Abstract REPORT OF A CASE A 60-year-old man complained of a persistent rash on his neck, chest, and forearms of three years' duration. He stated that the rash was not progressing, but that it showed no signs of resolution. The onset was insidious, with initial symptoms consisting of a stinging sensation in sun-exposed skin while sitting on his porch. The abnormal cutaneous sensation initially resolved on returning inside, but gradual, persistent pruritus occurred after several months.Two years prior to presentation in the dermatology clinic, the patient had undergone total gastrectomy for adenocarcinoma of the stomach. A feeding jejunostomy was put in place at that time and he received therapy with 3/4-strength Vivonex, a nutritionally complete elemental diet, in an attempt to ameliorate his persistent diarrhea. A rash on the neck and extremities had been noted on admission to the hospital at the time of surgery, but further investigation was postponed. References 1. Sydenstricker VP: The history of pellagra, its recognition as a disorder of nutrition and its conquest . Am J Clin Nutr 1958;6:409. 2. Castiello RJ, Lynch PJ: Pellagra and the carcinoid syndrome . Arch Dermatol 1972;105:574-577.Crossref 3. Cohen LK, George W, Smith R: Isoniazid-induced acne and pellagra . Arch Dermatol 1974;109:377-381.Crossref 4. Moore RA, Spies TD, Cooper ZK: Histopathology of the skin in pellagra . Ann Dermatol Venereol 1942;46:100-106.
Archives of Dermatology – American Medical Association
Published: Sep 1, 1987