The mask of deficiency: A rare case of facial hyperpigmentation in vitamin B ₁₂ deficiency – a case report and review of literature

Vitamin B12 deficiency can manifest in various forms, including skin changes in the form of hyperpigmentation. The hyperpigmentation in vitamin B12 deficiency commonly presents over the hands and feet, but presenting over the face and oral cavity is very rare. Here we describe an interesting case where there was hyperpigmentation in the face and oral cavity which was mimicking Addison's disease, but the actual diagnosis was vitamin B12 deficiency. This case stresses that knowing the uncommon manifestations of common disease is more important than knowing the common manifestations of uncommon disease.