Abstract
Until the discovery of vitamin PP, pellagra was an endemic social scourge among maize-growing populations unaware of nixtamalization. However, other deficiency modalities now predominate (vegetarianism, alcoholism, poverty or enteropathies). The classical 4D associating dermatosis-diarrhea-dementia-death may remain incomplete. Disorders are dominated by crusty dermatitis of the sunburnt extremities. Neurological damage goes beyond neuropsychiatric disorders and various type of abnormal movement may be described (parkinsonism, cerebellar or myoclonus syndrome). Pellagra should be widely suspected and prevented particularly complications of thiamin-resistant ethylism.
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