6th February 2024

A 56-year-old female presents to the dermatology clinic with large regions of hyperpigmented keratinised patches along the sun-exposed areas of her neck, arms and legs.

A 56-year-old female presents to the dermatology clinic with large regions of hyperpigmented keratinised patches along the sun-exposed areas of her neck, arms and legs. She reports having a six-month history of watery diarrhoea. Her husband has noticed she has become increasingly confused over the past 8-9 months. Her husband informs you that she has lived off a diet exclusively of corn for the past three years. 

Which of the following vitamin deficiencies could be associated with this presentation?