Dyssebacia:An Early Cutaneous Marker of Niacin Deficiency

"Dyssebacia" is the name coined to describe numerous plugs of inspissated sebum projecting from dilated orifices of sebaceous glands. This is a case series report of 12 patients who presented to our department with complaints of asymptomatic skin lesions which started first in lower part of nose followed by involvement of entire nose, cheeks and forehead .On examination there were multiple yellow plugs of sebum projecting out from follicular orifices resembling those of shark skin. Dermoscopic examination and Urinary levels of Niacinamide levels in urine were estimated in few cases. Based on history, clinical examination and laboratory, Diagnosis of dyssebacia was made and patients were started on niacinamide following which there was improvement in lesions in 8 of the 12 patients within two to four weeks. Diagnosis of pellagra is based on clinical criteria. Dyssebacia can be the early cutaneous marker of niacin deficiency. Thus in this context detection of dyssebecia acts as a primeval marker in diagnosis of pellagra, which still exists in epidemic proportions in many countries.