{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:40:01Z","timestamp":1756366801612,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,5,25]]},"abstract":"<jats:p>A 27-year-old woman presented with persistent dryness of the mouth and eyes. She presented with permanent photodistributed rash involving the face and distal extremities. Laboratory tests showed positive Sj\u00f6gren's syndrome (SS)-A and SS-B antibodies. Histological examination of minor salivary gland biopsy revealed inflammatory infiltration grade 4 according to Chisholm's classification. Skin biopsy showed acanthosis, hyperkeratosis in the epidermis and little inflammatory infiltrate in the dermis. There was an infiltration of CD4 T lymphocytes in the dermis. Based on the characteristics of the dermatitis and on a rapid response to niacin replacement, the diagnosis of pellagra was carried out. A complete resolution of the dermatological signs was obtained within 2\u2005months. To the best of our knowledge, the association between primary SS and pellagra has never been reported. We emphasise the possible mechanisms of this association.<\/jats:p>","DOI":"10.1136\/bcr-2014-204339","type":"journal-article","created":{"date-parts":[[2014,6,18]],"date-time":"2014-06-18T09:48:00Z","timestamp":1403084880000},"page":"bcr2014204339","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Pellagra in a patient with primary Sj\u00f6gren\u2019s syndrome"],"prefix":"10.1136","volume":"2014","author":[{"given":"Imed","family":"Ben Ghorbel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noureddine","family":"Litaiem","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ines","family":"Chelly","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Habib","family":"Houman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,6,18]]},"reference":[{"key":"2025082800035844000_2014.jun18_1.bcr2014204339.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ad.2011.05.001"},{"key":"2025082800035844000_2014.jun18_1.bcr2014204339.2","doi-asserted-by":"publisher","DOI":"10.1177\/0884533612464783"},{"key":"2025082800035844000_2014.jun18_1.bcr2014204339.3","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-4362.2002.01551.x"},{"key":"2025082800035844000_2014.jun18_1.bcr2014204339.4","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.6.554"},{"key":"2025082800035844000_2014.jun18_1.bcr2014204339.5","unstructured":"Weedon D . 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