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Isolated Palmar Hyperpigmentation: Rare Presentation of B12 Deficiency.

Mukti Nath Sankhi¹, Rajiv Sitaula¹, Samir Samadarshi²

¹Nepalese Army Institute of Health Sciences College of Medicine Kathmandu Bagmati Nepal.

Clinical Case Reports

|June 24, 2026

Summary

Vitamin B12 deficiency can cause skin darkening, often on knuckles. Rarely, it may appear only on the palms, differing from typical symptoms like anemia or nerve issues.

Keywords:

cutaneous manifestations macrocytic anemia palmar hyperpigmentation vitamin B12 deficiency

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Quantification of Hypopigmentation Activity In Vitro

Quantification of Hypopigmentation Activity In Vitro

Published on: March 6, 2019

Area of Science:

Dermatology
Hematology
Neurology

Background:

Vitamin B12 deficiency presents with diverse clinical manifestations.
Skin hyperpigmentation, particularly on the knuckles, is a recognized sign.
Typical symptoms include glossitis, anemia, and neurological deficits.

Purpose of the Study:

To highlight a rare presentation of Vitamin B12 deficiency.
To describe isolated palmar hyperpigmentation as a sole indicator.

Main Methods:

Case report analysis.
Clinical presentation review.
Differential diagnosis exploration.

Main Results:

A patient presented with hyperpigmentation exclusively on the palms.
This isolated finding mimicked other dermatological conditions.
Standard B12 deficiency signs were absent initially.

Conclusions:

Isolated palmar hyperpigmentation can be an atypical sign of Vitamin B12 deficiency.
Clinicians should consider B12 deficiency in cases of unexplained palmar hyperpigmentation.
Early recognition aids in preventing irreversible neurological damage.