Britannica
Sources used in this answer
What are the major symptoms of pellagra?
Created from Britannica articles
using AI.
AI can make mistakes, so verify using Britannica articles.
nutritional disease
Children with rickets. The disease, which most commonly strikes children, causes bone deformities such as bowlegs. Rickets is caused by a lack of vitamin D or calcium.
Pellagra is a nutritional disorder caused by a deficiency of niacin or the amino acid tryptophan. It is classically identified by the "four Ds": dermatitis, diarrhea, dementia, and death.12
Major symptoms include:
- Skin lesions: Often appearing symmetrically on surfaces exposed to sunlight, these lesions may resemble a severe sunburn before becoming reddish-brown, rough, and scaly.1
- Gastrointestinal disturbances: These typically include diarrhea, inflammation of the mouth and tongue, and fissuring or scaling of the lips and mouth corners.1
- Neurological signs: As the condition progresses, patients may experience mental aberrations such as confusion, depression, apathy, nervousness, and delirium.1
If left untreated, the disease can lead to multiple organ failure and death. While historically common, it is now primarily seen in populations subsisting on diets lacking sufficient protein or niacin, such as those relying heavily on corn that has not been processed to release bound niacin.12