Pellagra is caused by inadequate niacin (vitamin B3) in the diet, malabsorption, or due to azathioprine.[1]


- Reddened skin with scaling in areas exposed to sunlight, heat or friction. As the redness subsides it leaves a brownish-red coloration. The rash may itch or burn, be hard, scaly, and cracked with a clear line between skin that is affected and not affected.
- Diarrhea (50% of cases)
- Poor appetite
- Abdominal pain
- Nausea and vomiting
- Difficulty drinking
- Depression/fatigue/apathy
- Headache
- Confusion
- Irritability
- Restlessness
- Anxiety
- Bright red tongue[2]


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