The Pellagra, the clinical chameleon we should not forget
A case report in Peru
Abstract
Introduction: pellagra is an uncommon deficiency disease today, caused by a lack of niacin (vitamin B3) and characterized by the triad of dermatitis, diarrhea and dementia. Although its prevalence has diminished, it persists in vulnerable populations like people with chronic alcoholism, where it may be unrecognized due to its nonspecific presentation.
Case report: we report the case of a male in his 30s with a history of chronic alcoholism who was found disoriented, dehydrated and with extensive skin lesions in photoexposed areas. He was initially thought to have alcohol intoxication and extensive cellulitis. The clinical assessment and nutrition history oriented the diagnosis toward pellagra. He was treated with intravenous nicotinamide and showed progressive skin and neurological improvement over seven days.
Conclusions: this case highlights the importance of considering pellagra within the differential diagnosis of alcoholics with neurological and dermatological symptoms, given its potential reversibility and the need for prompt intervention to prevent complications
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