Pellagra (commonly known as Mal de la Rosa, Mal Rosso, Alpine Scurvy, Asturian Rose, or Psilosis Pigmentosa) is a non-contagious disease caused by a deficiency of vitamin B3 (nicotinic acid or niacin) in the diet, common among people where maize is the staple food, but also among poor peoples in Europe, Africa, Asia and North America. Pellagra is generally endemic and slowly evolves. It is characterised by burning or itching often followed by scaling of the skin, inflammation of the tongue and mouth, diarrhoea, and manic depression. In particular, patients exhibit a rash around the neck which resembles a rosary, from whence pellagra obtains its popular names. The symptoms usually reoccur each year in the same season, usually during the spring but sometimes autumn. The first authentic case of pellagra in Great Britain was reported in 1866, a second in 1906 and a third in 1909. In 1914 the first case in Canada was reported, and in 1920 an outbreak was reported in Nanking, China. During the Great War many Turkish troops and Armenian refugees developed the disease. Research Pellagra
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