Skin nontumor
Pigmentary disorders
Hyperpigmentation
Author: Christopher S. Hale, M.D.
Last author update: 1 April 2013
Last staff update: 18 November 2020
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: hyperpigmentation melanocytic
Table of Contents
Definition / general | Clinical features | Case reports | Treatment | Clinical images | Microscopic (histologic) description | Microscopic (histologic) images | Electron microscopy imagesCite this page: Hale CS. Hyperpigmentation. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumormelanocytichyperpigmentation.html. Accessed April 1st, 2023.
Definition / general
- Common, usually harmless condition, in which patches of skin become darker than normal surrounding skin (Wikipedia)
- Due to melanocyte stimulation from drugs (Merck), heat, hormones, inflammation (eMedicine), malignancy, metabolic disease, scars, sunlight, various dermatoses or familial progressive hyperpigmentation (Eur J Dermatol 2006;16:246)
- Patches near axilla may be postinflammatory due to hair plucking (Int J Cosmet Sci 2006;28:247)
- Hyperpigmentation can be evaluated with Taylor hyperpigmentation scale (Cutis 2005;76:270)
- See also solar lentigo: age / liver spots due to sun damage on hands or face
Clinical features
- Skin with darker pigmentation than surrounding healthy skin, due to increased melanin
Case reports
- Drugs:
- Amiodarone (Arch Dermatol 2008;144:92)
- Bleomycin (Arch Dermatol 2003;139:337)
- Diltiazem (Arch Dermatol 2006;142:206)
- Hydroxychloroquine (J Cutan Pathol 2008;35:1134)
- Imatinib (Dermatol Online J 2008;14:7)
- Imipramine (Dermatol Online J 2007;13:8)
- Interferon alpha (JAMA Dermatol 2013;149:675)
- Minocycline (J Clin Rheumatol 2008;14:17)
- Malignancy:
- Leukemia cutis (61 year old man, J Cutan Pathol 2008;35:662)
- Other:
- Periungual hyperpigmentation in newborns (Pediatr Dermatol 2008;25:25)
- Vitamin B12 deficiency (34 year old man, Indian J Dermatol Venereol Leprol 2006;72:389)
Treatment
- None
- Bleaching products with hydroquinone, retinol and antioxidants (Cutis 2008;81:365)
- Laser therapy (Plast Reconstr Surg 2008;121:282)
- Note: hydroquinone slows production of melanin, so darker areas gradually fade to match surrounding skin; tretinoin and cortisone take 3 - 6 months to produce improvement
Clinical images
Images hosted on other servers:
Drug related:
Amiodarone
Bleomycin
Diltiazem
Imatinib (figs 1A - B)
Imipramine
(fig. 1)
Other:
Familial Progressive Hyperpigmentation
Pre and post treatment for Vitamin B12 deficiency
42 year old African American
woman with lesions
on left side of face
as a result of acne excoriée
Microscopic (histologic) description
- Increased pigmentation of basal keratinocytes, increased transfer of melanin into adjacent keratinocytes
- Variable melanophages, deposits in dermal cells and apoptotic cells
- No atypia
Microscopic (histologic) images
Images hosted on other servers:
Amiodarone
Diltiazem
Imatinib (figs 2A - B)
Imipramine
(fig. 2)
Familial progressive hyperpigmentation
Electron microscopy images
Images hosted on other servers:
Photoexposed pigmented skin
