Pellagra: Dermatitis, dementia, and diarrhea
Abstract
Pellagra defines systemic disease as resulting from a marked cellular deficiency of niacin. It is characterized by 4 "D's": diarrhea, dermatitis, dementia, and death. Diagnosis of pellagra is difficult in the absence of the skin lesions, and is often facilitated by the presence of characteristic ones. The dermatitis begins as an erythema. Acute pellagra resembles sunburn in its first stages, but tanning occurs more slowly than typically in sunburn. Exacerbation follows re-exposure to sunlight. In this work we review the findings of this once mysterious disorder, one that still challenges clinicians world-wide.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Inadequate niacin intakes or status lead to nonspecific clinical symptoms including weakness, loss of appetite, fatigue and apathy.
“Inadequate niacin (vitamin B3) intakes or status lead to nonspecific clinical symptoms and include weakness, loss of appetite, fatigue and apathy [102].”
From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [102]
Long-term niacin deficiency can lead to neurological symptoms, including depression and loss of memory, which attenuate or disappear following niacin intake.
“Long-term niacin (vitamin B3) deficiency can lead to neurological symptoms, including depression and loss of memory [102]. These symptoms attenuate or disappear following niacin intake, confirming its role in the brain and nervous system [143].”
From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [102]
Cites
RELATION OF NICOTINIC ACID AND NICOTINIC ACID AMIDE TO CANINE BLACK TONGUE
Elvehjem, C. A., Madden, R. J., Strong, F. M., & Woolley, D. W. (1937) · Journal of the American Chemical Society · doi:10.1021/ja01288a509 · Cited by 244 · see citing works
Karthikeyan, K., & Thappa, D. M. (2002) · International Journal of Dermatology · doi:10.1046/j.1365-4362.2002.01551.x · Cited by 150 · see citing works
Effectiveness of food fortification in the United States: the case of pellagra
Park, Y. K., Sempos, C. T., Barton, C. N., Vanderveen, J. E., & Yetley, E. A. D. (2000) · American Journal of Public Health · doi:10.2105/ajph.90.5.727 · Cited by 105 · see citing works
Pellagra: a still existing disease
Stratigos, J., & Katsambas, A. (1977) · British Journal of Dermatology · doi:10.1111/j.1365-2133.1977.tb05197.x · Cited by 86 · see citing works
Pellagra in the United States: a historical perspective.
Rajakumar, K. (2000) · PubMed · Cited by 63 · see citing works
Effect of niacin on atherosclerotic cardiovascular disease
Guyton, J. R. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(98)00767-x · Cited by 63 · see citing works
Pellagra and the Carcinoid Syndrome
Castiello, R. J. (1972) · Archives of Dermatology · doi:10.1001/archderm.1972.01620070046016 · Cited by 59 · see citing works
Politics and pellagra: the epidemic of pellagra in the U.S. in the early twentieth century.
Bollet, A. J. (1993) · PubMed · Cited by 54 · see citing works
Pellagra in a patient with an eating disorder
Judd, L., & Poskitt, B. L. (1991) · British Journal of Dermatology · doi:10.1111/j.1365-2133.1991.tb06044.x · Cited by 52 · see citing works
Pellagra secondary to 5-fluorouracil
Stevens, H. P., Ostlere, L. S., Beǵent, R. H. J., et al. (1993) · British Journal of Dermatology · doi:10.1111/j.1365-2133.1993.tb00240.x · Cited by 48 · see citing works
Amino-Acid Deficiency Probably the Primary Etiological Factor in Pellagra
Goldberger, J., & Tanner, W. F. (1922) · Public Health Reports (1896-1970) · doi:10.2307/4576303 · Cited by 47 · see citing works
Pellagra in a Patient With Anorexia Nervosa
Rapaport, M. J. (1985) · Archives of Dermatology · doi:10.1001/archderm.1985.01660020113032 · Cited by 43 · see citing works
Isoniazid induced pellagra despite pyridoxine supplementation
Darvay, Basarab, McGregor, et al. (1999) · Clinical and Experimental Dermatology · doi:10.1046/j.1365-2230.1999.00444.x · Cited by 42 · see citing works
Murray, M. F., Langan, M. J., & MacGregor, R. R. (2001) · Nutrition · doi:10.1016/s0899-9007(01)00568-8 · Cited by 41 · see citing works
Kertesz, S. G. (2001) · Mayo Clinic Proceedings · doi:10.4065/76.3.315 · Cited by 39 · see citing works
Pellagra outbreak in Kuito, Angola
Baquet, S., Wuillaume, F., van Egmond, K., et al. (2000) · The Lancet · doi:10.1016/s0140-6736(05)73093-2 · Cited by 24 · see citing works
Niacin as a potential AIDS preventive factor
Murray, M. (1999) · Medical Hypotheses · doi:10.1054/mehy.1999.0908 · Cited by 24 · see citing works
Isaac, S. (1998) · International Journal of Dermatology · doi:10.1046/j.1365-4362.1998.00508.x · Cited by 21 · see citing works
Rajakumar, K. (2000) · Southern Medical Journal · doi:10.1097/00007611-200003000-00005 · Cited by 20 · see citing works
Pellagra in an immunocompetent patient with cytomegalovirus colitis
Lu, J.-Y., Yu, C., & Wu, M.-Z. (2001) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2001.03659.x · Cited by 19 · see citing works
A 70-year-old man with isolated weight loss and a pellagra-like syndrome due to celiac disease.
Schattner, A. (2000) · PubMed · Cited by 15 · see citing works
Bhatia, A. C., & Nunley, J. R. (2002) · Archives of Dermatology · doi:10.1001/archderm.138.6.847 · Cited by 15 · see citing works
Pellagra: a sporadic pediatric case with a full triad of symptoms.
Öztürk, F., Koca, R., Aydın, M., et al. (2001) · PubMed · Cited by 14 · see citing works
Nutritional influences of pellagra on sebum composition
Dogliotti, M., Liebowitz, M. R., Downing, D. T., et al. (1977) · British Journal of Dermatology · doi:10.1111/j.1365-2133.1977.tb15423.x · Cited by 11 · see citing works
[Prevalence of HIV infection in patients with pellagra and pellagra-like erythemas].
Pitche, P. V., Kombaté, K., & Tchangaï-Walla, K. (1999) · PubMed · Cited by 11 · see citing works
Pellagra in a patient with anorexia nervosa
Rapaport, M. J. (1985) · Archives of Dermatology · doi:10.1001/archderm.121.2.255 · Cited by 8 · see citing works
Don Caspar Casal, Francois Thiery and pellagra.
Major, R. H. (1944) · Bulletin of the history of medicine · Cited by 7 · see citing works
[Zinc deficiency and pellagra in alcohol abuse].
Hf, L., Am, F., & Weismann, K. (2000) · PubMed · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Singh, N., Gurav, A., Sivaprakasam, S., Brady, E., Padia, R., Shi, H., Thangaraju, M., Prasad, P. D., Manicassamy, S., Munn, D. H., et al. (2014) · Immunity · doi:10.1016/j.immuni.2013.12.007 · Cited by 2,368 · see citing works
Cantó, C., Menzies, K. J., & Auwerx, J. (2015) · Cell Metabolism · doi:10.1016/j.cmet.2015.05.023 · Cited by 1,648 · see citing works
The secret life of NAD+: an old metabolite controlling new metabolic signaling pathways
Houtkooper, R. H., Cantó, C., Wanders, R. J., & Auwerx, J. (2010) · Endocrine Reviews · doi:10.1210/er.2009-0026 · Cited by 899 · see citing works
Tardy, A.-L., Pouteau, E., Marquez, D., Yilmaz, C., & Scholey, A. (2020) · Nutrients · doi:10.3390/nu12010228 · Cited by 541 · see citing works
Nutritional psychiatry: Towards improving mental health by what you eat
Adan, R. A. H., van der Beek, E. M., Buitelaar, J. K., Cryan, J. F., Hebebrand, J., Higgs, S., Schellekens, H., & Dickson, S. L. (2019) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2019.10.011 · Cited by 454 · see citing works
Challenging microalgal vitamins for human health
Del Mondo, A., Smerilli, A., Sané, E., Sansone, C., & Brunet, C. (2020) · Microbial Cell Factories · doi:10.1186/s12934-020-01459-1 · Cited by 220 · see citing works
Complications from carcinoid syndrome: Review of the current evidence
Mota, J. M., Sousa, L. G., & Riechelmann, R. P. (2016) · ecancermedicalscience · doi:10.3332/ecancer.2016.662 · Cited by 99 · see citing works
Mayer, P. R., Huang, N., Dewey, C. M., Dries, D. R., Zhang, H., & Yu, G. (2010) · Journal of Biological Chemistry · doi:10.1074/jbc.m110.178913 · Cited by 82 · see citing works
- Authors
- Hegyi, J., Schwartz, R. A., & Hegyi, V.
- Affiliations
- Rutgers New Jersey Medical School (US)
- Corresponding author
- Schwartz, Robert A.
- Hegyi, Vladimír
- ORCID
- Schwartz, Robert A.
- Venue
- International Journal of Dermatology
- Publisher
- Wiley
- Published
- 2003-12-24
- Volume
- 43
- Issue
- 1
- Pages
- 1-5
- ISSN
- 0011-9059 (ISSN-L)
- 1365-4632
- OpenAlex
- W2095406887
- Cited by
- 379
- References
- 28
- Citations by year
- 2026: 10 · 2025: 25 · 2024: 22 · 2023: 25 · 2022: 21 · 2021: 34 · 2020: 34 · 2019: 23 · 2018: 22 · 2017: 15 · 2016: 29 · 2015: 11 · 2014: 13 · 2013: 13 · 2012: 19
- FWCI
- 5.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Medicine and Dermatology Studies History
- Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › melanin and skin pigmentation
- Keywords
- pellagra, niacin deficiency, skin inflammation, dementia, diarrhea, erythema, history of pellagra
- MeSH terms
- Dermatitis, Diagnosis, Differential, Diarrhea, Humans, Pellagra
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
