Twelve of 20 patients (60%) with Wilson's disease (hepatolenticular degeneration) were noted to have hyperpigmentation on the anterior aspect of the lower part of the legs. Histologically, this was found to be caused by increased melanin deposition. Copper and iron content in skin biopsy specimens was not different from that in controls.
Leu ML, Strickland GT, Wang CC, Chen TSN. Skin Pigmentation in Wilson's Disease. JAMA. 1970;211(9):1542–1543. doi:https://doi.org/10.1001/jama.1970.03170090058016
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