Pellagra: An old enemy of timeless importance

Background: In the United States, pellagra is infrequently reported. Yet this disorder does occur among malnourished persons. Objective: The author seeks to clarify diagnosis and treatment. Method: The author describes various presentations and effects of this disorder. Results: Knowledge of classic and atypical presentations can assist in making the diagnosis. The author presents two cases of pellagra that exemplify the classic and atypical presentations. Conclusion: The typically robust response of the disorder to physiologic doses of niacin can assist in confirming the diagnosis.