Niacin (VitaminB3) deficiency results in pellagra with deficiency manifestation that mainly involves skin, Gastrointestinal tract and Central Nervous system and thus includes dermatitis, diarrhoea, dementia and if not treated results in death.

Dermatitis mainly focuses on sun exposed part of skin involving area around the neck (Casal’s necklace), hand and feet (glove like appearance).

Since Niacin strictly speaking is not a Vitamin, pellagra like symptoms could also be seen due to Pyridoxal phosphate, Tryptophan, Riboflavin and Iron deficiency since these are required for the formation of Niacin from Tryptophan (an amino acid).

Thus pellagra like symptoms is seen in Hartnup’s disease where defective absorption of tryptophan from intestine takes place and Carcinoid syndrome where Tryptophan is diverted for the formation of serotonin.

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