What were the symptoms of pellegra?

Pellagra is a disease caused by a deficiency of niacin (vitamin B3) or tryptophan. It has three classic characteristics commonly referred to as the "4 D's":

1. Dermatitis: The skin becomes red, scaly, and inflamed, especially on areas exposed to the sun, such as the face, neck, and hands. It may lead to itching and painful burning sensations.

2. Diarrhea: Digestive problems and chronic intestinal inflammation can cause severe diarrhea, which may result in nutrient malabsorption and dehydration.

3. Dementia: Pellagra can affect the nervous system, leading to confusion, memory loss, disorientation, depression, hallucinations, and dementia, if left untreated.

4. Death: If untreated, severe cases of pellagra can lead to weakness, fatigue, and eventual death.