Abstract
A 30 years old, strictly vegetarian male presented with generalized weakness, weight loss, and gradually progressing cutaneous hyperpigmentation. On examination, pigmentation was more pronounced on sunexposed areas, flexural folds, and palmar creases along with mucosal involvement in the form of glossitis and pallor. Laboratory investigations revealed megaloblastic anaemia and low vitamin B12 level, thereby confirming the diagnosis of vitamin B12 deficiency. The treatment consisted of vitamin B12 supplementation. Vitamin B12 deficiency may occur due to malabsorption (due to pernicious anemia or gastric resection) and rarely, due to inadequate intake (almost exclusively in strict vegetarians). Cutaneous manifestations due to vitamin B12 deficiency manifest early and have diagnostic importance, thus allowing timely diagnosis and prevention of late neurological and other systemic complications.
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References
Hoffbrand AV. Megaloblastic anemias. In: Fauci AS, Braunwald E, Kasper DL, et al., editors. Harrison’s principles of internal medicine. 17th ed. New York: McGraw-Hill; 2008. p. 643–51.
Bernard M, Babior H, Franklin B. Megaloblastic anemias. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s principles of internal medicine. 16th ed. New York: McGraw-Hill; 2005. p. 601–7.
Agrawala RK, Sahoo SK, Choudhury AK, Mohanty BK, Baliarsinha AK. Pigmentation in vitamin B12 deficiency masquerading Addison’s pigmentation: a rare presentation. Indian J Endocrinol Metab. 2013;17(Suppl 1):S254–6.
Oh R, Brown DL. Vitamin B12 deficiency. Am Fam Physician. 2003;67(5):979–86.
Jithendriya M, Kumaran S, IB P. Addisonian pigmentation and vitamin B12 deficiency: a case series and review of the literature. Cutis. 2013;92:94–9.
Arora AK, Saini SS, De D, Handa S. Reticulate pigmentation associated with vitamin B12 deficiency. Indian Dermatol Online J. 2016;7(3):215–7.
Wadia RS, Bandishti S, Kharche M. B12 and folate deficiency: incidence and clinical features. Neurol India. 2000;48:302.
Pruthi RK, Tefferi A. Pernicious anemia revisited. Mayo Clin Proc. 1994;69:144–50.
Kannan R, Ng MJ. Cutaneous lesions and vitamin B12 deficiency: an often-forgotten link. Can Fam Physician. 2008;54(4):529–32.
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Sachdev, D., Kumar, P., Debbarman, P. (2020). A Young Man with Generalized Pigmentation. In: Kothiwala, S., Kumar Tiwary, A., Kumar, P. (eds) Clinical Cases in Disorders of Melanocytes. Clinical Cases in Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-030-22757-9_13
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