Acquired Bilateral Dyspigmentation on Face and Neck: Clinically Appropriate Approaches.
Facial dyspigmentation in Asian women often poses diagnostic and therapeutic challenges. Recently, a distinctive bilateral hyperpigmentation of face and neck has occasionally been observed. This study was performed to investigate the clinico-pathological features of this dyspigmentation as well as proper treatment approaches. We retrospectively investigated the medical records including photographs, routine laboratory tests, histopathologic studies of both lesional and peri-lesional normal skin and patch test of thirty-one patients presented acquired bizarre hyperpigmentation on face and neck. The mean age of patients was 52.3 years and the mean duration of dyspigmentation was 24.2 months. In histologic evaluations of lesional skin, a significantly increased liquefactive degeneration of basal layer, pigmentary incontinence and lymphocytic infiltration were noted, whereas epidermal melanin or solar elastosis showed no statistical differences. Among 19 patients managed with a step-by-step approach, seven improved with using only topical anti-inflammatory agents and moisturizer, and 12 patients gained clinical benefit after laser therapy without clinical aggravation. Both clinical and histopathologic findings of the cases suggest a distinctive acquired hyperpigmentary disorder related with subclinical inflammation. Proper step-by-step evaluation and management of underlying subclinical inflammation would provide clinical benefit.
Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
You Jin
http://orcid.org/0000-0002-7588-0642
YJ
Lee
Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ji Hye
http://orcid.org/0000-0002-6699-5202
JH
Park
Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Dong Youn
http://orcid.org/0000-0003-0765-9812
DY
Lee
Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.|Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Korea. bell711@hanmail.net.
Jong Hee
http://orcid.org/0000-0001-8536-1179
JH
Lee
D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D005145:Face / Q000473:pathology*; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D053685:Laser Therapy; D008297:Male; D008548:Melanosis; D008875:Middle Aged; D009333:Neck / Q000473:pathology*; D010328:Patch Tests; D010781:Photography; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D016559:Tacrolimus / Q000627:therapeutic use; D055815:Young Adult
D000893:Anti-Inflammatory Agents; D016559:Tacrolimus
Anti-inflammatory Agents; Facial Dyspigmentation; Hyperpigmentation; Laser Therapy; Subclinical Inflammation