Pellagra presenting with livedo reticularis: a case report

Background: Pellagra is a nutritional deficiency disorder caused by low intake of niacin or tryptophan. It commonly presents with a combination of dermatitis, diarrhea, and dementia. The dermatitis typically presents as symmetric, dark, scaly patches on sun-exposed skin, but other skin issues can also occur. This case is presented with livido reticularis, which is a rare presentation of pellagra. Case presentation: We present the case of a 31-year-old Ethiopian (black) woman with pellagra who developed livedo reticularis, a rare skin symptom. This case highlights the difficulty in telling pellagra apart from vasculitis and stresses the need to consider nutritional deficiencies in patients from high-risk groups. The patient responded very well to niacin supplements, with all symptoms gone in six weeks. Conclusion: Nutritional deficiencies should be considered when diagnosing atypical skin manifestations such as livedo reticularis, particularly in populations dependent on maize and sorghum.