Indan Journal of Medical Research Indan Journal of Medical Research Indan Journal of Medical Research
  Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login  
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 911       

   Table of Contents      
CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 227-228

Reversible hyperpigmentation of vitamin B12 deficiency


1 Department of Dermatology, Venereology & Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Puducherry 605 107, India
2 Department of Dermatology, All India Institute of Medical Sciences, Mangalagiri 522 503, Andhra Pradesh, India

Date of Submission20-Nov-2019
Date of Web Publication25-May-2021

Correspondence Address:
Hima Gopinath
Department of Dermatology, All India Institute of Medical Sciences, Mangalagiri 522 503, Andhra Pradesh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_2382_19

Rights and Permissions

How to cite this article:
Vijayakumar K, Gopinath H. Reversible hyperpigmentation of vitamin B12 deficiency. Indian J Med Res 2020;152, Suppl S1:227-8

How to cite this URL:
Vijayakumar K, Gopinath H. Reversible hyperpigmentation of vitamin B12 deficiency. Indian J Med Res [serial online] 2020 [cited 2021 Jul 31];152, Suppl S1:227-8. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/227/316844

Patient's consent obtained to publish clinical information and images.


A woman in her eighties was referred to the department of Dermatology of Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India, in April 2019, for the evaluation of hyperpigmentation. She had bilateral pallor and blotchy greyish-black hyperpigmentation over palms and soles [Figure 1], [Figure 4]A, proximal and lateral nail folds, dorsal aspect of the distal phalanx and the proximal interphalangeal joints. There was diffuse brownish discolouration of the nail and longitudinal melanonychia of the left middle finger nail [Figure 2]A. She was an ovo-lacto vegetarian. Investigations revealed pancytopenia (haemoglobin - 6.2 g%, WBCs - 1400/mm3 and platelets - 34,000/mm3) and a mean corpuscular volume of 104 fl (normal range 83-101 fl). A peripheral smear revealed dimorphic anaemia, leucopoenia and thrombocytopenia with a few giant forms. The serum vitamin B12 level was less than 83 pg/ml (normal range 187-883 pg/ml). She received intravenous methylcobalamin (1000 mg daily) for ten days. On the ninth day, there was rapid improvement in the haematological parameters (haemoglobin - 10.2 g%, WBCs - 6100/mm3, platelets - 245,000/mm3) and a mild reduction in hyperpigmentation. She was followed up with weekly intramuscular vitamin B12 injections, with iron and oral multivitamin supplements. There was a significant improvement in the cutaneous pigmentation [Figure 3] and [Figure 4]B at five weeks and reversal of the longitudinal melanonychia at 12 wk [Figure 2]B.
Figure 1: Blotchy greyish-black pigmentation over palms.

Click here to view
Figure 2: (A) Diffuse hyperpigmentation and longitudinal melanonychia. (B) Reduction in hyperpigmentation and reversal of longitudinal melanocychia at 12 weeks.

Click here to view
Figure 3: Reduction in pigmentation after five weeks.

Click here to view
Figure 4: (A) Blotchy greyish-black hyperpigmentation over soles. (B) Reduction in hyperpigmentation after five weeks.

Click here to view


Conflicts of Interest: None.




    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Article Figures

 Article Access Statistics
    Viewed202    
    Printed0    
    Emailed0    
    PDF Downloaded25    
    Comments [Add]    

Recommend this journal