The "gauntlet" of pellagra.
A 48-year-old alcoholic Filipino man presented to the outpatient department with a 2-year history of an eruption in a photosensitive distribution and episodes of mild diarrhea. He was otherwise in good health. Dermatologic examination revealed a browny-red coloration, with a sharply demarcated erythematous border, affecting both hands and lower forearms, where it was striking in its symmetry (Fig. 1). Around the neck, it was typical of a casal's necklace. The fronts and backs of the legs and the dorsa of the feet were also erythematous. The patient showed no evidence of mental confusion. A clinical diagnosis of pellagra was made based on the morphology, and treatment with nicotinamide 500 mg daily was instituted. The eruption quickly improved and resolved in 2 weeks (Fig. 2).
Isaac
S
S
Saint Barnabas Medical Center, Livingston, New Jersey 07039, USA.
D006801:Humans; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000627:therapeutic use; D010383:Pellagra / Q000175:diagnosis* / Q000188:drug therapy; D012871:Skin Diseases / Q000175:diagnosis* / Q000188:drug therapy
D009536:Niacinamide