A Photosensitive Dermatitis in the Intensive Care Unit  

Oleh:

Mercieri, Marco ; Goldhaber, Samuel Z.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 364 no. 04 (Jan. 2011), page 361.
Topik: Obstructive Lung Disease; Dermatitis
Fulltext: A Photosensitive Dermatitis.pdf (51.41KB)

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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An 88-year-old man with long-standing obstructive lung disease was admitted to the intensive care unit with pneumonia and acute respiratory failure requiring mechanical ventilation. He was noted to have a symmetric, scaly, sunburn-like, hyperpigmented rash extending from his hands to a clearly demarcated border midway up the arm, suggesting a photosensitive distribution in a patient accustomed to wearing short sleeves. He had no history of diarrhea or dementia before his admission. Dietary habits were reported to be poor. Serum niacin levels were low (<0.5 ng per milliliter; normal range, 0.5 to 15 ng per milliliter), and a cutaneous biopsy showed parakeratosis, epidermal necrosis, and lymphocytic infiltrates. These findings suggested a diagnosis of pellagra-like dermatitis. Classic pellagra manifestations include dermatitis, dementia, and diarrhea. If not treated, the condition may have a fatal outcome. In this case, there was substantial improvement in the cutaneous lesions over several days of niacin supplementation. However, the patient subsequently died of complications from hospital-acquired pneumonia.

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