The ascorbate/glutathione cycle
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Description
The pathophysiologic mechanism of hyperpigmentation involves increased melanin synthesis and the inadequate transfer of the pigment from the melanocytes to the nearby keratinocytes
It is unusual for young people to be somewhat low in vitamin B12, but it is not uncommon for elderly individuals to be deficient
The mechanism appears to involve increased serotonin synthesis in substantia nigra (both compacta and reticulata), a regional pattern unlike any existing antidepressant drug, plus potential dopaminergic contributions given the nigrostriatal location
There is no responsible universal answer
