Pellagra may be a rare secondary XXXX : a systematic review of the literature.

@entity1 @entity172 @entity49270 @entity3136 @entity368 @entity303 @entity294 @entity448 @entity1670 @entity344 @entity1278 @entity2340 @entity35160 @entity4303 @entity1130 @entity204 @entity1909
Pellagra is a nutritional wasting disease attributable to a combined deficiency of @entity2340 and @entity1670 ( @entity1670 ). It is characterized clinically by four classic symptoms often referred to as the four Ds: @entity294 , @entity1909 , @entity303 , and @entity204 . Prior to the development of these symptoms, other nonspecific symptoms insidiously manifest and mostly affect the @entity344 . A review of the literature reveals several case reports describing @entity49270 in @entity1 with @entity1278 . The most common features of @entity49270 in @entity1 with @entity1278 are cutaneous manifestations such as erythema on sun-exposed areas, @entity35160 , and @entity3136 . Health care providers might consider a trial of 150-500 mg @entity1670 if anorexic @entity1 exhibit these cutaneous findings. Pellagra can be diagnosed if cutaneous symptoms resolve within 24-48 hours after oral @entity1670 administration. To further corroborate a diagnosis of @entity49270 in anorexic @entity1 , specific 24-hour urine tests for @entity1670 metabolites and @entity1130 could be run prior to treatment with @entity1670 being instituted. Other factors, such as mycotoxins, excessive dietary @entity368 intake (although not in @entity448 ), @entity172 and progestogens, @entity4303 , and various medications, might also lead to the development of @entity49270 . Although @entity49270 appears to be a rare, yet possible secondary @entity1278 , it should be considered in the work-up of @entity1 who exhibit cutaneous manifestations subsequent to sunlight exposure.
