An affection of the skin characterized by redness especially in exposed areas scaling and shedding of the skin and accompanied with severe gastrointestinal disturbance and nervous symptoms It is due to a deficiency of niacin vitamin B3 nicotinic acid and protein in the diet and may be caused by malnutrition or in some cases by a heavy dependence on maize for food It was at one time ca 1890 endemic in Northern Italy and was called Alpine scurvy It may also be caused by alcoholism or diease causing an impairment of nutrition It is also called St Ignatiuss itch maidism mal de la rosa mal rosso and psychoneurosis maidica A variety of pellagra seen in children is called infantile pellagra or kwashiorkor
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