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Cutaneous hyperpigmentation in woman with vitamin B12 deficiency and pernicious anemia

A 52-year-old Indian woman with megaloblastic anemia and peculiar cutaneous hyperpigmentation (prior to therapy). Photo shows diffuse, brownish-black discoloration of the palms (A1) and knuckle pad hyperpigmentation in the dorsum of hands (A2). Gastric atrophy was established on endoscopic biopsy. Laboratory studies showed pancytopenia, macrocytosis (MCV 116fL), and severe vitamin B12 deficiency (55 pg/ml). (Source: Padhi S, Sarangi R, Ramdas A, et al. Cutaneous hyperpigmentation in megaloblastic anemia: a five year retrospective review. Mediterr J Hematol Infect Dis 2016;8[1]:e2016021. Creative Commons Attribution 2.0 License.)

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  • Cerebral vascular disease
  • Dementia
  • Depression
  • Developmental delay
  • Folate deficiency
  • Gastric resection
  • Glossitis
  • Imerslund-Grasbeck syndrome
  • Malabsorption
  • Megaloblastic anemia
  • Myelopathy
  • Optic neuropathy
  • Pernicious anemia
  • Polyneuropathy
  • Regional enteritis
  • Subacute combined degeneration of the spinal cord