Pellagra

Pellagra is a disease caused by a lack of niacin (vitamin B3). Niacin is found in most foods. A person can die from pellagra if it is not treated. The main results of pellagra can be remembered as "the three D's": diarrhea, dermatitis, dementia, and sometimes a fourth D, which is death.

Some symptoms of pellagra according to a few sources^{[verification needed]} are:

• abdominal cramping
• depression
• diarrhea
• headache
• loss of appetite
• mucus membrane inflammation
• dilated cardiomyopathy

It may also cause a copper-colored 'necklace', or 'gauntlet' called the cascals necklace and gauntlet of pellagra to show^{[verification needed]}.

It is also caused due to cellular deficiency of a vitamin called niacin or sometimes nicotinic acid. Other causes are chronic alcoholism and gastro-intestinal malabsorption. It can be prevented by adequate intake of niacin or foods rich in vitamin B3 and dietary advice to vulnerable groups.

It is endemic in China and Africa^{[verification needed]}.