History:

A middle-aged woman, a known case of Coeliac disease presented with well-circumscribed, bilateral symmetrical, psoriasiform to phototoxic dermatitis-like rash involved both lower limbs of three months duration. At these three months the patient suffered anorexia, weight loss and diarrhea in addition to the skin rash. The rash improved greatly on multi-vitamin supplements. She was referred to a gastroenterologist to exclude complicating small intestinal lymphoma.