Images in the Medical Sciences| Volume 346, ISSUE 5, P421, November 2013

The Peeling Dermatitis With a Peculiar Demarcation

      A 28-year-old Malawian man presented with a 6-month history of dermatitis associated with chronic diarrhea and personality change. He was taking isoniazid to treat tuberculosis. His skin was inflamed, particularly in sun-exposed sites, with dryness, hyperpigmentation and desquamation. The eruption around his neck formed a well-circumscribed band (Figure 1A). A diagnosis of pellagra was assumed. A high-protein diet along with nicotinamide and vitamin B therapy was initiated, and his symptoms markedly improved.
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