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Case Reports
. 2013 Oct;17(Suppl 1):S254-6.
doi: 10.4103/2230-8210.119591.

Pigmentation in vitamin B12 deficiency masquerading Addison's pigmentation: A rare presentation

Affiliations
Case Reports

Pigmentation in vitamin B12 deficiency masquerading Addison's pigmentation: A rare presentation

Ritesh Kumar Agrawala et al. Indian J Endocrinol Metab. 2013 Oct.

Abstract

A 35-year-female presented with generalized weakness, weight loss, and progressive pigmentation was worked up for suspicion of Addisons disease. On examination hyper pigmentation was noted on both palmar and dorsal aspect of hands involving knuckles, creases, feet, tongue, oral mucosa and gluteal region. There was no evidence of hypocortisolemia as initially suspected, and literature search revealed a possibility of vitamin B12 deficiency. She had megaloblastic anemia with a low serum vitamin B12, mostly due to poor dietary intake. Her hyper pigmentation resolved with vitamin B12 supplementation. Skin biopsy showed increased pigmentation at stratum spinosum and basal-layer. The mechanism of hyper pigmentation in vitamin B12 deficiency was due to an increase in melanin synthesis.

Keywords: Addisons disease; B12 deficiency; hyper pigmentation; vitamin B12 deficiency.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Hyperpigmentation before treatment
Figure 2
Figure 2
Skin Biopsy (Increased pigmentation in stratum spinosum and basal layer)
Figure 3
Figure 3
Post treatment reversal of hyper pigmentation after 12 weeks of vitamin B12 supplementation

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