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It has been found that low vitamin B12 levels can cause a variety of dermatologic disturbances, including hyperpigmentation, nail discoloration, and the loss of skin color in the form of patches i.e

Additionally, a meta-analysis by et al

In view of a clear Vit B12 deficiency and/or HHcy and/or high MMA levels in a PwPD presetting with clinical signs of PN, a complete neurographic assessment and an extensive alternative-causes workup should be performed