Kosmetische Medizin 4-2009: 128 – 132
The price of a “rail-thin model” body:
Pellagra in a patient with self-imposed restriction diet
JANA KAZANDJIEVA, VALENTINA BROSHTILOVA, RAZVIGOR DARLENSKI
KEYWORDS: pellagra, kynurenine pathway, eating disorders
A case of 40-year-old woman with photodermatitis associated with subclinical form of an anxiety mood disorder that appeared after a prolonged course of self-imposed restriction diet was verified as pellagra due to the low urinary excretion of 5-hydroxy-indole-acetic acid and the prompt resolution of all clinical symptoms upon niacin administration. A thorough review of literature proves that pellagra is a possible complication of various nutritional disorders and ought to be considered in the clinical work-up and therapeutic administration of comprehensive nutritional plan for all patients with even subtle photosensitive cutaneous changes, regardless the lack of insight for their eating disorder.