Pellagra



Pellagra uses color pictures and clear explanations to teach you about this nutritional disease which affects the skin.

Table of contents:
Chapter 1. What causes Pellagra?
Chapter 2. What are the symptoms and signs of Pellagra?
Chapter 3. What investigations are done for Pellagra?
Chapter 4. What are the differential diagnosis for Pellagra?
Chapter 5. What is the treatment for Pellagra?
Chapter 6. What are the complications of Pellagra?
Chapter 7. How can Pellagra be prevented?

BOOK EXCERPT
Chapter 1
WHAT CAUSES PELLAGRA?
Pellagra is a nutritional disease that is caused by deficiency of vitamin B3 or niacin which is a water soluble vitamin.

Pellagra can be classified in the following way:
1. Primary pellagra
Primary pellagra develops as a result of inadequate dietary niacin intake. Primary pellagra can also develop as a result of inadequate dietary tryptophan intake since this amino acid is converted to niacin in the body. The causes of primary pellagra include poverty related malnutrition, maize (corn) based diet, anorexia nervosa, chronic parenteral nutrition, fad diets and severe elimination diets.  

2. Secondary pellagra
Secondary pellagra develops despite adequate dietary niacin due to poor niacin intake, absorption, and processing by the body. Causes of secondary pellagra include:
a. Gastrointestinal diseases such as chronic diarrhea, Crohn’s disease, ulcerative colitis, regional enteritis, gastrointestinal tuberculosis, and liver cirrhosis.
b. Chronic alcoholism and chronic drug addiction
c. Anorexia nervosa
d. Chronic dialysis
e. Malignant carcinoid tumors since the tryptophan is used to form the serotonin.
f. Hartnup syndrome which is an inherited disorder of amino acid transport which results in defective absorption of tryptophan by the gastrointestinal tract and kidneys.
g. Medications such as isoniazid which competes with niacin, pyrazinamide, 5-fluorouracil, 6-mercaptopurine, azathioprine, chloramphenicol, and phenytoin.

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Poikiloderma

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Poikiloderma uses color pictures and clear explanations to teach you about this skin condition.
Table of contents:
Chapter 1. What is Poikiloderma?
Chapter 2. What causes Poikiloderma?
Chapter 3. What are the symptoms and signs of Poikiloderma?
Chapter 4. What investigations are done for Poikiloderma?
Chapter 5. What is the treatment for Poikiloderma?
Chapter 6. Poikilodermatous Mycosis Fungoides or Poikiloderma vasculare atrophicans
Chapter 7. Poikiloderma of Civatte

BOOK EXCERPT

WHAT IS POIKILODERMA?
Poikiloderma is a skin condition characterized by patches of hyperpigmentation, hypopigmentation and atrophy (thinning skin) with telangiectases (dilated capillaries).

WHAT CAUSES POIKILODERMA?
Conditions associated with prominent poikiloderma include:
1. Poikilodermatous mycosis fungoides
2. Poikiloderma of Civatte
3. Large plaque parapsoriasis
4. Connective tissue disease such as lupus erythematosus and dermatomyositis
5. Overuse of topical glucocorticoids
6. Radiation dermatitis
7. Graft versus host disease
8. Genodermatoses such as Rothmund-Thompson syndrome, Bloom syndrome, and dyskeratosis congenita.

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Urticaria

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Urticaria uses color pictures and clear explanations to teach about this common skin disorder which can progress to life threatening angioedema and anaphylaxis.

Table of contents:
Chapter 1. What is Urticaria?
Chapter 2. What are the different types of Urticaria?
Chapter 3. What causes Urticaria?
Chapter 4. What is the pathophysiology of Urticaria?
Chapter 5. What are the symptoms and signs of Urticaria?
Chapter 6. What investigations are done for Urticaria?
Chapter 7. How is a diagnosis of Urticaria made?
Chapter 8. What are the differential diagnosis for Urticaria?
Chapter 9. What is the treatment for Urticaria?
Chapter 10. What are the complications of Urticaria?
Chapter 11. How can Urticaria be prevented?

BOOK EXCERPT

WHAT IS URTICARIA?
Urticaria, which is also known as hives or wheals, occurs in all races and affects approximately 15-20% of the general population at one time. It is the most commonly seen skin disorder in the emergency department and one that should be attended to emergently since it can progress to life threatening angioedema and anaphylaxis.


WHAT ARE THE DIFFERENT TYPES OF URTICARIA?
Urticaria can either be classified acute urticaria or chronic urticaria depending on the duration of the lesions.
1. Acute urticaria
Acute urticaria is usually a self-limiting illness since the transient lesions usually resolve within 24 hours though they may recur for up to 6 weeks. It can occur in all age groups and its incidence is equal in both men and women. 

Acute urticaria can develop because of physical contact with allergens such as latex, inhalation of allergens in molds, ingestion of allergens in shellfish and intravenous administration of allergens in radio-contrast dye.  

The cause of acute urticaria are usually identified in around 50% of patients. Most cases of acute urticaria respond well to treatment with histamine receptor blockers and patients have complete resolution of symptoms within a week.

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