Dermatological findings of vitamin B12 deficiency and resolving time of these symptoms

Demir, Nihat; Doğan, Murat; Köç, Ahmet; Kaba, Sultan; Bulan, Keziban; Özkol, Hatice Uce; Doğan, Şekibe Zehra

doi:10.3109/15569527.2013.861477

Cited by 38 publications

(37 citation statements)

References 17 publications

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“…It is often impossible to alleviate patients’ burning sensations. A simple search for nutritional deficiencies is strongly recommended [124]. …”

Section: Diagnostic Hintsmentioning

confidence: 99%

Diagnosis of Lingual Atrophic Conditions: Associations with Local and Systemic Factors. A Descriptive Review

Erriu¹,

Pili²,

Cadoni³

et al. 2016

TODENTJ

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Atrophic glossitis is a condition characterised by absence of filiform or fungiform papillae on the dorsal surface of the tongue. Consequently, the ordinary texture and appearance of the dorsal tongue, determined by papillary protrusion, turns into a soft and smooth aspect.Throughout the years, many factors, both local and systemic, have been associated with atrophic glossitis as the tongue is currently considered to be a mirror of general health. Moreover, various tongue conditions were wrongly diagnosed as atrophic glossitis. Oral involvement can conceal underlying systemic conditions and, in this perspective, the role of clinicians is fundamental.Early recognition of oral signs and symptoms, through a careful examination of oral anatomical structures, plays a crucial role in providing patients with a better prognosis.

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“…It is often impossible to alleviate patients’ burning sensations. A simple search for nutritional deficiencies is strongly recommended [124]. …”

Section: Diagnostic Hintsmentioning

confidence: 99%

Diagnosis of Lingual Atrophic Conditions: Associations with Local and Systemic Factors. A Descriptive Review

Erriu¹,

Pili²,

Cadoni³

et al. 2016

TODENTJ

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“…[1,2] The mechanism of hyperpigmentation in B12 is complex and poorly understood. The two more accepted hypotheses are increased melanin synthesis and defective melanin transfer from melanocytes to adjacent megaloblastic keratinocytes.…”

Section: Discussionmentioning

confidence: 99%

Hyperpigmentation of palms - A clue to B12 deficiency

Boopathy¹,

Balasubramanian²

2018

JCRI

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“…The clinical manifestations of vitamin B 12 deficiency are megaloblastic anaemia, glossitis and neurological symptoms like sensory abnormalities, tremors and psychiatric symptom 1. Other less common features are cutaneous hyperpigmentation, aphthous stomatitis, cheilitis, vitiligo, sparse lusterless hypopigmented hairs and blue-black pigmentation of nails 2.…”

Section: Descriptionmentioning

confidence: 99%

Blue nails: window to micronutrient deficiency

Sharawat

Vinay

2018

BMJ Case Reports

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DesCripTionA 12-year-old boy presented with progressive darkening of nails of both hands and feet for the past 3 months. He noticed the blue-black pigmentation of all the fingernails and toenails ( figure 1A,B). Pigmentation was more marked in fingernails, particularly over thumbnails ( figure 1C,D). The pigmentation started proximally and progressed distally. It was associated with hyperpigmentation of distal phalanges and nail bed. There was no history of any exposure to dyes or work in factory, trauma or exposure to any other agents. There was no history of dermatitis or rash prior to this complaint. He was a non-vegetarian. Other systemic examination was unremarkable.Lab investigations revealed macrocytic hypochromic anaemia (haemoglobin 10.9 g/dL, mean corpuscular volume 110 fL), decreased serum vitamin B 12 (80.61 pg/mL), normal serum folate levels (4.8 ng/mL), elevated serum homocysteine level (55.47 µmol/L) and mildly elevated urinary methyl malonic acid. His serum adrenocorticotropin hormone level was within normal limits. The severe vitamin B 12 deficiency was considered as the attributing factor for his nail hyperpigmentation. He was started on daily intramuscular vitamin B 12 therapy (1 mg/day) for 7 days followed by weekly injections for 4 weeks along with oral B 12 (1 mg/day) and other micronutrients. Serum homocysteine became normal after 1 month of therapy (6.4 µmol/L).The clinical manifestations of vitamin B 12 deficiency are megaloblastic anaemia, glossitis and neurological symptoms like sensory abnormalities, tremors and psychiatric symptom.1 Other less common features are cutaneous hyperpigmentation, aphthous stomatitis, cheilitis, vitiligo, sparse lusterless hypopigmented hairs and blue-black pigmentation of nails. 2 Nail changes in vitamin B 12 deficiency present as hyperpigmentation of nails like bluish discoloration of nails, blue-black pigmentation with dark longitudinal streaks, and longitudinal and reticulate darkened streaks. The nail pigmentation associated with B 12 deficiency is more frequent in patients with dark skin. The mechanism of hyperpigmentation is proposed to be decreased glutathione levels resulting in disinhibition of tyrosinase, an enzyme of melanogenesis leading to increased melanin synthesis. 3 The cutaneous manifestations can be reversed with B 12 therapy. Possibility of vitamin B 12 deficiency should be kept in a patient presenting with only cutaneous manifestation of hyperpigmentation. Complications of vitamin B 12 deficiency may be prevented if the condition is recognised early and treatment is initiated.

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Dermatological findings of vitamin B12 deficiency and resolving time of these symptoms

Abstract: Deficiency of vitamin B12 should be considered in the differential diagnosis of infants who present with skin and mucosal lesions.

Cited by 38 publications

References 17 publications

Diagnosis of Lingual Atrophic Conditions: Associations with Local and Systemic Factors. A Descriptive Review

Diagnosis of Lingual Atrophic Conditions: Associations with Local and Systemic Factors. A Descriptive Review

Hyperpigmentation of palms - A clue to B12 deficiency

Blue nails: window to micronutrient deficiency

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