Carbamazepine-induced pellagra: Dermoscopic findings and response to oral nicotinamide

Abstract

ABSTRACT Pellagra is a nutritional disorder characterized clinically by the four Ds: dermatitis, diarrhea, dementia, and severe systemic photosensitivity manifesting as death. The disorder results from a deficiency of niacin or its precursor tryptophan and is mainly associated with compromised dietary intake of niacin and tryptophan or excessive intake of leucine (a natural antagonist). Other causes include chronic alcohol intake, malabsorption, metabolic disorders, and the administration of certain medications. Herein, we report the clinical and dermoscopic findings in a twenty-year-old male with seizure disorder presenting with carbamazepine-induced pellagrous dermatitis that resolved after the administration of niacin. Key words: Pellagra; Photosensitivity; Carbamazepine; Dermoscopy; Niacin