Skin nontumor

Pigmentary disorders

Hyperpigmentation



Last author update: 1 April 2013
Last staff update: 18 November 2020

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PubMed Search: hyperpigmentation melanocytic

Christopher S. Hale, M.D.
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Cite this page: Hale CS. Hyperpigmentation. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumormelanocytichyperpigmentation.html. Accessed March 29th, 2024.
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
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

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Image 01 Image 02