is a nutritional disorder caused by the deficiency of niacin and is characterized classically with three 3 Ds, namely dermatitis, diarrhea and dementia.1 These classical manifestations are rarely seen nowadays, especially due to dietary deficiency alone.2 We report a case of pellagra
with the classical dermatological manifestations on the hands and feet but no involvement of the facial and neck region.
Table Types of Nutrient Deficiency Caused by Heavy Drinking and the Associated Signs and Symptoms Selected Nutrient Deficiency Signs/Symptoms Magnesium Insulin resistance, muscle cramps Selenium Myopathy, cardiomyopathy Vitamin B1/Thiamine Wernicke-Korsakoff syndrome, neurologic symptoms Vitamin B2/Riboflavin Glossitis, cheilitis, and lingual papillae atrophy Vitamin A/Retinol Abnormal dark adaptation, rough skin Vitamin C Scurvy with purpura and petechiae Vitamin D Altered bone metabolism, altered gut barrier/immune function Vitamin E Oxidative stress Niacin Skin photosensitivity, confusion, pellagra
Folate, S-Adenosylmethionine Anemia, altered methylation, epigenetic effects
This could have been a way for Lind to get funding for his scurvy trial; Snow for his cholera work; Goldberger for pellagra
; Winkelstein for cervical cancer; a way for us to more easily cross the divide between infectious and chronic diseases; to obtain funding for studies of, say, blood type and social determinants of health.
4 (1915) The world's first pellagra
experiment, which proved that the chronic disease was caused by a niacin deficiency, was begun at a Rankin County branch of the Mississippi State Penitentiary by Dr Joseph Goldberger.
is a disease characterized by dermatitis and other health maladies.
psychosis due to niacin deficiency was hidden under the schizophrenia umbrella.
They were intended to reflect the best scientific judgment on nutrient allowances for the maintenance of good health and to serve as the basis for evaluating the adequacy of diets and preventing diseases linked to nutritional deficiencies, such as rickets, scurvy, beriberi, pellagra
, and goiter.
Vitamin [B.sub.3] deficiency causes pellagra
, characterised by a photosensitive dermatitis, like severe sunburn, typically with a butterfly-like pattern of distribution over the face, affecting all parts of the skin that are exposed to sunlight.
, which is a protein deficiency, was endemic to poor whites and poor blacks.
Besides poverty and illiteracy, scourges including pellagra
, rickets, hookworm, yellow fever, and malaria meant that "conditions in the state were so bad that Northern life insurance companies refused to write policies for Mississippians" (246).
In the past, this hypothesis has been highly useful when applied to the task of reducing human illness, an example of its usefulness is the identification of the nutritional deficit that causes the previously common disease pellagra
. Assuming that all such nutritional illnesses have been discovered is unwarranted.
A Plague of Corn: The Social History of Pellagra
(Ithaca NY: Cornell University Press).