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Visual Treats in Dermatology
2022
:2;
74
doi:
10.25259/CSDM_80_2022

Gauntlet-appearance in a chronic alcoholic

Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Corresponding author: Arunachalam Narayanan, Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. narayanan359@gmail.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Narayanan A, Ram Kumar KR. Gauntlet-appearance in a chronic alcoholic. CosmoDerma 2022;2:74.

A 45-year-old male patient presented with well-to-ill defined, scaly, dusky erythematous to hyperpigmented, photosensitive plaques with few erosions over the extensor aspect of the forearms, and dorsum of hands in a gauntlet-like distribution [Figure 1]. He did not have any lesion over his neck. The patient was a chronic alcoholic. Based on the characteristic history and clinical presentation, we made a clinical diagnosis of pellagra and treated him with niacinamide 300 mg/day with good improvement. Pellagra is characterized by symmetric photosensitive skin eruptions, gastrointestinal manifestations, neurologic, and psychiatric disturbances. It occurs due to niacin or Vitamin B3 deficiency. The classically described four Ds of pellagra are dermatitis, diarrhea, dementia, and death. A gauntlet is a glove worn with medieval armor which extends above the wrist. In pellagra, the lesions most commonly appear in this distribution. It occurs prevalently in chronic alcoholics as a result of a nutritionally poor diet and malabsorption. Pellagra responds well to oral nicotinic acid supplementation.[1]

Figure 1:: Well-to-ill defined, scaly, dusky erythematous to hyperpigmented, photosensitive plaques with few erosions over the extensor aspect of the forearms, and dorsum of hands in a gauntlet-like distribution.

Declaration of patient consent

Patient’s consent not required as patients identity is not disclosed or compromised.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

  1. , , , , , . Pathophysiology and clinical management of pellagra a review. Folia Med Cracov. 2021;61:125-37.
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