Pellagra was first identified among Spanish peasants by Don Gaspar Casal in 1735. A loathsome skin disease, it was called 'mal de la rosa' and often mistaken for leprosy. Pellagra has sometimes been called the disease of the four Ds – dermatitis, diarrhoea, dementia and death.

How did the pellagra start?

Primary pellagra is due to a diet that does not contain enough niacin and tryptophan. Secondary pellagra is due to a poor ability to use the niacin within the diet. This can occur as a result of alcoholism, long-term diarrhea, carcinoid syndrome, Hartnup disease, and a number of medications such as isoniazid.

Who studied pellagra in 1914?

In 1914, the U.S. Public Health Service's Dr. Joseph Goldberger (1874-1929) was already known for his success in fighting U.S. epidemics when he was asked to investigate pellagra.