50 years female complaining of burning black patches on both hands and neck, legs since 3 weeks. She is chronic alcoholic since 30 years. Past history of same illness since 3 years.

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Symmetrical skin lesion on sun exposed areas. which are characteristic in Pellagra. Pellagra is caused by deficiency of vit B3 Niacin and/or tryptophan. Mostly seen in Chronic alcohlics as a result of nutritionally poor diet and malabsorption Photosensitivity has been associated with pellagra. Presentation of pellagra is 3D's Dementia, Diarrhoea and Dermatitis (photosensitive symmetrical) Is there any history of gastro intestinal disturbances like loss of appetite, abdominal pain, enteritis. Also very important is neurlogical and psychiatric assessment. Treatment 500mg of Nicotinamide daily. B complex vitamin supplements & zinc@ high protein diet Absistence of alcohol

What about diabetics?.
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@Dr. P.kishore Kumar Sir PELLAGRA Pellagra is a disease characterised by diarrhoea, dermatitis and dementia. If left untreated, death is the usual outcome. Pellagra is caused by having too little niacin (Vitamin B-3) or tryptophan in the diet. It can also occur if the body fails to absorb these nutrients. It may develop after gastrointestinal diseases or with alcoholism, HIV/AIDS, or anorexia. Management: Pellagra can be effectively cured with intravenous or oral niacin or nicotinamide.  A high protein diet supplemented with B-group vitamins is needed for complete recovery. Skin lesions may be treated with topical emollients. Sun protection is important during the recovery phase. Cover up and apply a broad spectrum sunscreen to all exposed areas daily.

Sir Pellagra cause by niacin or vit b3 or nictonamide defficiency due to malnutrition, immunocomprmised, gastroentrostomy,gastrointestinal deseas, chronic alcoholism , stress, depression, anti tubercular drug , immunosuppressive drug, anti cancer drug and carcinoide syndrome.. So sir ji niacin or vitb3 get by many food sources and suppliements. Thease food sources r sea food, green vegetable, peanuts, dry fruit etc. Pellagra pt Requirements r:(vitb3)10 to13 miligram per day . So sir u can manage d deseas according to pt history profile, condition, symptom and sign.

Pellagra. Niacin deficiency 3 Ds of niacin deficiency. Diarrhoea Dermatitis and Dementia. Dermatitis occurs in sunexposed area.

Any hx of ch.alchohole abuses? Hx of Sun exposed occupation? Can b pellagra if above r negative.

Pellagra

Bcomplex in high doses.sonography Of liver.fundoscopy is more accurate to rule out liver pathology.advice alkohol abstinence.ear points stimulation ,three times a day.is useful. Effect remain perhaps for 1 year.
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Sir if it pellagra then diarrhea will be present. What about mental status As 4d sign in pellagra

PELLAGRA.

Itchthosis ddpellagra

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