Pellagra is a nutritional disorder characterized by the well-known group of symptoms called "Pellagra's four D": dermatitis, diarrhea, dementia and, when untreated, death. The main cause of pellagra is niacin and tryptophan deficiency. Niacin is a vitamin taken directly from the diet or synthetized from dietary tryptophan in the presence of vitamins B2 and B6. Accordingly, a deficiency of one of these two vitamins may cause pellagra. Nicotinamide or vitamin PP (Pellagra Preventive factor) is a natural derivative of niacin.
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