- Kate O’Dwyer, specialty trainee year 2 general practice,
- Kun Sen Chen, specialty trainee year 3 dermatology,
- Periasamy Balasubramaniam, consultant dermatologist
- kunsen{at}hotmail.com
A 60 year old woman presented with a six month history of a non-itchy rash. She had been having endoscopic dilatation of an inoperable upper oesophageal carcinoma every six weeks to help with her swallowing. She was not taking any drugs. On examination, she had well defined brownish patches on the parts of her body exposed to sun. Pellagra (niacin deficiency) was suspected and the patient was treated with oral B complex preparations. The rash cleared within a week. Although vitamin deficiencies are rare in developed countries they should be suspected in patients with comorbidities that predispose to poor dietary intake.⇑
Notes
Cite this as: BMJ 2012;344:d8206
Footnotes
Patient consent obtained.
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