The skin of patients with cholestasis may darken. Hyperpigmentation is a classic finding in patients with PBC. The pigment is melanin. The etiology of the hyper-

TABLE 122-3. Selected Regimens for Vitamin Supplementation in Patients with Cholestasis and Vitamin Deficiencies

Deficient Dose/Mode of

Vitamin Preparation Administration/Frequency

A Vitamin A 30,000 IU/orally/3 times per week (105)

D Cholecalciferol 50,000 IU/orally/3 times per week (105)

E a-tocopherol 100 mg bid (105)

K Ki 10 to 10 mg SC daily for 3 consecutive days or monthly* (112)

bid = twice daily; SC = subcutaneously. *For patients who have chronic cholestasis.

pigmentation of cholestasis is not known. Increased availability of P-melanocyte stimulating hormone has been proposed as an etiologic factor in PBC. There are no treatments recommended for this complication.

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