Question

A farmer is having skin rash which increases on sun exposure. There is also redness of tongue. Maize is his staple diet. Which of the following vitamin deficiency can cause this type of feature?

• A. Niacin deficiency
• B. Folic acid deficiency
• C. Vit C deficiency
• D. Vit K deficiency

Hint:

Think about the classic vitamin deficiency associated with a corn/maize-based diet and photosensitive skin rash.

Answer 1

The Correct Option is A

Step 1: Identify the clinical syndrome. The farmer has: (i) photosensitive skin rash, (ii) glossitis (redness of tongue), and (iii) a diet predominantly based on maize (corn). This triad -- dermatitis, diarrhea, and dementia -- is characteristic of Pellagra.

Step 2: Identify the causative deficiency. Pellagra is caused by deficiency of Niacin (Vitamin B3) or its precursor tryptophan. Corn (maize) is a poor source of both niacin and tryptophan, making populations dependent on maize vulnerable to pellagra.

Step 3: Explain the rash. The skin rash of pellagra occurs on sun-exposed areas (Casal's necklace on the neck, dorsum of hands and feet). It is a photosensitive dermatitis.

Step 4: Explain glossitis. Niacin deficiency leads to glossitis (red, beefy tongue), stomatitis, and GI symptoms including diarrhea.

Step 5: Eliminate distractors. Folic acid deficiency causes megaloblastic anemia. Vitamin C deficiency causes scurvy. Vitamin K deficiency causes bleeding disorders. None of these explain photosensitive dermatitis with glossitis in a maize-eating farmer.

Conclusion: The correct answer is Option A -- Niacin deficiency.