Question
A 36 year old man presents with decreased appetite, mouth soreness, diarrhoea and irritability. On examination he has a bright red tongue with a pigmented scaly rash around the neck. Which one of the following food items in his diet has a bearing on his disease?
| A. |
Rice |
| B. |
Wheat |
| C. |
Corn |
| D. |
Fish |
|
Correct Answer � C Explanation |
 |
Classic Triad of Pellagra:
– Dermatitis: Pigmented, scaly rash on sun-exposed areas, e.g., neck (“Casal necklace”).
– Diarrhea
– Dementia/Neuropsychiatric Symptoms: Irritability, confusion.
Etiology:
– Caused by niacin (vitamin B3) or tryptophan deficiency.
– Corn diets → low bioavailable niacin & tryptophan. Processing (e.g., nixtamalization) ↑ availability; unprocessed diets ↑ pellagra risk.
Incorrect Options:
– A. Rice: Low in niacin but needs extreme diet restrictions to cause deficiency.
– B. Wheat: Provides enough niacin; not linked to pellagra.
– D. Fish: Rich in tryptophan & niacin; deficiency unlikely.