Vitamin B3 Deficiency When Oral Nicotinamide Supplementation Has Not Achieved Clinical Improvement

The previous treatment line involved oral nicotinamide (niacinamide) supplementation together with other group B vitamins and photoprotection measures. Escalation to this protocol is indicated when the anticipated early clinical improvement — in particular, subsidence of skin lesions — was not achieved within the expected response window.

The next-step protocol involves an alternative vitamin B3 compound used under specific circumstances. The complete regimen — including selection criteria, accompanying measures, and clinical guidance — is set out in the full structured protocol.