PMC5735604_01
Marked hyperpigmentation over the knuckle pads (interphalangeal joints) and (periungual areas) of the hands and feet.
CRINM2017-7140908.001.jpg
PMC5735604_01_CRINM2017-7140908.001.jpg
fig1
It was not itchy, associated with leukonychia and melanonychia on hands and toes' nails (Figure 1).
T2 weighted MRI in both axial and sagittal views of the spine shows long segment of abnormal high signal involving the posterior aspect of the cervical cord extending from C1 to C5.
CRINM2017-7140908.002.jpg
PMC5735604_01_CRINM2017-7140908.002.jpg
fig2
The bone marrow was hypercellular and was supporting the diagnosis of megaloblastic anemia. T2 weighted MRI in both axial and sagittal views of the spine shows long segment of abnormal high signal involving the posterior aspect of the cervical cord extending from C1 to C5 (Figure 2).