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BRIEF COMMUNICATION
Year : 2013  |  Volume : 17  |  Issue : 7  |  Page : 254-256

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


Department of Endocrinology, Sriram Chandra Bhanj Medical College and Hospital, Cuttack, Odisha, India

Correspondence Address:
Ritesh Kumar Agrawala
Department of Endocrinology, Sriram Chandra Bhanj Medical College and Hospital, Cuttack - 753 001, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.119591

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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.


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