Background: Acne, the most common skin disease characterized by comedones, papules, pustules, nodules, and/or cysts, has a prevalence of 90% during adolescence. The pathogenesis of acne vulgaris requires further study based on the pathological and pathophysiological changes in acne. Recent findings and evidence: Adolescence is the period when teenagers have very high nutritional demands. The occurrence of acne during adolescence suggests that the patient is nutritionally deficient or has increased nutritional requirements. Malnutrition of vitamins (niacin) is the most important cause of abnormal metabolism and inflammation. A pellagra diagnosis should focus on the presence of the “3 D’s” (diarrhea, dermatitis and dementia). The clinical features of acne include “3 D’s”: dermatitis (acne, seborrheic dermatitis), dyspepsia, and depression. Patients with acne are frequently associated with abnormal serum lipid profiles and elevated sebum secretion. Foam cells are an important pathological change in acne lesions. Niacin is the only vitamin that promotes the efflux of cholesterol and other lipids from cells and prevents foam cell formation. Foam cells in acne lesions suggest that patients with acne are deficient in niacin. Recently, several studies have reported the efficacy and safety of nicotinamide and niacin for acne treatment. Summary: Based on an analysis of the clinical feature of acne patients, pathological changes in acne lesions and the therapeutic effects of niacin on acne, we propose that acne can be diagnosed as a specific clinical type of pellagra, and niacin is the first choice for the treatment of acne vulgaris.
| Published in | American Journal of Clinical and Experimental Medicine (Volume 9, Issue 6) |
| DOI | 10.11648/j.ajcem.20210906.13 |
| Page(s) | 204-208 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Acne, Niacin, Nicotinamide, Pellagra, Vitamin B3
| [1] | Hegyi J, Schwartz RA, Hegyi V. Pellagra: dermatitis, dementia, and diarrhea. Int J Dermatol. 2004 Jan; 43 (1): 1–5. |
| [2] | Brown TM. Pellagra: an old enemy of timeless importance. Psychosomatics. 2010 Mar–Apr; 51 (2): 93–7. |
| [3] | Rajakumar K. Pellagra in the United States: a historical perspective. South Med J. 2000 Mar; 93 (3): 272–7. |
| [4] | Toyoda M, Morohashi M. Pathogenesis of acne. Med Electron Microsc. 2001 Mar; 34 (1): 29–40. |
| [5] | Zouboulis CC. Acne as a chronic systemic disease. Clin Dermatol. 2014 May–Jun; 32 (3): 389–96. |
| [6] | Jacob JA, Nair MK. Protein and micronutrient supplementation in complementing pubertal growth. Indian J Pediatr. 2012 Jan; 79 (Suppl 1): S84–91. |
| [7] | Halvorsen JA, Stern RS, Dalgard F, Thoresen M, Bjertness E, Lien L. Suicidal ideation, mental health problems, and social impairment are increased in adolescents with acne: a population-based study. J Invest Dermatol. 2011 Feb; 131 (2): 363-70. Epub 2010 Sep 16. |
| [8] | Samuels DV, Rosenthal R, Lin R, Chaudhari S, Natsuaki MN. Acne vulgaris and risk of depression and anxiety: A meta-analytic review. J Am Acad Dermatol. 2020 Aug; 83 (2): 532-541. |
| [9] | Uhlenhake E, Yentzer BA, Feldman SR. Acne vulgaris and depression: a retrospective examination. J Cosmet Dermatol. 2010 Mar; 9 (1): 59-63. |
| [10] | Elman M, Lebzelter J. Light therapy in the treatment of acne vulgaris. Dermatol Surg. 2004 Feb; 30 (2 Pt 1): 139–46. |
| [11] | Leyden JJ. Therapy for acne vulgaris. N Engl J Med. 1997; 336 (16): 1156–62. |
| [12] | Wan P, Moat S, Anstey A. Pellagra: a review with emphasis on photosensitivity. Br J Dermatol. 2011 Jun; 164 (6): 1188–200. |
| [13] | R Dodel, G Deuschl. Demenzfrüherkennung: nur zerstreut oder schon krank?Early diagnosis of dementia: Kognitive Defizite. MMW Fortschritte der Medizin, 2020, 162 (6): 60-68. |
| [14] | Deardorff WJ, Grossberg GT. Behavioral and psychological symptoms in Alzheimer's dementia and vascular dementia. Handb Clin Neurol. 2019; 165: 5-32. |
| [15] | Bondi MW, Edmonds EC, Salmon DP. Alzheimer's Disease: Past, Present, and Future. J Int Neuropsychol Soc. 2017 Oct; 23 (9-10): 818-831. |
| [16] | Barrah S, Jebali H, Kheder R, Krid M, Smaoui W, Beji S, Hmida FB, Fatma LB, Rais L, Zouaghi MK. Pellagra Disease in a Hemodialysis Patient. Saudi J Kidney Dis Transpl. 2020 Jul-Aug; 31 (4): 874-876. |
| [17] | Sood S, Jafferany M, Vinaya Kumar S. Depression, psychiatric comorbidities, and psychosocial implications associated with acne vulgaris. J Cosmet Dermatol. 2020 Dec; 19 (12): 3177-3182. |
| [18] | Tan JK. Psychosocial Impact of Acne Vulgaris: Evaluating the Evidence. Skin Therapy Lett. 2004; 9 (7): 1-3, 9. |
| [19] | Hazarika N, Archana M. The Psychosocial Impact of Acne Vulgaris. Indian J Dermatol. 2016 Sep-Oct; 61 (5): 515-20. doi: 10.4103/0019-5154.190102. PMID: 27688440; PMCID: PMC5029236. |
| [20] | Cengiz GF, Gürel G. Difficulties in emotion regulation and quality of life in patients with acne. Qual Life Res. 2020 Feb; 29 (2): 431-438. |
| [21] | Awad SM, Morsy H, Sayed AA, Mohamed NA, Ezzat GM, Noaman MM. Oxidative stress and psychiatric morbidity in patients with facial acne. J Cosmet Dermatol. 2018 Apr; 17 (2): 203-208. |
| [22] | Tan JK. Psychosocial impact of acne vulgaris: evaluating the evidence. Skin Therapy Lett. 2004 Aug-Sep; 9 (7): 1-3, 9. PMID: 15334275. |
| [23] | Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol. 2006; 27 (1): 24-31. |
| [24] | Ting C, Rajji TK, Ismail Z, Tang-Wai DF, Apanasiewicz N, Miranda D, Mamo D, Mulsant BH. Differentiating the cognitive profile of schizophrenia from that of Alzheimer disease and depression in late life. PLoS One. 2010; 5 (4): e10151. |
| [25] | A. F. Jorm. Is depression a risk factor for dementia or cognitive decline? Gerontology 2000; 46: 219-227. |
| [26] | Dinesh Bhugra. The global prevalence of schizophrenia. PLoS Med. 2005 May; 2 (5): e151. |
| [27] | Harrop C, Trower P. Why does schizophrenia develop at late adolescence? Clin Psychol Rev. 2001 Mar; 21 (2): 241-65. |
| [28] | Hoffer LJ. Vitamin therapy in schizophrenia. Isr J Psychiatry Relat Sci. 2008; 45 (1): 3-10. |
| [29] | Morris MC, Evans DA, Bienias JL, Scherr PA, Tangney CC, Hebert LE, Bennett DA, Wilson RS, Aggarwal N. Dietary niacin and the risk of incident Alzheimer's disease and of cognitive decline. J Neurol Neurosurg Psychiatry. 2004, 75 (8): 1093-9. |
| [30] | Wang B, Yang W, Wen W, Sun J, Su B, Liu B, Ma D, Lv D, Wen Y, Qu T, Chen M, Sun M, Shen Y, Zhang X. Gamma-secretase gene mutations in familial acne inversa. Science. 2010 Nov 19; 330 (6007): 1065. |
| [31] | Devita Surjana, Gary M. Halliday, Diona L. Damian. Role of nicotinamide in DNA damage, mutagenesis, and DNA repair. J Nucleic Acids. 2010; 2010: 157591. |
| [32] | Benavente CA, Jacobson MK, Jacobson EL. NAD in skin: therapeutic approaches for niacin. Curr Pharm Des. 2009; 15 (1): 29-38. |
| [33] | Pitche PT. Pellagra. Sante. 2005; 15 (3): 205-8. |
| [34] | Haber R, El Gemayel M. Comorbidities in rosacea: A systematic review and update. J Am Acad Dermatol. 2018 Apr; 78 (4): 786-792. e8. |
| [35] | Lim HG, Fischer A, Rueda MJ, Kendall J, Kang S, Chien AL. Prevalence of gastrointestinal comorbidities in rosacea: Comparison of subantimicrobial, modified release doxycycline versus conventional release doxycycline. J Am Acad Dermatol. 2018 Feb; 78 (2): 417-419. |
| [36] | Yang X. Relationship between Helicobacter pylori and Rosacea: review and discussion. BMC Infect Dis. 2018 Jul 11; 18 (1): 318. |
| [37] | Lu CY, Hsieh MS, Wei KC, Ezmerli M, Kuo CH, Chen W. Gastrointestinal involvement of primary skin diseases. J Eur Acad Dermatol Venereol. 2020 Dec; 34 (12): 2766-2774. |
| [38] | Jiang Hao, Li Changyi. A preliminary investigation of acne vulgaris associated with dyspepsia. Chinese Journal of Aesthetic Medicine. 2010. 19 (7): 1049-1051. |
| [39] | Zanchi C, Pintaldi S, Di Leo G, Ronfani L, Zamagni G, Viel M, Barbi E, Cozzi G. Fifteen-Years Follow-Up in a Cohort of Children with Functional Gastrointestinal Disorders: Prevalence and Risk Factors to Develop Neuropsychiatric Disorders and Other Comorbidities. Children (Basel). 2021 Sep 24; 8 (10): 838. |
| [40] | Savvidou S. Pellagra: a non-eradicated old disease. Clin Pract. 2014 Apr 28; 4 (1): 637. doi: 10.4081/cp.2014.637. PMID: 24847436; PMCID: PMC4019925. |
| [41] | Jonathan E. Prousky, Claire Kerwin. Niacin (Nicotinic Acid) a Putative Treatmentfor Hypochlorhydria: Re-analysis of Two Case Reports. Journal of Orthomolecular Medicine, 2002, 17 (3). |
| [42] | Jiang H, Li C, Zhou L, Lu B, Lin Y, Huang X, Wei B, Wang Q, Wang L, Lu J. Acne patients frequently associated with abnormal plasma lipid profile. Journal of Dermatology. 2015, 42 (3): 296-299. |
| [43] | Hao Jiang, Changyi Li. Common Pathogenesis of Acne Vulgaris and Atherosclerosis. Inflammation. 2019 Feb; 42 (1): 1-5. |
| [44] | Wu ZH, Zhao SP. Niacin promotes cholesterol efflux through stimulation of the PPARgamma-LXRalpha -ABCA1 pathway in 3T3-L1 adipocytes. Pharmacology. 2009; 84 (5): 282–7. |
| [45] | Yvan-Charvet L, Kling J, Pagler T, Li H, Hubbard B, Fisher T, Sparrow CP, Taggart AK, Tall AR. Cholesterol efflux potential and antiinflammatory properties of high-density lipoprotein after treatment with niacin or anacetrapib. Arterioscler Thromb Vasc Biol. 2010 Jul; 30 (7): 1430-8. |
| [46] | Huang H, Koelle P, Fendler M, Schroettle A, Czihal M, Hoffmann U, Kuhlencordt PJ. Niacin reverses migratory macrophage foam cell arrest mediated by oxLDL in vitro. PLoS One. 2014 Dec 18; 9 (12): e114643. |
| [47] | Ronsein GE, Hutchins PM, Isquith D, Vaisar T, Zhao XQ, Heinecke JW. Niacin Therapy Increases High-Density Lipoprotein Particles and Total Cholesterol Efflux Capacity But Not ABCA1-Specific Cholesterol Efflux in Statin-Treated Subjects. Arterioscler Thromb Vasc Biol. 2016 Feb; 36 (2): 404-11. |
| [48] | Ganji SH, Kashyap ML, Kamanna VS. Niacin inhibits fat accumulation, oxidative stress, and inflammatory cytokine IL-8 in cultured hepatocytes: Impact on non-alcoholic fatty liver disease. Metabolism. 2015 Sep; 64 (9): 982–90. |
| [49] | Ganji SH, Qin S, Zhang L, Kamanna VS, Kashyap ML. Niacin inhibits vascular oxidative stress, redox-sensitive genes, and monocyte adhesion to human aortic endothelial cells. Atherosclerosis. 2009 Jan; 202 (1): 68-75. |
| [50] | Chai JT, Digby JE, Ruparelia N, Jefferson A, Handa A, Choudhury RP. Nicotinic acid receptor GPR109A is down-regulated in human macrophage-derived foam cells. PLoS One. 2013 May 2; 8 (5): e62934. doi: 10.1371/journal.pone.0062934. Print 2013. |
| [51] | Ying Zhu, Ke-ke Zhao, Yao Tong, Ya-li Zhou, Yi-xiao Wang, Pei-quan Zhao, Zhao-yang Wang. Exogenous NAD+ decreases oxidative stress and protects H2O2-treated RPE cells against necrotic death through the up-regulation of autophagy. Sci Rep. 2016; 6: 26322. |
| [52] | Walocko FM, Eber AE, Keri JE, Al-Harbi MA, Nouri K. The role of nicotinamide in acne treatment. Dermatol Ther. 2017 Feb 21. |
| [53] | Chen AC, Damian DL. Nicotinamide and the skin. Australas J Dermatol. 2014 Aug; 55 (3): 169–75. |
| [54] | Forbat E, Al-Niaimi F, Ali FR. Use of nicotinamide in dermatology. Clin Exp Dermatol. 2017 Mar; 42 (2): 137–44. |
| [55] | Niren NM, Torok HM. The Nicomide Improvement in Clinical Outcomes Study (NICOS): results of an 8-week trial. Cutis. 2006; 77 (Suppl 1): 17–28. |
| [56] | Khodaeiani E, Fouladi RF, Amirnia M, Saeidi M, Karimi ER. Topical 4% nicotinamide vs. 1% clindamycin in moderate inflammatory acne vulgaris. Int J Dermatol. 2013 Aug; 52 (8): 999–1004. |
| [57] | Rolfe HM. A review of nicotinamide: treatment of skin diseases and potential side effects. J Cosmet Dermatol. 2014 Dec; 13 (4): 324–8. |
| [58] | Fivenson DP. The mechanisms of action of nicotinamide and zinc in inflammatory skin disease. Cutis. 2006 Jan; 77 (Suppl 1): 5–10. |
| [59] | Di Meo S, Reed TT, Venditti P, Victor VM. Role of ROS and RNS Sources in Physiological and Pathological Conditions. Oxid Med Cell Longev. 2016; 2016: 1245049. |
| [60] | Hao J, Changyi L. High dose niacin in the treatment of acne vulgaris: a pilot study. Chin J Aesthet Med. 2016; 25 (12): 54–9. |
APA Style
Jiang Hao, Li Changyi. (2021). Acne Vulgaris Is a Special Clinical Type of Pellagra. American Journal of Clinical and Experimental Medicine, 9(6), 204-208. https://doi.org/10.11648/j.ajcem.20210906.13
ACS Style
Jiang Hao; Li Changyi. Acne Vulgaris Is a Special Clinical Type of Pellagra. Am. J. Clin. Exp. Med. 2021, 9(6), 204-208. doi: 10.11648/j.ajcem.20210906.13
AMA Style
Jiang Hao, Li Changyi. Acne Vulgaris Is a Special Clinical Type of Pellagra. Am J Clin Exp Med. 2021;9(6):204-208. doi: 10.11648/j.ajcem.20210906.13
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ajcem.20210906.13,
author = {Jiang Hao and Li Changyi},
title = {Acne Vulgaris Is a Special Clinical Type of Pellagra},
journal = {American Journal of Clinical and Experimental Medicine},
volume = {9},
number = {6},
pages = {204-208},
doi = {10.11648/j.ajcem.20210906.13},
url = {https://doi.org/10.11648/j.ajcem.20210906.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20210906.13},
abstract = {Background: Acne, the most common skin disease characterized by comedones, papules, pustules, nodules, and/or cysts, has a prevalence of 90% during adolescence. The pathogenesis of acne vulgaris requires further study based on the pathological and pathophysiological changes in acne. Recent findings and evidence: Adolescence is the period when teenagers have very high nutritional demands. The occurrence of acne during adolescence suggests that the patient is nutritionally deficient or has increased nutritional requirements. Malnutrition of vitamins (niacin) is the most important cause of abnormal metabolism and inflammation. A pellagra diagnosis should focus on the presence of the “3 D’s” (diarrhea, dermatitis and dementia). The clinical features of acne include “3 D’s”: dermatitis (acne, seborrheic dermatitis), dyspepsia, and depression. Patients with acne are frequently associated with abnormal serum lipid profiles and elevated sebum secretion. Foam cells are an important pathological change in acne lesions. Niacin is the only vitamin that promotes the efflux of cholesterol and other lipids from cells and prevents foam cell formation. Foam cells in acne lesions suggest that patients with acne are deficient in niacin. Recently, several studies have reported the efficacy and safety of nicotinamide and niacin for acne treatment. Summary: Based on an analysis of the clinical feature of acne patients, pathological changes in acne lesions and the therapeutic effects of niacin on acne, we propose that acne can be diagnosed as a specific clinical type of pellagra, and niacin is the first choice for the treatment of acne vulgaris.},
year = {2021}
}
TY - JOUR T1 - Acne Vulgaris Is a Special Clinical Type of Pellagra AU - Jiang Hao AU - Li Changyi Y1 - 2021/11/24 PY - 2021 N1 - https://doi.org/10.11648/j.ajcem.20210906.13 DO - 10.11648/j.ajcem.20210906.13 T2 - American Journal of Clinical and Experimental Medicine JF - American Journal of Clinical and Experimental Medicine JO - American Journal of Clinical and Experimental Medicine SP - 204 EP - 208 PB - Science Publishing Group SN - 2330-8133 UR - https://doi.org/10.11648/j.ajcem.20210906.13 AB - Background: Acne, the most common skin disease characterized by comedones, papules, pustules, nodules, and/or cysts, has a prevalence of 90% during adolescence. The pathogenesis of acne vulgaris requires further study based on the pathological and pathophysiological changes in acne. Recent findings and evidence: Adolescence is the period when teenagers have very high nutritional demands. The occurrence of acne during adolescence suggests that the patient is nutritionally deficient or has increased nutritional requirements. Malnutrition of vitamins (niacin) is the most important cause of abnormal metabolism and inflammation. A pellagra diagnosis should focus on the presence of the “3 D’s” (diarrhea, dermatitis and dementia). The clinical features of acne include “3 D’s”: dermatitis (acne, seborrheic dermatitis), dyspepsia, and depression. Patients with acne are frequently associated with abnormal serum lipid profiles and elevated sebum secretion. Foam cells are an important pathological change in acne lesions. Niacin is the only vitamin that promotes the efflux of cholesterol and other lipids from cells and prevents foam cell formation. Foam cells in acne lesions suggest that patients with acne are deficient in niacin. Recently, several studies have reported the efficacy and safety of nicotinamide and niacin for acne treatment. Summary: Based on an analysis of the clinical feature of acne patients, pathological changes in acne lesions and the therapeutic effects of niacin on acne, we propose that acne can be diagnosed as a specific clinical type of pellagra, and niacin is the first choice for the treatment of acne vulgaris. VL - 9 IS - 6 ER -
Information
Email: