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題 名 | Acute Pellagra in an Alcoholic Manifesting Generalized Pemphigus-Like Crusted Eruption=慢性酒精中毒引起的急性癩皮病表現全身性天疱瘡樣結痂性皮疹 |
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作 者 | 陳英璋; 李玉雲; | 書刊名 | 中華皮膚科醫學雜誌 |
卷 期 | 16:4 1998.12[民87.12] |
頁 次 | 頁319-323 |
分類號 | 415.7 |
關鍵詞 | 急性癩皮病; Pellagra; Chronic alcoholism; Pemphigus-like eruption; Bullous eruption; |
語 文 | 英文(English) |
英文摘要 | Pellagra is a multiple vitamin (mainly niacin) deficiency disease characterized by photosensitive dermatitis, diarrhea, dementia, and sometimes death. Less commonly, severe and acute cases may manifest vesiculobullous eruptions and delirium. A 32-year-old man, a chronic alcoholic, presented with a 2-week history of widespread crusted and scaly lesions on the face, chest, back and buttocks in association with glossal erosion, lip fissuring, and purulent bullae on the feet. He also complained of insomnia, general malaise and diarrhea and became delirious. Laboratory data revealed thrombocytopenia, hyponatremia, hypochloremia, hypokalemia, hypophosphatemia, hypertriglyceridemia, and evidence of alcoholic hepatitis. Histopathology of a crusted lesion revealed confluent parakeratosis with pallor of the underlying epidermis, features indicating a deficiency disease. A diagnosis of pellagra was made and parenteral multiple vitamins containing niacin 40 mg/d were initiated. The skin lesions and neurologic signs improved rapidly within 3 days. This is case of acute pellagra manifesting delirium and generalized crusted vesicular eruptions without typical Casal's necklace photodermatitis. Acute pellagra should be considered in the differential diagnosis of pemphigus-like vesicular or crusted eruptions in patients with chronic alcoholism, malnutrition or amino acid imbalance. |
本系統中英文摘要資訊取自各篇刊載內容。