The initial symptom of pellagra is the appearance of reddish and symmetrical areas on the skin. These are photosensitive spots, similar to sunburns that worsen with exposure to the sun.
These changes in the skin do not disappear and may darken, brownish, and usually flake.
In general, skin-related symptoms are accompanied by disorders that affect the entire gastrointestinal tract. It is common for the patient with pellagra to present nausea, lack of appetite and fetid diarrhea, which can sometimes be bloody. The stomach may not produce enough of the acid and the tongue and mouth inflame, giving a bright red color.
Pellagra can also cause mental changes such as fatigue, insomnia and apathy. Usually, these symptoms precede a brain dysfunction, with symptoms such as mental confusion, disorientation, hallucinations, amnesia and even manic-depressive psychosis.