four weeks Ago the woman would have signed without Hesitation, that she is completely healthy. Now, however, such a strong, painful rash covering the hands, it seems the lower legs and especially the feet of the 34-Year-old, that is impossible, nor put on shoes.

The skin is swollen, cracked and covered with a scab. Especially hard hit were the dorsum of the foot. There, where the skin in the vicinity of the toe curls at every step, by dragging deep Furrows in the scab. Several doctors could not help the 34-Year-olds. In the meantime, your complaints are so strong that she is looking for in the emergency Department of the Alfred Health Clinic in Melbourne advice.

it All began with a few dry Spots on the feet, the woman tells the Doctors. From there, the rash moved up the legs, eventually he showed up on the poor. In the meantime, all jobs are affected in the extremities, which are exposed to the sun. Otherwise, the patient will feel only a little tired to focus is difficult for you, write to the Doctors to Elisabeth Ng in the journal “BMJ Case Reports”. Fever or sweating, but they do not.

The view in the medical record paints the picture of a healthy young woman. No pre-existing medical conditions, no allergies. Alcohol, cigarettes, and other drugs were never an issue, the 34-Year-old lives aware of health, working in the alternative medicine industry. The Only thing that stands out to the Doctors: your weight is too low, at a size of 1.72, she weighs only 51 kilograms.

infection? Or Autoimmune Disease?

The paramedics, the woman in the clinic for infectious diseases. Your skin doctors had typed in the past few weeks, several times a infection and prescribed antibiotics, once they received the drugs, even intravenously, without success. Nevertheless, the Doctors in the clinic first, on antibiotics, they push the wife a cannula in the Arm for Flucloxacillin in your body drops, a Penicillin-type.

An enigmatic patient

the skin of the patient is torn At the time of their arrival in the hospital.

the hands plating a reddish-brown rash.

at the same time you try to go to the cause of the rash. The doctors suspect that your patient has either a pathogen captured by or under an autoimmune disease, i.e. a disease in which the immune system is directed against the own body.

The clarification of the question of hope to the doctors in the laboratory. You take the woman’s blood, ask for a urine sample, scraping skin something in a container. A fungus maybe, HIV, Syphilis, Hepatitis A, B or C? None of the Tests results in eye-catching. Also, according to anti-bodies, the Doctors can look in vain, moreover, they x-ray the chest of the patient. The woman seems to be missing nothing.

it was Only when the Doctors to their patient to their diet, respondents guessed that the real Problem is the woman is quite another. The immune system of the 34-Year-olds not working properly, it is also an infection she has. Instead, the wife has added to their complaints themselves – without knowing anything about it.

Twelve Times deficient

The 34-Year-old for a long time now on a strict diet that keeps you healthy. She eats almost vegan, makes only rare exceptions for some fish or dairy products. Meat and alternative products to avoid them completely, whole-grain products you eat hardly any – in the mistaken belief that to do something Good for your body. But the fact is, she has restricted her diet so much that she suffers from symptoms of different deficiency.

the food of the woman covers only 21 percent of its energy needs. It also falls short of twelve important nutrients to the needs of your body – including substances such as proteins, B-vitamins and iron. The Deficiency explains your fatigue, concentration difficulties, and rash. What is on your skin is visible, the lack of Vitamin B3. He has caused a disease called Pellagra.

nutritional intake of the patient

nutrient covered need Protein 36%, Vitamin B3 69% folic acid 44 per cent of Vitamin B1, 33 percent of Vitamin B2, 63 percent of Vitamin A, 61 percent of calcium occurs in 28 per cent of Magnesium, 17 percent of phosphorus, 36 percent iron, 29 percent zinc, 43 percent Iodine 9 percent

Today, Pellagra is almost exclusively in developing countries, when people primarily need to feed from Maize or millet. Both cereals contain Vitamin B3, but in a Form which can be absorbed by the body. The reddish-brown, light-dependent rash is typical of Pellagra, often it also leads to diarrhea, and neurological deficits such as confusion and dementia. The lack of stops, it is life-threatening.

dietary advice, tablets, and six weeks ‘ time

In the West meets the Suffering people especially the addiction due to a lean or alcohol dependence and extreme malnutrition. “More frequent reports in the media and professional journals suggest that lack of disease are on the rise again,” write the Doctors. Reason people have got into the habit of as a patient for the extreme patterns of behavior, in addition to eating disorders, probably – and to think, to live with healthy.

The physicians to prescribe their patient a nutritional counseling and dietary supplements. From now on, you have to swallow daily Vitamin B3, a multi-vitamin tablet, a pill with iron sulfate, and a Vitamin B complex. In addition, the Doctors inject a Form of Vitamin B-12, which can be stored in the body.

hands and feet of the patient after six weeks of Diet and tablets

With the statement that the tablets over the next six weeks to continue and to adhere to the new nutritional recommendations, send the Doctors to their patient’s home. The to therapy. When it comes to six weeks a follow-up examination in the clinic, recovering your skin almost completely. “Nutrient deficiencies are easy to treat,” write the doctors. “The challenge for us is to identify you.”