DIAGNOSIS OF AN UNUSUAL CASE OF PELLAGRA WITH HYPOTHYROIDISM

Abstract

Niacin deficiency, Pellagra or the 3D´S 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