Pigment International

CASE REPORT
Year
: 2019  |  Volume : 6  |  Issue : 1  |  Page : 37--42

Mucocutaneous hyperpigmentation as presentation of vitamin B12 deficiency: A case report and brief review


Prachi V Agrawal, Yugal K Sharma, Kirti S Deo, Rahul H Ranpariya, Pallavi Singh 
 Department of Dermatology, Venereology and Leprosy, D.Y. Patil Vidyapeeth Society, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India

Correspondence Address:
Dr. Kirti S Deo
Associate Professor, G-11, Gokhale Vrindavan, Near Chapekar Chowk, Chinchwad, Pune 411033
India

Vitamin B12 deficiency presents usually with hematologic, gastrointestinal, neurologic, and less commonly, psychiatric, cardiovascular, and dermatological manifestations. A 20-year-old female presented with palmoplantar hyperpigmentation, accentuated over creases and knuckles. She also had intertriginous, perioral/intraoral hyperpigmentation, and gray, thin, lustreless hair. She consumed nonvegetarian diet occasionally. Histopathology revealed increased pigmentation of stratum malpighii. Hemoglobin, vitamin B12, and folate levels were reduced; RBC indices, deranged and parietal cell antibodies, weakly reactive. Pernicious anemia was diagnosed; the patient responded to intramuscular cobalamin injections. Review of Indian and global cases/case series of this deficiency with mucocutaneous presentation iterates knuckle hyperpigmentation to be its prime clinical marker. However, the nonvegetarians comprising a majority of participants in case series from India of vitamin B12 deficiency presenting with hyperpigmentation is confounding and necessitates reassessment with larger future studies. Moreover, increased awareness of the mucocutaneous signs—often nonspecific, subtle, or asymptomatic—of this widely pervasive deficiency among Indians may facilitate prompt management and rectify underreporting.


How to cite this article:
Agrawal PV, Sharma YK, Deo KS, Ranpariya RH, Singh P. Mucocutaneous hyperpigmentation as presentation of vitamin B12 deficiency: A case report and brief review.Pigment Int 2019;6:37-42


How to cite this URL:
Agrawal PV, Sharma YK, Deo KS, Ranpariya RH, Singh P. Mucocutaneous hyperpigmentation as presentation of vitamin B12 deficiency: A case report and brief review. Pigment Int [serial online] 2019 [cited 2022 Aug 15 ];6:37-42
Available from: https://www.pigmentinternational.com/article.asp?issn=2349-5847;year=2019;volume=6;issue=1;spage=37;epage=42;aulast=Agrawal;type=0