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The characteristic dermatological sign of vitamin B 12 deficiency is cutaneous pigmentation, which can be reversed by administration of vitamin B 12 .[4] Increased cutaneous pigmentation is especially accentuated in palmar creases, on the dorsa of hands and feet, in intertriginous areas, on oral mucosa and in recent scars

The probable etiologies for the vitamin B 12 deficiencies in the patients without a history of gastrectomy were gastritis, diabetes medications, a vegetarian diet, antibodies to the intrinsic factor, and early gastric cancer

"Focused review: myofascial pain." Arch Phys Med Rehabil

doi:10.1016/s0140-6736(78)92379-6