Vitamin B12 deficiency causing neurological syndrome with rare skin manifestation

摘要

Vitamin B12 is an essential vitamin for metabolism of carbohydrates, protein and fat. It is also required for proper functioning of nervous system. Skin hyper pigmentation, hair changes, vitiligo and angular stomatitis are cutaneous manifestations of vitamin B12 deficiency. Hyper pigmentation in Indian patients as first presentation of this deficiency is rarely reported. Our case was a 39-year-old lady who has presented with selective dark hyperpigmentation of hands and feet with electrophysiological evidence of peripheral neuropathy and biochemically proven vitamin B12 deficiency. Skin manifestation was reversed with intramuscular vitamin B12 administration of 1000mcg for 6 weeks. This case emphasizes the importance of rare skin presentation of reversible condition. It also marks the necessity of understanding all aspects and presentations of vitamin B12. Role of nutritional aspects of a person and their importance to prevent neurological sequel is discussed.