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hyperpigmentation
Etiology:
1) primary cutaneous disorders
a) epidermal alteration
- seborrheic keratosis
- acanthosis nigricans (obesity)
- pigmented actinic keratosis
b) proliferation of melanocytes
- lentigo
- melanocytic nevus
- melanoma
c) reactive hypermelanosis of postinflammatory hyperpigmentation
d) increased systemic disorders
- ephelides (freckles)
- cafe au lait spots
2) systemic disorders
a) localized
- epidermal alteration
- seborrheic keratosis (sign of Leser-Trelat)
- acanthosis nigricans
- endocrine disorders
- paraneoplastic disorders
- proliferation of melanocytes
- lentigines
- Peutz-Jeghers syndrome
- LEOPARD syndrome
- xeroderma pigmentosum
- nevi (Carney complex)
- LAMB syndrome
- NAME syndrome
- increased pigment production
- cafe au lait spots
- neurofibromatosis
- Albright's syndrome
- urticaria pigmentosa
- dermal pigmentation
- incontinentia pigmenti
- dyskeratosis congenita
- melasma (mask of pregnancy)
b) diffuse
- endocrinopathies
- Addison's disease
- Nelson's syndrome
- ectopic ACTH syndrome
- metabolic disorders
- porphyria cutanea tarda
- hemochromatosis
- vitamin B12 & folate deficiency
- pellagra
- malabsorption: Whipple's disease
- melanosis secondary to metastatic melanoma
- autoimmune disorders
- biliary cirrhosis
- scleroderma
- POEMS syndrome
- eosinophilia-myalgia syndrome
- pharmacologic agents [1]
- bleomycin
- busulfan
- chloroquine & other antimalarials
- corticotropin (ACTH)
- cyclophosphamide
- gold salts
- hypervitaminosis A
- oral contraceptives
- phenothiazines
Related
hypopigmentation
Specific
familial progressive hyperpigmentation (melanosis universalis hereditaria)
melanoderma
postinflammatory hyperpigmentation
tattoo
General
sign/symptom
References
- Harrison's Principles of Internal Medicine, 13th ed.
Companion Handbook, Isselbacher et al (eds), McGraw-Hill
Inc. NY, 1995, pg 829-39
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 318
- Medical Knowledge Self Assessment Program (MKSAP) 17,
American College of Physicians, Philadelphia 2015