Rare Presentation of a Very Common Deficiency (Vitamin B12 Deficiency)

Dr. Bhakti Godbole, Dr. Siddhant Kamble, Dr. Sanjay Agrawal, Dr. Supriya Patil, Dr. Bhakti Godbole

Abstract: Vitamin B12 deficiency has multisystem involvement with hematologic, neurologic, psychiatric, gastrointestinal, dermatologic, and cardiovascular manifestations. Skin hyperpigmentation, vitiligo, angular stomatitis, and hair changes are dermatological manifestations. Mucocutaneous manifestations as the only and primary symptom of vitamin B12 deficiency can be often overlooked as these signs are not specific to B12 deficiency and very few cases are reported in literature. Here, we present such a case where hyperpigmentation was the primary and solo symptom of vitamin B12 deficiency. This case underlines the need to rule out vitamin B12 deficiency when clinicians encounter hyperpigmentation as a solo presentation and also emphasizes the significance of early treatment in preventing the irreversible neurological manifestations of vitamin B12 deficiency which can be a late manifestation.

Keywords: Vitamin B12 deficiency, skin hyperpigmentation, primary symptom