Skin Hyperpigmentation: An Under-Recognized Dermatological Clue to Vitamin B12 Deficiency.

Cutaneous hyperpigmentation, an overlooked manifestation, can be an early sign of vitamin B12 deficiency. This case highlights symmetric pigmentation on the dorsum of hands and palms in a long-term vegetarian. Recognizing such subtle skin changes aids early diagnosis. Timely treatment reverses both pigmentation and systemic symptoms, underscoring its clinical relevance.