Pellagra: how did it come to stand from clinical changes to vitamin deficiency ?

• The words of origin are:
  • pellis (Latin) = skin
  • aegre (Latin) = sick, diseased …or… aγρa (Greek) = affection, condition

• This condition can be summarized by the 4 d’s:
  • dermatitis
  • diarrhea
  • dementia
  • death

• The skin is characterized by the following:
  • photosensitivity of exposed areas
  • erythema accompanied sometimes by skin sloughing, followed by pigmentation and lichenification
  • orificial mucous membranes such as the tongue are often affected

• The condition was unknown by the doctors in Ancient history.
• It was described by a Spanish physician in the 18th century.
• During the 19th century, pellagra was quite widespread in Europe and America whereas today it is quite prevalent in Africa and Asia.

• After observing diverse populations (orphans, diseased individuals in asylums, prisoners, cotton fields), the America physician Dr Joseph Goldberger was able to demonstrate in 1915 that the condition was not due to an infection, but to malnutrition.
• He also found that yeast could cure the affection.
• Later on the reduction of vitamin B3 (also called Nicotinamide, Niacin, or vitamin PP) was shown to be causative of this deficiency.

Contributors

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

Source of information:

-Harms M. Dermatologica Helvetica (The Swiss Journal of Dermatology and Venereology: www.dermatologicahelvetica.com