Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
Acknowledgements
Authors’ reply
Book Review
Book Reviews
Classics In Indian Medicine
Clinical Case Report
Clinical Case Reports
Clinical Research Methods
Clinico-pathological Conference
Clinicopathological Conference
Conferences
Correspondence
Corrigendum
Editorial
Eminent Indians in Medicine
Errata
Erratum
Everyday Practice
Film Review
History of Medicine
HOW TO DO IT
Images In Medicine
Indian Medical Institutions
Letter from Bristol
Letter from Chennai
Letter From Ganiyari
Letter from Glasgow
Letter from London
Letter from Mangalore
Letter From Mumbai
Letter From Nepal
Masala
Medical Education
Medical Ethics
Medicine and Society
News From Here And There
Notice of Retraction
Notices
Obituaries
Obituary
Original Article
Original Articles
Review Article
Selected Summaries
Selected Summary
Short Report
Short Reports
Speaking for Myself
Speaking for Ourselve
Speaking for Ourselves
Students@nmji
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
Acknowledgements
Authors’ reply
Book Review
Book Reviews
Classics In Indian Medicine
Clinical Case Report
Clinical Case Reports
Clinical Research Methods
Clinico-pathological Conference
Clinicopathological Conference
Conferences
Correspondence
Corrigendum
Editorial
Eminent Indians in Medicine
Errata
Erratum
Everyday Practice
Film Review
History of Medicine
HOW TO DO IT
Images In Medicine
Indian Medical Institutions
Letter from Bristol
Letter from Chennai
Letter From Ganiyari
Letter from Glasgow
Letter from London
Letter from Mangalore
Letter From Mumbai
Letter From Nepal
Masala
Medical Education
Medical Ethics
Medicine and Society
News From Here And There
Notice of Retraction
Notices
Obituaries
Obituary
Original Article
Original Articles
Review Article
Selected Summaries
Selected Summary
Short Report
Short Reports
Speaking for Myself
Speaking for Ourselve
Speaking for Ourselves
Students@nmji
View/Download PDF

Translate this page into:

Images In Medicine
2019:32:6;378-378
doi: 10.4103/0970-258X.303626
PMID: 33380641

Casal's necklace

Sweta Subhadarshani1 , Pooja Sharma2 , Neena Khanna1
1 Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
2 Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

Corresponding Author:
Sweta Subhadarshani
Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi
India
shweta.aiims07@gmail.com
Published: 15-Dec-2020
How to cite this article:
Subhadarshani S, Sharma P, Khanna N. Casal's necklace. Natl Med J India 2019;32:378
Copyright: (C)2019 The National Medical Journal of India

An 18-year-old male presented with a 2-week history of hyperpigmented scaly plaque associated with mild burning and itching. There was characteristic involvement of the front and nape of the neck and lower half of the face in a sharply demarcated symmetrical manner [Figure 1]. In addition, the lesion extended to the anterior aspect of the chest resembling a ‘cravat’. He had associated photosensitivity but no history of diarrhoea or neurological symptoms. There was no history of antecedent drug use, alcohol abuse or topical application. The patient used to stay alone and had poor dietary habits. A skin biopsy showed irregular acanthosis, lymphocytic exocytosis and spongiosis along with focal basal cell vacuolar degeneration [Figure 2]. A diagnosis of pellagra was made, and he was started on oral nicotinamide 500 mg daily with which he started responding within 3 days and lesions cleared completely within a week [Figure 1].

Figure 1: (a) Sharply demarcated plaque on the neck; (b) clinical response after treatment with nicotinamide 500 mg daily for 1 week
Figure 2: Histopathology (H and E, ×10) showing irregular acanthosis, lymphocytic exocytosis and spongiosis along with focal basal cell vacuolar degeneration

Conflicts of interest. None declared


Fulltext Views
5,730

PDF downloads
1,575
Show Sections