Case analysis shows isolated palmar hyperpigmentation in patients, indicating a unique clinical manifestation of deficiency.
Vitamin B12 deficiency has a myriad of presentations. Skin hyperpigmentation, especially at the knuckles, is common. However, in rare instances, a patient may present with isolated palmar hyperpigmentation instead of the usual features, such as knuckle hyperpigmentation, smooth tongue, symptoms related to anemia, and neurologic features.
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Sankhi et al. (2026) studied this question.
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