title: [Pellagra (deficiency of vitamin B3 or of the amino acid tryptophan): a disease still extant in the Netherlands].
abstract: Pellagra was diagnosed in a 48-year-old female patient with a bullous skin disease. The skin disease with purple/red sharply demarcated spots on hands and feet had worsened after sun exposure. She was a chronic alcoholic and for the last few months she had had diarrhoea. The treatment included vitamin B3, vitamin B complex and a high-quality protein diet. Within three days her skin disease improved. Pellagra is caused by a deficiency of nicotinamide or of its precursor tryptophan. It may occur in patients with dietary deficiency diseases (e.g. chronic alcoholics), carcinoid syndrome, HIV infections and drugs: fluorouracil, isoniazid, chloramphenicol and mercaptopurine. Pellagra leads to the triad: dermatitis, diarrhoea and dementia, eventually followed by death. The skin changes are characteristic and pathognomonic. Recognition of pellagra is important; the prognosis is good after treatment.
authors.affiliation: Academisch Ziekenhuis, afd. Dermatologie, Utrecht.
authors.forename: S G
authors.initials: SG
authors.lastname: Pasmans
authors.forename: A H
authors.initials: AH
authors.lastname: Preesman
authors.forename: W A
authors.initials: WA
authors.lastname: van Vloten
mesh_terms: D000437:Alcoholism / Q000150:complications; D000601:Amino Acids, Essential / Q000737:chemistry / Q000172:deficiency; D004044:Dietary Proteins / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D009536:Niacinamide / Q000627:therapeutic use*; D010383:Pellagra / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D012872:Skin Diseases, Vesiculobullous / Q000209:etiology*; D016896:Treatment Outcome; D014364:Tryptophan / Q000737:chemistry / Q000172:deficiency
chemical_list: D000601:Amino Acids, Essential; D004044:Dietary Proteins; D009536:Niacinamide; D014364:Tryptophan
vernacular_title: Pellagra (deficiëntie van vitamine B3 of van het aminozuur tryptofaan): een ziekte die nog steeds voorkomt in Nederland.