What is pellagra

Everyone's skin condition is different, which is generally determined by the genetic factors of the parents, the roughness of the skin color, etc., and is also related to acquired care. Many female friends pay more attention to their skin care, but some skin looks particularly dry no matter how they care for it. This is most likely caused by pellagra. So what is pellagra?

Pellagra is also known as niacin deficiency, which is mainly caused by a lack of niacin. The incidence rate in China is relatively low. The main sources of niacin are animal liver, eggs, beans, etc. in the diet. Therefore, people who often eat corn have a relatively low niacin content in their diet and are prone to the disease. Pellagra has certain regional differences, but the seasonal differences are not obvious. The mortality rate is mostly due to the combination of other complications, and death simply from pellagra is rare.

1. Skin

Dermatitis is the most typical symptom of this disease, which often appears symmetrically on exposed parts of the limbs, most commonly on the back of the hands, back of the feet, wrists, forefoot, arms, fingers, ankles, etc., followed by areas of friction on the limbs. In acute cases, the skin lesions are initially red and itchy, very similar to sunburn, but with a clear boundary with the surrounding skin, a slightly raised edge, and obvious lesions in the center; afterwards, the skin color quickly turns reddish brown, with obvious swelling, which may be accompanied by herpes and epidermal rupture, forming exudative wounds, which can easily induce secondary infection. As the condition improves, the swelling and redness may gradually subside, and there may be large peeling of the skin during healing, followed by the appearance of new pink thickening skin; it may also become thinner and atrophic, with pigmentation at the edges.

In chronic cases, the edema is mild or not significant, but the pigmentation is darker. The skin in areas prone to wear and tear, such as elbows, knuckles, and knees, is often thickened and hyperkeratotic, with a brown-black skin color that is different from its surroundings, and is dry and scaly. Another manifestation is scaly skin changes on the front and outer sides of the lower legs, which are very similar to other manifestations of chronic malnutrition, and the lesions often have pigmentation.

2. Digestive system

Glossitis and diarrhea are the most obvious.

1. Glossitis

In the early stage, the tip and edges of the tongue become red and red, and the fungiform papillae become enlarged. Afterwards, the entire tongue, oral mucosa, pharynx and esophagus may become red and swollen, with epithelial exfoliation and superficial ulcers, causing tongue pain, difficulty swallowing food, and increased saliva secretion. When the disease lasts for a long time, the lingual papillae atrophy, the entire tongue becomes smooth and dry like beef, and is often accompanied by angular cheilitis due to riboflavin deficiency.

2. Diarrhea

In the early stage, patients often suffer from constipation, and later diarrhea occurs due to the atrophy of the digestive glands and villi and the occurrence of enteritis. The stool is watery or pasty, with a large amount and a foul odor, and may also contain blood. If the lesion is close to the anus, tenesmus may occur. Diarrhea is often severe and difficult to treat and may be complicated by malabsorption.

3. Neuropsychiatric system

Early neuropsychiatric symptoms are relatively mild and may include dizziness, blurred vision, irritability, anxiety, depression, forgetfulness, insomnia, and paresthesias, but may later progress to neurotic disorder, disorientation, epileptic seizures, catatonic schizophrenia, hallucinations, confusion, delirium, and even death. Symptoms of peripheral neuritis such as numbness of the limbs, burning sensation, gastrocnemius tenderness and abnormal reflexes may occur. Sometimes there are subacute combined degeneration of the posterior and lateral columns of the spinal cord, which may be related to deficiencies of other B vitamins. However, this disease is different from beriberi in that this disease mostly affects the central nervous system while the latter mainly affects the peripheral nerves. Other symptoms include vaginitis, menstrual disorders and amenorrhea in women, and a burning sensation when urinating and sometimes a loss of libido in men.

This disease often coexists with beriberi, riboflavin deficiency and other nutritional deficiency diseases.