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Pellagra is caused by deficiency of niacin or its amino acid precursor tryptophan. Clinical features are characterized by dermatitis, dementia and diarrhea. Dermatitis is observed only in 33% of patients. We report a 110-year-old woman, with history of diarrhea and dementia, who presented a bilateral and symmetrical dermatosis, characterized by welldemarcated violaceous plaques due to sun exposition. Dermatological symptoms had directed investigations. Pellagra was diagnosed and treatment withdoi:10.7241/ourd.2020e.89 fatcat:rtvuuhz73fhkbptzaq3d2lekba