Pellagra is a disease associated with Organic Brain Syndroms, caused by dietary insufficiency of nicotinic acid and it’s precursor, tryptophan, which are vital to the function of cellular dehydrogenases in tissue respiration. Classical literature survey shows that the disease was most commonly caused by nutritional deficiency in famish areas. However, recent survey reveals that Pellagra occurs more commonly in a person as a form of secondary diseases followed by insufficient dietary condition due to, for example, chronic excessive alcohol drinking. The case is a 37 year old widower who was brought in to our psychiatric out patient clinic with complaints of confusion, excitement as well as persecutory delusion such as “being poisoned”. Patient is said to have been drinking excessively ever since he was in late teens, while taking little amount of foods. Physical examination on admission revealed that patient showed photosenstive erythematous skin lesions on hand, face, particulary around the mose as well as marked dehydration in general physical condition. Subsequent atrophy of mucous membranes of the above mentioned area as well as stomatitis along with painful red tongue were also noted. These physical signs as well as mental confusion were rapidly responded within one week with application of nicotinic acid, along with high calory diets. Delusional state was also gradually cleared with chlorpromazine and chlordiazepoxide. The patient was discharged with fairly well condition after 39 days of hospitalization
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