Akakpo A S, Saka B, Teclessou J N, Mouhari-Toure A, Moise Elegbede Y, Kombate K, Tchangai-Walla K, Pitche P
Service dermatologie et IST, CHU Sylvanus Olympio, Université de Lomé, 14BP 200 Lomé, Togo.
Service de dermatologie du CHU Kara, Université de KARA, Togo.
Med Sante Trop. 2019 Feb 1;29(1):68-70. doi: 10.1684/mst.2018.0856.
The aim of this study was to describe the epidemiological, clinical, and therapeutic profile as well as the outcome and to document the causes of pellagra and pellagra-like erythema in a hospital setting in Lomé, Togo.
This retrospective study examined the records of patients seen for outpatient consultation and/or hospitalization in the three public dermatology departments of Lomé from January 1997 to September 2017.
During the study period, 178 (0.4%) of 47,219 patients seen in these dermatology departments consulted for pellagra or pellagra-like erythema; 159 (89.3%) had pellagra-like erythema. The patients' mean age was 45.8±16 years, and the sex ratio (M/F) 1.8. All patients had at least one site of cutaneous involvement, nearly always erythematous or pigmented lesions in the photo-exposed areas (99.4% of cases). Gastrointestinal and neurological signs were dominated respectively by diarrhea (12.4 % of cases), peripheral neuropathies (8.4% of cases) and insomnia (8.4% of cases). The main causes identified were alcoholism (42.1% of cases) and nutritional deficiency (6.7% of cases). Five of 178 patients were infected with HIV. All patients were treated with nicotinamide and multivitamin supplementation. No deaths were recorded during follow-up.
Our results document the extreme rarity of pellagra-like erythema/pellagra. Its two main causes remain alcoholism and nutritional deficiency. Moreover, its prognosis is good when treated quickly and adequately.
