Asokan Ishan, Wheatley Rachel, Lullo Jenna, Yuen Meiling, Smogorzewski Jan
Department of Medicine, UCLA Medical Center, Los Angeles, CA, USA.
Division of Dermatology, Harbor-UCLA Medical Center, Torrance, CA, USA.
SAGE Open Med Case Rep. 2020 Dec 14;8:2050313X20979207. doi: 10.1177/2050313X20979207. eCollection 2020.
Reversible cutaneous hyperpigmentation often occurs in the setting of nutritional deficiencies and protein energy malnourishment, with atypical presentations arising from autoimmune disease. Here, we present a 52-year-old female with hypertension, type 1 diabetes, and Hashimoto's thyroiditis, under the diagnosis of polyglandular autoimmune syndrome type II, referred for evaluation of asymptomatic hyperpigmentation of the palms, soles, hard palate, and tongue for 6 months. The patient underwent a significant work-up, including esophagogastroduodenoscopy, which revealed hypertrophic gastropathy as well as evidence of acquired B12 deficiency secondary to pernicious anemia. The patient was initiated on B12 supplementation, with eventual resolution of mucocutaneous findings.
可逆性皮肤色素沉着过度常发生于营养缺乏和蛋白质能量营养不良的情况下，自身免疫性疾病也会出现非典型表现。在此，我们报告一名52岁女性，患有高血压、1型糖尿病和桥本甲状腺炎，诊断为Ⅱ型多腺体自身免疫综合征，因手掌、足底、硬腭和舌部无症状色素沉着6个月前来评估。患者接受了全面检查，包括食管胃十二指肠镜检查，结果显示为肥厚性胃病以及恶性贫血继发获得性维生素B12缺乏的证据。患者开始补充维生素B12，黏膜皮肤症状最终得以缓解。
