1921
Volume s1-30, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645
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Abstract

Summary

  • 1.  Consideration of the diet of natives in Fiji (South-West Pacific) shows that it is not adequate and complete. The traditional foodstuffs of Fiji are very rich in concentrated carbohydrates, comparatively poor in protein content and definitely lacking in Vitamin B complex.
  • 2.  The staple foods of the native population in Fiji are roots, tubers and leafy plants. Unfortunately very little is known about the Vitamin B content of the plants grown in Fiji. However as the plants are generally boiled and the water discarded, their value as a source of Vitamin B supply is doubtful.
  • 3.  Between July 1948 and October 1949, 14 cases of typical pellagra and 16 cases of pellagra-like dermatitis were seen. The pellagra-like dermatitis responded very well to specific treatment with nicotinamide alone or in combination with riboflavin, and, therefore, should be considered as mild pellagrous manifestation.
  • 4.  Three cases of typical pellagra and four cases of pellagra-like dermatitis were observed amongst Europeans. These cases of pellagra amongst the white population in Fiji are believed to be the first recorded. It is of interest to notice that two European patients with typical pellagra were born in Fiji and are permanent residents in the colony.
  • 5.  Consideration of 16 cases of pellagra-like dermatitis show that in 5 cases the lesions were symmetrical, and in 7 were accompanied with edema of the lips, ears and eyebrows. The lesions are usually found on exposed portions. The main clinical symptoms are extreme itching and feeling of heat around the affected areas. They become red and swollen in from 24 to 48 hours after the onset. Small vesicles usually appear at this time. Later on the skin becomes dry, less red, thick and scaly, surrounded by a narrow zone of hyperpigmentation, better seen on the white skin. It has a “dirty” appearance on a dark skin, and grey-brownish on a white one.
  • 6.  The 14 cases of typical pellagra all had symmetrical dermatitis; 12, angular stomatitis; 8, edema of lips, ears and eyebrows; 7, glossitis; and 4, mental disturbances (the cases over 5 years duration). As a rule the patients, when untreated, showed some improvement during the rainy season, and relapsed with the advance of dry weather.
  • 7.  It has been found that the addition of riboflavin to nicotinamide is beneficial in the treatment of typical pellagra and pellagra-like dermatitis. This combination of vitamins produces a dramatic improvement in all patients in whom edema of lips, ears and eyebrows is well marked. The intravenous use of Vitamin B Complex in injectable form shortens the course of treatment.
  • 8.  A careful analysis of the diet of each patient is essential, as without strict adherence to a well balanced diet, even properly treated cases, are liable to relapse.

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/content/journals/10.4269/ajtmh.1950.s1-30.921
1950-11-01
2017-12-11
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