Pruritic Rash and Diarrhea in a Man with Chronic Alcohol Use Disorder

This report describes a 62-year-old male with long-term heavy alcohol consumption, who presented with pruritic, hyperpigmented scaly plaques on sun-exposed skin and recent non-bloody diarrhea. Skin histopathology showed psoriasiform hyperplasia and superficial perivascular lymphocytic infiltration, supporting the diagnosis of pellagra. The patient responded well to oral nicotinamide supplementation, with gradual and complete resolution of skin lesions within three months. This case emphasizes that alcoholic pellagra should be considered in patients with chronic alcoholism and typical photosensitive dermatitis.