ペラグラの皮膚

Skin Manifestations of Pellagra

ペラグラはニコチン酸，ニコチン酸アミドの欠乏症であり，ビタミンB群の欠乏あるいはトリプトファン代謝異常が合併して生じると考えられている。皮膚炎，消化器症状（下痢），精神・神経症状（抑うつ状態，認知症）を3主徴とする。皮膚炎は露光部に日焼けとの類似の症状を呈する。ペラグラは近年稀な疾患となりつつあるが，アルコール多飲者，消化管術後の患者の露光部に皮疹が出現した際には鑑別すべき疾患としてペラグラを挙げる。

Abstract

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. The diagnostic triad of pellagra includes symptoms of dermatitis, dementia, and diarrhea. Dermatitis is important for the diagnosis of this condition, because dementia and diarrhea show low specificity. In the modern era, pellagra rarely occurs in developed countries. However, pellagra should be considered in the differential diagnoses of dermatitis occurring on the sun-exposed areas of skin. Additionally, a hypoalimentation state with concomitant vitamin and/or zinc deficiency is observed in patients with pellagra. After checking the patient's overall nutritional status specifically with respect to pellagra, it is important to provide adequate food, supplemented with vitamins, zinc, and nicotinic acid to treat the patient's nutritional deficiencies.