A Young Man with Generalized Pigmentation
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.
KeywordsVitamin B12 Diffuse hyperpigmentation Glossitis Megaloblastic anemia Peripheral neuropathy Subacute combined degeneration of the spinal cord
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