Periocular skin hyperpigmentation in children treated with prostaglandin analogues.
OBJECTIVE
To report periocular skin hyperpigmentation related to prostaglandin analogue (PGA) use in children with glaucoma.


METHODS
This cross-sectional study examined children treated with PGA for at least 6 months between June 2013 and December 2013. The pigmentation scores of the upper eyelids, lower eyelids and cheek were recorded with a chromameter. Hyperpigmentation was defined as a positive difference in scores between the cheek and the upper/lower eyelid. The influence of age, baseline skin pigmentation, duration of PGA, type of PGA and mono- or multitherapy on hyperpigmentation were evaluated. Subjective grading of pigmentation on standardized face photographs and the parent's perception of hyperpigmentation were also recorded. A P value of <0.05 was considered significant.


RESULTS
A total of 55 patients were included. Hyperpigmentation of the upper and lower eyelids occurred in all eyes. Subjectively, 26 (47%) eyes had mild and 14 (26%) moderate hyperpigmentation. The upper eyelid showed significantly greater hyperpigmentation than the lower eyelid (P = 0.00004). Chromameter measurements overlapped with pigmentation grading on photographs. The type of and duration of PGA use, PGA mono- or multidrug therapy or baseline skin pigmentation had no effect on the grade of hyperpigmentation.


CONCLUSIONS
PGA use for more than 6 months was associated with periocular skin hyperpigmentation that was greater in the upper eyelid versus lower eyelid. All variables examined failed to show a relationship with the grade of hyperpigmentation.
King Khaled Eye Specialist hospital, Riyadh, Saudi Arabia.
Mohammed
M
Al-Zobidi
King Khaled Eye Specialist hospital, Riyadh, Saudi Arabia.
Rajiv
R
Khandekar
King Khaled Eye Specialist hospital, Riyadh, Saudi Arabia; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Earl Randy
ER
Craven
King Khaled Eye Specialist hospital, Riyadh, Saudi Arabia.
Soumya
S
Hanafi
King Khaled Eye Specialist hospital, Riyadh, Saudi Arabia; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: dedwar39@jhmi.edu.
Deepak P
DP
Edward
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D046169:Dermoscopy / Q000295:instrumentation; D005141:Eyelid Diseases / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced* / Q000175:diagnosis; D007223:Infant; D008297:Male; D011465:Prostaglandins, Synthetic / Q000009:adverse effects*; D012880:Skin Pigmentation / Q000187:drug effects*; D011795:Surveys and Questionnaires
D011465:Prostaglandins, Synthetic