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J Dermatol 2018 Oct 31. 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 Oct 23. Epub 2018 Oct 23.

Department of Dermatology.

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

Beth Israel Deaconess Medical Center, Boston, MA.

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 Nov 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

J Nutr 2018 02;148(2):167-169

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD.

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

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

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

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

JAMA Dermatol 2017 Dec;153(12):1262

Department of Dermatology, University of Pennsylvania, Philadelphia.

Int J Paleopathol 2017 12 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

G Ital Dermatol Venereol 2017 Nov 30. Epub 2017 Nov 30.

Allergological and Occupational Dermatology Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.

J Emerg Med 2018 Feb 22;54(2):238-240. Epub 2017 Nov 22.

Dermatology Division, Department of Medical Clinics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

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

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

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

Presse Med 2017 Jul - Aug;46(7-8 Pt 1):779-782. Epub 2017 Jun 1.

Hôpital Razi, service de psychiatrie Légale, 1, rue des Orangers, 2010 La Manouba, Tunisie; Université de Tunis El Manar, faculté de médecine de Tunis, Tunisie.

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

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

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

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

Proc Biol Sci 2017 01;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

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

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

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

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

Int J Tuberc Lung Dis 2016 08;20(8):1136

King's College Hospital NHS Foundation Trust, London, UK.

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

Rev Med Interne 2016 Aug 9;37(8):570-1. Epub 2016 Mar 9.

Service de médecine interne et polyvalente, centre hospitalier de Polynésie française, avenue du Général-de-Gaulle, 98716 Pirae, Tahiti, Polynésie française. Electronic address:

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

Am J Dermatopathol 2016 Jan;38(1):50-1, 77-8

Departments of *Dermatology, and †Pathology, Wake Forest Baptist Hospital, Winston-Salem, NC.

Neurol Clin Pract 2015 Dec;5(6):472-474

Department of Neurology and Clinical Research Center, Utano National Hospital, Kyoto, Japan.

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

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

JAMA Dermatol 2015 Sep;151(9):951

Department of Dermatology, Children's National Medical Center, Washington, DC.

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

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

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

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

Gen Hosp Psychiatry 2015 Sep-Oct;37(5):e1-4. Epub 2013 Oct 16.

M.S. Ramaiah Medical College, Bangalore.

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

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

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

Med Clin (Barc) 2015 Aug 24;145(4):e7. Epub 2015 Mar 24.

Servicio de Dermatología, Hospital de Jarrio, Jarrio, Coaña Asturias, España.