Reversible Hyperpigmentation: A Diagnostic Dilemma

The document discussed a case of a female vegetarian patient with anemia, generalized weakness, and acral hyperpigmentation, which was linked to vitamin B12 deficiency. Despite normal RBC folate levels, the patient exhibited megaloblastic anemia. Treatment with blood transfusion and intramuscular vitamin B12 injections led to improvement in symptoms and fading of skin lesions, indicating that vitamin B12 deficiency was the cause of the hyperpigmentation. The case highlighted the need for clinicians to consider vitamin B12 deficiency as a potential cause of reversible hyperpigmentation for timely intervention.