Pellagra

Abstract

It was reported in a previous publication 1 that the skin lesions of pellagrins improved while they were restricted to a so-called “pellagra-producing” diet. Since this diet consisted of such diverse foods as cornmeal, pork fat, artificially colored (synthetic) maple syrup, polished rice, cornstarch pudding, and sugar, it seemed advisable to observe the skin lesions of pellagrins limited to a diet less complex in food materials and even more deficient in vitamin G. Evidence is presented in this paper to show that the dermatitis of pellagra often improves while the patient is restricted to cornstarch and lactose.

Ten cases with the characteristic dermatitis of pellagra were chosen for this experiment and extreme care was exercised to select patients without neurological involvement. Each patient remained in bed during the experiment and was given a diet of cornstarch and lactose amounting to 2,000 or 3,000 calories per day. Two of the 6 individuals in this series with stomatitis were unable to tolerate this diet so it was discontinued. The skin lesions of the 8 patients who remained on the diet of lactose and cornstarch showed definite improvement during the first 6 to 15 days of the experiment. The stomatitis of one individual improved and that of the 3 others became worse while they received the restricted diet. The 4 patients free of stomatitis at the beginning of the experiment did not develop it and none of the pellagrins used in this experiment showed any signs of central nervous system involvement.

It has been noted by the writer 2 as well as by others that pellagra may involve the central nervous system, the gastro-intestinal tract, and the skin in the same patient, while in other patients it may affect one or 2 organ systems. In several instances 2 the writer has observed that the dermatitis and stomatitis healed while there was a steady progression of the central nervous system disease.