Muhammad Latif, Mohammad Ibthaj-ul Haq, Raja Omer Fiaz, Ikram-ur Rahim, Zafar Iqbal Ch, Maryam Sheikh.
Diagnosis of an Unusual Case of Pellagra with Hypothyroidism.
J Akhtar Saeed Med Coll Jan ;3(1):41-5.

Niacin deficiency, Pellagra or the 3DS disease, is a disorder associated with either poor intake of niacin-containing food or secondarily decreased bioavailability of the same. Being an essential component in several co enzymes, its deficiency is also considered a multi-nutritional disorder involving the deficiency of tryptophan and consequently vitamin B2 and B6. the low clinical suspicion of this disease, which may be associated with hypothyroidism, made it a clinical challenge even with the classical triad of symptomatology. A case report of 38 years old woman presented with a 3-month history of progressive erythematous lesions on the dorsum of hands resembling photosensitivity eruptions but lacking the typical Casal necklace sign and preceded by multiple episodes of diarrhea, a paradoxical manifestation to its underlying hypothyroid state. Key Words: Hypothyroidism, Pellagra, Vitamin B6

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