Right away, Goldberger saw a flaw in the fly - infection theory: Institutions with
pellagra cases consistently reported that staff members, presumably vulnerable to the same flies, weren't diagnosed with the disease.
Vitamin B3 deficiency lasting for few months [7] causes
pellagra (Italian pella agra = rough skin) with «four D» symptoms: dermatitis with burn - like blisters and later rough, scaly and painful, but
not itchy, lesions on the sun - exposed areas (face, extension side of the hands / arms and leg / feet), diarrhea, dementia and death (if
not treated)[1].