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These lesions were circular in shape, with distinct margins, and initially light in color, with a size of about 56 mm, but over a subsequent span of 6 months, the macules became completely colorless and increased in size
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Vitamin B12 deficiency results in megaloblastic anemia, GI lesions, and neurologic damage (which begins with an inability to produce myelin and is followed by gradual degeneration of the axon and nerve head)

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doi: 10.1002/pmic.201700145

This stress is often amplified by drought and high temperatures (Kumar 2020) and manifests as osmotic imbalance, ionic toxicity, and excessive reactive oxygen species (ROS) production, which disrupt redox homeostasis, cell division, membrane integrity, and cytoplasmic metabolism (Mushtaq et al