Pellagra presenting as Casal’s necklace dermatitis and upper limbs dermatitis in a person with chronic alcohol dependence: A rare case report

Chronic alcohol dependence can lead to a deficiency of Vitamin B3 (niacin). Niacin deficiency secondary to chronic alcoholism can present with a triad of three Ds in the form of dermatitis, diarrhea, and dementia. If not recognized early and treated promptly, it can lead to the fourth D, known as death. In the present case report, we have highlighted a clinical picture of a 34-year-old male who had chronic alcohol dependence who presented with Casal’s necklace dermatitis and both upper limb dermatitis characteristic of pellagra. Early diagnosis and proper intervention led to his complete recovery.