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L. Indumathi*

Nurse Educator, Department of Nursing, Kauvery Hospital, Salem

*Correspondence: [email protected]

Case-1:

What is your diagnosis?

Answer: Vitamin B 12 deficiency anaemia with nail discolouration

Hyperpigmentation of nails can signify vitamin B 12 deficiency, also known as cobalamin deficiency, which is a condition that develops when our body can’t make enough healthy red blood cells. This would appear as bluish discolouration of nails, blue-black pigmentation with dark longitudinal streaks and longitudinal and reticulate darkened streaks.

The nail pigmentation associated with B 12 deficiency is more frequent in patients with dark skin. The mechanism of hyperpigmentation is proposed to be decreased glutathione levels resulting in the disinhibition of tyrosinase, an enzyme of melanogenesis leading to increased melanin synthesis. The cutaneous manifestations can be reversed with B 12 therapy. The possibility of vitamin B 12 deficiency should be kept in a patient presenting with the only cutaneous manifestation of hyperpigmentation. Complications of vitamin B 12 deficiency may be prevented if the condition is recognised early and treatment is initiated. Beautify your nails as much as you want, but keep an eye on them also for some important health signs that they can give.

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