Vulvovaginal pellagra and lichen sclerosus complicating carcinoid syndrome.

Abstract:

BACKGROUND:Pellagra is a rare clinical syndrome caused by niacin deficiency, and although most commonly nutritional in origin, may be secondary to carcinoid syndrome. CASE:A premenopausal nulliparous woman with metastatic carcinoid tumor developed isolated vulvovaginal manifestations characterized by well-demarcated symmetrical vulvar erythema, mild scaling, ulcerations, and dyspareunia. Tryptophan levels were low. Treatment with nicotinamide resulted in dramatic improvement; however, after 2 years of effective treatment, she developed lichen sclerosus. CONCLUSION:Patients with carcinoid tumor presenting chronic vulvar lesions should be evaluated for pellagra. Subsequent development of lichen sclerosus at the site of vulvar dermatosis may be a feature of the "Koebner phenomenon," which describes appearance of lichen sclerosus in scarred areas or sites prone to friction.

journal_name

Obstet Gynecol

authors

Reichman O,Sobel JD

doi

10.1097/AOG.0b013e318191bb51

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

543-545

issue

2 Pt 2

eissn

0029-7844

issn

1873-233X

pii

00006250-200902001-00027

journal_volume

113

pub_type

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