A Case of Pellagra with the Low Serum Niacin Level Caused by Duodenal Ulcer

Abstract

A 44-year-old woman had repeated duodenal ulcer for 3 years since her rst visit. Investigations performed 3 months prior to presentation revealed pyloric stenosis secondary to scarring, which resulted in prolonged nausea and loss of appetite. She developed erythema on both ngers and did not show improvement despite treatment at a previous hospital. Subsequently, erythema and erosion extended to the dorsum and palms of both hands with the appearance of erythema and pustules between the eyebrows and both nose wings. Blood test results showed a low level of nicotinic acid, so we initiated nicotinamide therapy for suspected pellagra. Signicant improvement in the eruption following 2-week nicotinamide administration was observed. In the present case,intractable erythema was found in the stimulated area, even in the unexposed area. Herein, we report the mechanism of the appearance of eruption in the stimulated area in pellagra, including a review of the literature. Skin Research, 22 : 36-41, 2023