|Description:||This photograph depicts the lower legs of a patient displaying dermatologic symptoms due to a conditions associated with malnutrition known as pellagra and scurvy. Note the roughened skin, and its mottled pigmentation due to both a niacin (vitamin B3), and ascorbic acid (vitamin C) deficiency brought on by malnutrition.|
Pellagra is the deficiency of niacin and/or tryptophan, usually in combination with lack of other amino acids and micronutrients. Inadequate intake of either niacin or tryptophan is most common in areas where corn is the primary constituent of the diet. In addition, pellagra occurs in areas of South Asia where people eat millet with a high leucine content, which may contribute to pellagra. Secondary deficiency may occur due to diarrhea, cirrhosis, or alcoholism.
The clinical signs and symptoms of vitamin C deficiency, also known as scurvy, are manifest due to impaired collagen synthesis, and include ecchymoses, petechiae, bleeding gums, hyperkeratosis, and impaired wound healing. Other systemic symptoms include weakness, malaise, joint pain and swelling, edema, depression, and neuropathy.