Cutaneous idiopathic hyperchromia of the orbital region (CIHOR): a histopathological study.
BACKGROUND
Dark circles under or around the eyes is a cosmetic problem for a large number of people. It is a condition of unknown etiology characterized by the darkening of the eyelids and periorbital skin. The aim of this study was to determine histopathological changes associated with cutaneous idiopathic hyperchromia of the orbital region (CIHOR).


METHODS
Twenty-eight adult patients with CIHOR were consecutively selected for the study. Biopsy specimens were taken from the darkened skin of the eyelid and from the normal retroauricular skin as a control.


RESULTS
Hemosiderin was absent in all cases. The increase in melanin content in the papillary dermis was slight in mild clinical cases and moderate in both the moderate and severe clinical cases of CIHOR. Mild dilation of blood vessels was observed in the papillary dermis at the different clinical levels of CIHOR severity, while in the reticular dermis, blood vessels showed moderate dilation and few melanophages were found.


CONCLUSIONS
An increase in melanin content was the most marked histological change in specimens of darkened skin. Dilation of dermal blood vessels may contribute to the severity of CIHOR. Hemosiderin was not observed in any case.


METHODS
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Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), R. Bandeira Paulista 275, cj 101, 10° andar, Itaim Bibi, São Paulo, SP, CEP 04532-010, Brazil. antonio@graziosi.com.br
Antonio Carmo
AC
Graziosi
Marina Rodrigues
MR
Quaresma
Nilceo Schwery
NS
Michalany
Lydia Masako
LM
Ferreira
D000328:Adult; D000367:Age Factors; D000368:Aged; D001707:Biopsy, Needle; D003430:Cross-Sectional Studies; D005143:Eyelids / Q000473:pathology*; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D007150:Immunohistochemistry; D008297:Male; D008543:Melanins / Q000378:metabolism*; D008875:Middle Aged; D009915:Orbit; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors
D008543:Melanins