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If there is a lack of cobalamin in the body, methylmalonyl CoA accumulates, which presumably leads to the neurological manifestations of B12 deficiency.[4][7][9][12] The replenishment with parenteral cyanocobalamin causes a rapid and complete improvement of megaloblastic anemia and gastrointestinal symptoms caused by vitamin B12 deficiency
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This can lead to uneven contours and even damage to the surrounding tissues
In fact, there was a 2022 case report presented a 22-year-old student who exhibited hyperpigmentation as the only symptom of B12 deficiency
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