A 59-year-old man presents with fatigue, a smooth tongue, and darkening skin on his palms and soles. Explore the Differential Diagnosis for these unusual signs.
A 59-year-old tile layer presented with fatigue and one year of progressive skin darkening on his palms and soles. Physical examination showed a smooth tongue with patchy areas of mucosal darkening, as well as hyperpigmented palms and soles. Laboratory studies showed a hemoglobin level of 9.4 g per deciliter (reference range, 14 to 18), a mean corpuscular volume of 117 femtoliters (reference range, 80 to 94), and mild leukopenia and thrombocytopenia. Which of the following is the most likely diagnosis?
What is the most likely diagnosis?
Atrophic Glossitis, Hyperpigmentation, Macrocytic Anemia, Pernicious Anemia, Vitamin B12 deficiency
