• S Isaac.
• Saint Barnabas Medical Center, Livingston, New Jersey 07039, USA.
• Int. J. Dermatol. 1998 Aug 1;37(8):599.

AbstractA 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).

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