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To the Editor.—
In the Archives, Cawley et al (100:1-6, 1969) noted that, although the hyperpigmentation in hemochromatosis was due only to the pigment melanin, there were few speculations as to the cause of the melanosis.I propose that the melanin hyperpigmentation of hemochromatosis is the result of ascorbic acid deficiency.1 Hemochromatosis is associated with metabolic disturbances indicative of ascorbic acid deficit.2 Massive tissue deposits of iron produce an irreversible oxidative catabolism of ascorbic acid.3 Ascorbic acid has skin lightening effects: large doses of it can decrease addisonian pigmentation,4 while scurvy can be associated with melanosis.4,5 This vitamin has the important role of maintaining optimal sulfhydryl group concentrations in the body. Sulfhydryl groups have an inhibitory effect on melanogenesis.4,6 Thus, the ascorbic acid deficiency in hemochromatosis would cause a low epidermal sulfhydryl content which, in turn, would release melanogenesis from inhibition.1 The increased
Hemochromatosis, Melanosis, and Hypovitaminosis C. Arch Dermatol. 1972;106(5):768. doi:10.1001/archderm.1972.01620140102037