b12 peds clinical photo nejm syndrome diagnosis bleeding dermatology derm striae nutrition

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Etiologies of Vitamin B12 Deficiency
• Inadequate intake - Rare but seen in very strict vegans

but seen in very strict ... pump blockers is leading ... malabsorption syndromes ... #differential #diagnosis ... #hematology #nutrition

Lichen Planus- ...On examination, numerous purple papules were noted on the anterior surface of the forearms

sawtooth rete pegs ... confirming the diagnosis ... #NEJM #clinical ... #photo #lichen # ... planus #derm #wickhams

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