanne.

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. Read More

Pan Afr Med J 2019 12;33:195. Epub 2019 Jul 12.

Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.

Pellagra is a nutritional disorder of niacin deficiency which is characterized by triad of dermatitis, diarrhea and dementia. It is often seen in a state of poor nutrition among alcoholics, homeless and patients suffering from malabsorption. Though seldom occurs in children, its re-emerging is seen as a result of worsening food security in vulnerable population during conflict or insurgency. Read More

Postgrad Med J 2020 Apr 25;96(1134):234. Epub 2019 Oct 25.

Department of Dermatology, Government Medical College and Hospital, Chandigarh, Chandigarh, India

Nutr Clin Pract 2019 Oct 9. Epub 2019 Oct 9.

Department of Hospitalist, Charlton Memorial Hospital, Fall River, MA, USA.

Pellagra, caused by vitamin B3 (niacin) deficiency, is traditionally described as dermatitis, diarrhea, dementia (3D), and even death (4D) syndrome if not recognized and treated promptly. Although full-blown pellagra with all 3D features has become rare, pellagra still exists, especially in high-risk populations, which is actually more prevalent than we think. We report that a recently treated patient with the full spectrum of 3D clinical features of pellagra presents as chronic diarrhea of unknown etiology for 1 year. Read More

Curr Dev Nutr 2019 Sep 21;3(9):nzz075. Epub 2019 Jun 21.

The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine, University of Sydney, New South Wales 2006, Australia.

Vitamin deficiencies remain major etiological factors in the global burden of disease, especially in low- and middle-income countries. The purpose of this state-of-the-art review was to update current information on deficiencies of vitamins and public health approaches to addressing them. Some stages of life present a higher risk of deficiency than others: risks are higher in pregnant women, children (from conception to young childhood), adolescents, the elderly, and all of the over 800 million people globally who are undernourished. Read More

BMJ Case Rep 2019 Sep 30;12(9). Epub 2019 Sep 30.

Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts, USA.

The case involves a 62-year-old female native of the USA with a history of bipolar disorder and chronic obstructive pulmonary disease who presented with intractable diarrhoea. Prior to the index admission, she was admitted to the intensive care unit and required pericardiocentesis for an idiopathic pericardial effusion with tamponade physiology. Following discharge, she suffered intractable diarrhoea and represented for medical evaluation. Read More

Eat Weight Disord 2019 Sep 17. Epub 2019 Sep 17.

Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, PV, Italy.

Background: While pellagra appears to be a rare entity currently, it may still develop. It is important to recognize how the disease manifests to ensure adequate and timely treatment.

Case Presentation: We present a case of pellagra secondary to anorexia nervosa in a 28-year-old woman. Read More

Metabolites 2019 Sep 10;9(9). Epub 2019 Sep 10.

Hepatology, Department for BioMedical Research, University of Bern, 3008 Bern, Switzerland.

Nicotinamide adenine dinucleotide (NAD) has a critical role in cellular metabolism and energy homeostasis. Its importance has been established early with the discovery of NAD's therapeutic role for pellagra. This review addresses some of the recent findings on NAD physiopathology and their effects on nonalcoholic fatty liver disease (NAFLD) pathogenesis, which need to be considered in the search for a better therapeutic approach. Read More

Dermatol Clin 2019 Oct 10;37(4):545-554. Epub 2019 Jul 10.

Department of Dermatology, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Ezralow Tower, Suite 5301, Los Angeles, CA 90033-9174, USA. Electronic address:

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. Read More

Br J Dermatol 2019 12 20;181(6):e147. Epub 2019 Aug 20.

Department of Pathology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu, 210000, China.

Int J Paleopathol 2020 Jun 31;29:54-64. Epub 2019 Jul 31.

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:

John Verano's 1997 synthesis of Andean paleopathology guided two decades of research and was instrumental in establishing modern Andean paleopathology. This paper reviews the current state and new directions in the study of skeletal metabolic disorders in the Central Andean archaeological record. Key historical, ecological, methodological, and contextual issues intersect with the study of metabolic bone diseases in Andean paleopathology. Read More

Eur J Intern Med 2019 Oct 24;68:e3-e4. Epub 2019 Jul 24.

Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address:

Int J Tryptophan Res 2019 3;12:1178646919855940. Epub 2019 Jul 3.

School of Biomedical Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK.

Good health and rapid progress depend on an optimal dose of nicotinamide. Too little meat triggers the neurodegenerative condition pellagra and tolerance of symbionts such as tuberculosis (TB), risking dysbioses and impaired resistance to acute infections. Nicotinamide deficiency is an overlooked diagnosis in poor cereal-dependant economies masquerading as 'environmental enteropathy' or physical and cognitive stunting. Read More

Indian J Dermatol Venereol Leprol 2019 Sep-Oct;85(5):499-502

Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

JAMA Psychiatry 2019 Jul 3. Epub 2019 Jul 3.

Queensland Brain Institute, University of Queensland, Brisbane, Australia.

Importance: Genome-wide association studies (GWASs) in European populations have identified more than 100 schizophrenia-associated loci. A schizophrenia GWAS in a unique Indian population offers novel findings.

Objective: To discover and functionally evaluate genetic loci for schizophrenia in a GWAS of a unique Indian population. Read More

IDCases 2019 3;17:e00550. Epub 2019 May 3.

School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, 300072, China.

Pellagra is caused by cellular deficiency of niacin or its precursor amino acid, tryptophan. Isoniazid preventive therapy (IPT) is the administration of isoniazid (INH) to latent tuberculosis (TB) infection affected people preventing advancement to active TB disease. Although potentially life-saving for human immunodeficiency virus (HIV)-infected people with no active TB, IPT is arguably a possible player in pellagra in addition to well-known malnourishment determinants particularly in developing nations where diagnosis is often overlooked or delayed. Read More

Med Sante Trop 2019 Feb;29(1):68-70

Service dermatologie et IST, CHU Sylvanus Olympio, Université de Lomé, 14BP 200 Lomé, Togo.

Objective: The aim of this study was to describe the epidemiological, clinical, and therapeutic profile as well as the outcome and to document the causes of pellagra and pellagra-like erythema in a hospital setting in Lomé, Togo.

Methods: This retrospective study examined the records of patients seen for outpatient consultation and/or hospitalization in the three public dermatology departments of Lomé from January 1997 to September 2017.

Results: During the study period, 178 (0. Read More

Int J Womens Dermatol 2019 Jun 17;5(2):137-139. Epub 2018 Oct 17.

Department of Dermatology, SUNY Downstate College of Medicine, Brooklyn, New York.

Brain Nerve 2019 Apr;71(4):360-363

Department of Dermatology University of the Ryukyus, Graduate School of Medicine.

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. Read More

Alcohol Alcohol 2019 Mar;54(2):148-151

Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, India.

Aim: To define the prevalence and clinical presentation of pellagra, a multi-systemic disease caused by the deficiency of niacin, in patients admitted to a tertiary addiction treatment centre in southern India, with alcohol dependence syndrome (ADS)-(ICD10).

Methods: Review of the health records of 2947 patients who received inpatient care for ADS between 2015 and 2017.

Results: Out of 2947, 31 (1%) were diagnosed with pellagra. Read More

Int Orthop 2019 03 9;43(3):735-749. Epub 2019 Jan 9.

Hôpital Henri Mondor, 94010, Creteil, France.

Purpose: After Glisson's description of rickets, it took two centuries to realize that rickets was due to the absence of antirachitic nutrients in the diet or lack exposure of the skin to ultraviolet rays. This bone disease caused by vitamin D deficiency was one of the most common diseases of children 100 years ago. This paper explores how the definition, diagnosis, and treatment of rickets shifted in the first decades of the twentieth century. Read More

BMJ Case Rep 2018 Nov 28;11(1). Epub 2018 Nov 28.

Department of Nutrition, Alfred Health, Melbourne, Victoria, Australia.

A 34-year-old previously well woman presented with a 4-week history of diffuse erythema and crusting of skin affecting all four limbs. Examination revealed erythematous skin plaques associated with ulceration and fissuring affecting sun-exposed areas of all four limbs primarily on the dorsal surfaces, and a body mass index of 17 kg/m She was admitted under the infectious diseases unit, and an autoimmune and infective screen was performed which returned unremarkable. Dietetic consultation led to the diagnosis of severe protein-energy malnutrition, consequent to a severely restricted, primarily vegan, diet. Read More

Am J Cardiol 2019 02 22;123(4):697-700. Epub 2018 Nov 22.

Baylor Scott & White Heart and Vascular Institute, Baylor University Medical Center, Baylor Scott & White Health, Dallas, Texas. Electronic address:

J Dermatol 2019 Jan 31;46(1):43-47. Epub 2018 Oct 31.

Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

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. Read More

Eur J Dermatol 2018 Dec;28(6):832-833

Department of Dermatology.

J Oncol Pract 2018 Oct 10:JOP1800227. Epub 2018 Oct 10.

Beth Israel Deaconess Medical Center, Boston, MA.

Indian J Dermatol Venereol Leprol 2018 Nov-Dec;84(6):723-725

Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India.

Methods Mol Biol 2018 ;1813:3-8

Niadyne Pharma, Inc., Fort Worth, TX, USA.

This introductory chapter briefly reviews the history, chemistry, and biochemistry of NAD (the term NAD as it is used here refers to both oxidized and reduced forms of the molecule) consuming ADP-ribose transfer enzymes as components of the involvement of vitamin B3 in health and disease. Read More

Acta Dermatovenerol Croat 2017 Dec;25(4):303-304

Veronica Iliescu, MD, Zizinului street no. 40, Brasov, Romania;

Half and half nails or Lindsay's nails were first mentioned by Bean (1) in 1964 and later described by Lindsay (2) in 1967 in patients with chronic kidney disease. They can occur in various diseases but also in healthy individuals. A 57-year-old patient with no significant pathological personal history consulted us for discoloration of all his nails on the fingers (Figure 1) and toes (Figure 2). Read More

Mult Scler Relat Disord 2018 Oct 21;25:104-107. Epub 2018 Jul 21.

Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China. Electronic address:

Neuromyelitis optica (NMO), also known as Devic's disease, is a classical autoimmune disorder of the central nervous system (CNS). The relapsing-remitting disease course contributes to application of a variety of immunosuppressants to prevent further relapses after high-dose methylprednisolone pulse therapy for acute attacks. Azathioprine is one of the most widely used immunosuppressive drugs during the remission stage of NMO due to its good efficacy and favorable side-effect profile. Read More

Nutr Diet 2018 11 24;75(5):541. Epub 2018 Jul 24.

Department of Molecular Medicine, Unit of History of Medicine, Sapienza University of Rome, Rome, Italy.

Clin Exp Dermatol 2018 Oct 31;43(7):766-769. Epub 2018 May 31.

Department of Dermatology, King's College Hospital, London, UK.

During the Second World War, thousands of captured British and Commonwealth troops were interned in prisoner-of-war (POW) camps in the Far East. Imprisonment was extremely harsh, and prisoners developed multiple pathologies induced by physical hardship, tropical infections and starvation. Immediately after the war, several POW doctors published their clinical experiences, including reports of skin disease caused by malnutrition. Read More

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