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Facial Hyperpigmentation in Skin of Color: Special Considerations and Treatment

  • Therapy in Practice
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A Letter to the Editor to this article was published on 08 June 2017

Abstract

Differences in cutaneous diseases in people of color call for nuanced evaluation and management. One of the most common dermatological complaints from patients with skin of color is dyspigmentation, particularly hyperpigmentation. The challenge for clinicians is to establish correct diagnoses along with consistently successful treatments to meet the needs of the increasingly diverse population served. This review focuses on facial hyperpigmentation and outlines the most common skin disorders and treatment options.

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References

  1. Larocca CA, Kundu RV, Vashi NA. Physiologic pigmentation: molecular mechanisms and clinical diversity. Pigm Int. 2014;1(2):44–51.

    Article  Google Scholar 

  2. Alexis AF, Sergay AB, Taylor SC. Common dermatologic disorders in skin of color: a comparative practice survey. Cutis. 2007;80(5):387–94.

    PubMed  Google Scholar 

  3. Kang SJ, Davis SA, Feldman SR, McMichael AJ. Dyschromia in skin of color. J Drugs Dermatol. 2014;13(4):401–6.

    PubMed  Google Scholar 

  4. Pawaskar MD, Parikh P, Markowski T, McMichael AJ, Feldman SR, Balkrishnan R. Melasma and its impact on health-related quality of life in Hispanic women. J Dermatol Treat. 2007;18(1):5–9.

    Article  Google Scholar 

  5. Ikino JK, Nunes DH, Silva VP, Frode TS, Sens MM. Melasma and assessment of the quality of life in Brazilian women. An Bras Dermatol. 2015;90(2):196–200.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Khanna N, Rasool S. Facial melanoses: Indian perspective. Indian J Dermatol Venereol Leprol. 2011;77(5):552–63 (quiz 64).

    Article  PubMed  Google Scholar 

  7. Cestari TF, Dantas LP, Boza JC. Acquired hyperpigmentations. An Bras Dermatol. 2014;89(1):11–25.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Handel AC, Miot LD, Miot HA. Melasma: a clinical and epidemiological review. An Bras Dermatol. 2014;89(5):771–82.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Rodrigues M, Pandya AG. Melasma: clinical diagnosis and management options. Australas J Dermatol. 2015;56(3):151–63.

    Article  PubMed  Google Scholar 

  10. Achar A, Rathi SK. Melasma: a clinico-epidemiological study of 312 cases. Indian J Dermatol. 2011;56(4):380–2.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ogita A, Funasaka Y, Ansai S, Kawana S, Saeki H. Melasma in a male patient due to estrogen therapy for prostate cancer. Ann Dermatol. 2015;27(6):763–4.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Stratigos AJ, Katsambas AD. Optimal management of recalcitrant disorders of hyperpigmentation in dark-skinned patients. Am J Clin Dermatol. 2004;5(3):161–8.

    Article  PubMed  Google Scholar 

  13. Kwon SH, Hwang YJ, Lee SK, Park KC. Heterogeneous pathology of melasma and its clinical implications. Int J Mol Sci. 2016;17(6):824–34.

    Article  PubMed Central  CAS  Google Scholar 

  14. Hernandez-Barrera R, Torres-Alvarez B, Castanedo-Cazares JP, Oros-Ovalle C, Moncada B. Solar elastosis and presence of mast cells as key features in the pathogenesis of melasma. Clin Exp Dermatol. 2008;33(3):305–8.

    Article  CAS  PubMed  Google Scholar 

  15. Torres-Alvarez B, Mesa-Garza IG, Castanedo-Cazares JP, Fuentes-Ahumada C, Oros-Ovalle C, Navarrete-Solis J, et al. Histochemical and immunohistochemical study in melasma: evidence of damage in the basal membrane. Am J Dermatopathol. 2011;33(3):291–5.

    Article  PubMed  Google Scholar 

  16. Duteil L, Cardot-Leccia N, Queille-Roussel C, Maubert Y, Harmelin Y, Boukari F, et al. Differences in visible light-induced pigmentation according to wavelengths: a clinical and histological study in comparison with UVB exposure. Pigment Cell Melanoma Res. 2014;27(5):822–6.

    Article  CAS  PubMed  Google Scholar 

  17. Boukari F, Jourdan E, Fontas E, Montaudie H, Castela E, Lacour JP, et al. Prevention of melasma relapses with sunscreen combining protection against UV and short wavelengths of visible light: a prospective randomized comparative trial. J Am Acad Dermatol. 2015;72(1):189–90.e1.

  18. Shankar K, Godse K, Aurangabadkar S, Lahiri K, Mysore V, Ganjoo A, et al. Evidence-based treatment for melasma: expert opinion and a review. Dermatol Ther. 2014;4(2):165–86.

    Article  Google Scholar 

  19. Molinar VE, Taylor SC, Pandya AG. What’s new in objective assessment and treatment of facial hyperpigmentation? Dermatol Clin. 2014;32(2):123–35.

    Article  CAS  PubMed  Google Scholar 

  20. Lynde CB, Kraft JN, Lynde CW. Topical treatments for melasma and postinflammatory hyperpigmentation. Skin Ther Lett. 2006;11(9):1–6.

    CAS  Google Scholar 

  21. Sheth VM, Pandya AG. Melasma: a comprehensive update: part II. J Am Acad Dermatol. 2011;65(4):699–714 (quiz 5).

    Article  PubMed  Google Scholar 

  22. Mazurek K, Pierzchala E. Comparison of efficacy of products containing azelaic acid in melasma treatment. J Cosmet Dermatol. 2016;15(3):269–82.

    Article  PubMed  Google Scholar 

  23. Farshi S. Comparative study of therapeutic effects of 20% azelaic acid and hydroquinone 4% cream in the treatment of melasma. J Cosmet Dermatol. 2011;10(4):282–7.

    Article  PubMed  Google Scholar 

  24. Sardana K, Chugh S, Garg V. Are Q-switched lasers for Nevus of Ota really effective in pigmented skin? Indian J Dermatol Venereol Leprol. 2012;78(2):187–9 (author reply 9–90).

    Article  PubMed  Google Scholar 

  25. Hofbauer Parra CA, Careta MF, Valente NY, de Sanches Osorio NE, Torezan LA. Clinical and histopathologic assessment of facial melasma after low-fluence Q-switched neodymium-doped yttrium aluminium garnet laser. Dermatol Surg. 2016;42(4):507–12.

    Article  CAS  PubMed  Google Scholar 

  26. Na JI, Choi SY, Yang SH, Choi HR, Kang HY, Park KC. Effect of tranexamic acid on melasma: a clinical trial with histological evaluation. J Eur Acad Dermatol Venereol. 2013;27(8):1035–9.

    Article  CAS  PubMed  Google Scholar 

  27. Tan AW, Sen P, Chua SH, Goh BK. Oral tranexamic acid lightens refractory melasma. Australas J Dermatol (Epub 13 May 2016).

  28. Lee HC, Thng TG, Goh CL. Oral tranexamic acid (TA) in the treatment of melasma: a retrospective analysis. J Am Acad Dermatol. 2016;75(2):385–92.

    Article  CAS  PubMed  Google Scholar 

  29. Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010;3(7):20–31.

    PubMed  PubMed Central  Google Scholar 

  30. Bulengo-Ransby SM, Griffiths CE, Kimbrough-Green CK, Finkel LJ, Hamilton TA, Ellis CN, et al. Topical tretinoin (retinoic acid) therapy for hyperpigmented lesions caused by inflammation of the skin in black patients. N Engl J Med. 1993;328(20):1438–43.

    Article  CAS  PubMed  Google Scholar 

  31. Lowe NJ, Rizk D, Grimes P, Billips M, Pincus S. Azelaic acid 20% cream in the treatment of facial hyperpigmentation in darker-skinned patients. Clin Ther. 1998;20(5):945–59.

    Article  CAS  PubMed  Google Scholar 

  32. Kakita LS, Lowe NJ. Azelaic acid and glycolic acid combination therapy for facial hyperpigmentation in darker-skinned patients: a clinical comparison with hydroquinone. Clin Ther. 1998;20(5):960–70.

    Article  CAS  PubMed  Google Scholar 

  33. Alexis AF, Blackcloud P. Natural ingredients for darker skin types: growing options for hyperpigmentation. J Drugs Dermatol. 2013;12(9 Suppl):s123–7.

    CAS  PubMed  Google Scholar 

  34. Fleischer AB Jr, Schwartzel EH, Colby SI, Altman DJ. The combination of 2% 4-hydroxyanisole (Mequinol) and 0.01% tretinoin is effective in improving the appearance of solar lentigines and related hyperpigmented lesions in two double-blind multicenter clinical studies. J Am Acad Dermatol. 2000;42(3):459–67.

    Article  PubMed  Google Scholar 

  35. Jarratt M. Mequinol 2%/tretinoin 0.01% solution: an effective and safe alternative to hydroquinone 3% in the treatment of solar lentigines. Cutis. 2004;74(5):319–22.

    PubMed  Google Scholar 

  36. Lee do H, Oh IY, Koo KT, Suk JM, Jung SW, Park JO, et al. Reduction in facial hyperpigmentation after treatment with a combination of topical niacinamide and tranexamic acid: a randomized, double-blind, vehicle-controlled trial. Skin Res Technol. 2014;20(2):208–12.

    Article  PubMed  Google Scholar 

  37. Vashi NA, Kundu RV. Approach to the patient with hyperpigmentation disorders. 2015. http://www.uptodate.com/contents/approach-to-the-patient-with-hyperpigmentation-disorders#H804857. Accessed 6 Sept 2016.

  38. Sonthalia S, Sarkar R. Maturational hyperpigmentation. In: Koushik L, Chaterjee M, Sarkar R, editors. Pigmentary disorders: a comprehensive compendium. 1st ed. New Delhi: Jaypee Brothers Medical; 2014.

    Google Scholar 

  39. Cunliffe T. Hyperpigmentation—of the face and neck. 2013. http://www.pcds.org.uk/clinical-guidance/melasma-syn.-chloasma-and-other-causes-of-facial-hyperpigmentation. Accessed 6 Sept 2016.

  40. Besra L, Jaisankar TJ, Thappa DM, Malathi M, Kumari R. Spectrum of periorbital dermatoses in South Indian population. Indian J Dermatol Venereol Leprol. 2013;79(3):399–407.

    Article  PubMed  Google Scholar 

  41. Sahni K, Kassir M. Dermafrac: an innovative new treatment for periorbital melanosis in a dark-skinned male patient. J Cutan Aesthet Surg. 2013;6(3):158–60.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Malakar S, Lahiri K, Banerjee U, Mondal S, Sarangi S. Periorbital melanosis is an extension of pigmentary demarcation line-F on face. Indian J Dermatol Venereol Leprol. 2007;73(5):323–5.

    Article  PubMed  Google Scholar 

  43. Roberts WE. Periorbital hyperpigmentation: review of etiology, medical evaluation, and aesthetic treatment. J Drugs Dermatol. 2014;13(4):472–82.

    PubMed  Google Scholar 

  44. Alsaad SM, Mikhail M. Periocular hyperpigmentation: a review of etiology and current treatment options. J Drugs Dermatol. 2013;12(2):154–7.

    CAS  PubMed  Google Scholar 

  45. Sarkar R, Ranjan R, Garg S, Garg VK, Sonthalia S, Bansal S. Periorbital hyperpigmentation: a comprehensive review. J Clin Aesthet Dermatol. 2016;9(1):49–55.

    PubMed  PubMed Central  Google Scholar 

  46. Levin CY, Maibach H. Exogenous ochronosis. An update on clinical features, causative agents and treatment options. Am J Clin Dermatol. 2001;2(4):213–7.

    Article  CAS  PubMed  Google Scholar 

  47. Merola JF, Meehan S, Walters RF, Brown L. Exogenous ochronosis. Dermatol Online J. 2008;14(10):6.

    PubMed  Google Scholar 

  48. Simmons BJ, Griffith RD, Bray FN, Falto-Aizpurua LA, Nouri K. Exogenous ochronosis: a comprehensive review of the diagnosis, epidemiology, causes, and treatments. Am J Clin Dermatol. 2015;16(3):205–12.

    Article  PubMed  Google Scholar 

  49. Liu WC, Tey HL, Lee JS, Goh BK. Exogenous ochronosis in a Chinese patient: use of dermoscopy aids early diagnosis and selection of biopsy site. Singapore Med J. 2014;55(1):e1–3.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Chowdary S, Mahalingam M, Vashi NA. Reading between the layers: early histopathological findings in exogenous ochronosis. Am J Dermatopathol. 2014;36(12):989–91.

    Article  PubMed  Google Scholar 

  51. Chaptini C, Huilgol SC. Erbium-doped yttrium aluminium garnet ablative laser treatment for endogenous ochronosis. Australas J Dermatol. 2015;56(3):212–4.

    Article  PubMed  Google Scholar 

  52. Tan SK. Exogenous ochronosis—successful outcome after treatment with Q-switched Nd:YAG laser. J Cosmet Laser Ther. 2013;15(5):274–8.

    Article  PubMed  Google Scholar 

  53. Kramer KE, Lopez A, Stefanato CM, Phillips TJ. Exogenous ochronosis. J Am Acad Dermatol. 2000;42(5 Pt 2):869–71.

    Article  CAS  PubMed  Google Scholar 

  54. Bellew SG, Alster TS. Treatment of exogenous ochronosis with a Q-switched alexandrite (755 nm) laser. Dermatol Surg. 2004;30(4 Pt 1):555–8.

    PubMed  Google Scholar 

  55. Kanechorn-Na-Ayuthaya P, Niumphradit N, Aunhachoke K, Nakakes A, Sittiwangkul R, Srisuttiyakorn C. Effect of combination of 1064 nm Q-switched Nd:YAG and fractional carbon dioxide lasers for treating exogenous ochronosis. J Cosmet Laser Ther. 2013;15(1):42–5.

    Article  PubMed  Google Scholar 

  56. Schwartz RA. Acanthosis nigricans. J Am Acad Dermatol. 1994;31(1):1–19 (quiz 20–2).

    Article  CAS  PubMed  Google Scholar 

  57. Phiske MM. An approach to acanthosis nigricans. Indian Dermatol Online J. 2014;5(3):239–49.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Sinha S, Schwartz RA. Juvenile acanthosis nigricans. J Am Acad Dermatol. 2007;57(3):502–8.

    Article  PubMed  Google Scholar 

  59. Kutlubay Z, Engin B, Bairamov O, Tuzun Y. Acanthosis nigricans: a fold (intertriginous) dermatosis. Clin Dermatol. 2015;33(4):466–70.

    Article  PubMed  Google Scholar 

  60. Park YJ, Kang HY, Lee ES, Kim YC. Differentiating confluent and reticulated papillomatosis from acanthosis nigricans. J Cutan Pathol (Epub 12 Aug 2015).

  61. Sriboonnark L, Arora H, Falto-Aizpurua L, Choudhary S, Connelly EA. Costello syndrome with severe nodulocystic acne: unexpected significant improvement of acanthosis nigricans after oral isotretinoin treatment. Case Rep Pediatr. 2015;2015:934865.

    PubMed  PubMed Central  Google Scholar 

  62. Rosenbach A, Ram R. Treatment of Acanthosis nigricans of the axillae using a long-pulsed (5-msec) alexandrite laser. Dermatol Surg. 2004;30(8):1158–60.

    PubMed  Google Scholar 

  63. Gregoriou S, Anyfandakis V, Kontoleon P, Christofidou E, Rigopoulos D, Kontochristopoulos G. Acanthosis nigricans associated with primary hypogonadism: successful treatment with topical calcipotriol. J Dermatolog Treat. 2008;19(6):373–5.

    Article  PubMed  Google Scholar 

  64. Niang SO, Kane A, Diallo M, Choutah F, Dieng MT, Ndiaye B. Dermatosis papulosa nigra in Dakar, Senegal. Int J Dermatol. 2007;46(Suppl 1):45–7.

    Article  PubMed  Google Scholar 

  65. Vashi NA, Kundu RV. Facial hyperpigmentation: causes and treatment. Br J Dermatol. 2013;169(Suppl 3):41–56.

    Article  PubMed  Google Scholar 

  66. Lupo MP. Dermatosis papulosis nigra: treatment options. J Drugs Dermatol. 2007;6(1):29–30.

    PubMed  Google Scholar 

  67. Hafner C, Landthaler M, Mentzel T, Vogt T. FGFR3 and PIK3CA mutations in stucco keratosis and dermatosis papulosa nigra. Br J Dermatol. 2010;162(3):508–12.

    Article  CAS  PubMed  Google Scholar 

  68. Babapour R, Leach J, Levy H. Dermatosis papulosa nigra in a young child. Pediatr Dermatol. 1993;10(4):356–8.

    Article  CAS  PubMed  Google Scholar 

  69. Veraitch O, Rickaby W, Robson A, Higgins E, Mellerio JE. Early-onset dermatosis papulosa nigra. Br J Dermatol. 2016;174(5):1148–50.

    Article  CAS  PubMed  Google Scholar 

  70. Garcia MS, Azari R, Eisen DB. Treatment of dermatosis papulosa nigra in 10 patients: a comparison trial of electrodesiccation, pulsed dye laser, and curettage. Dermatol Surg. 2010;36(12):1968–72.

    Article  CAS  PubMed  Google Scholar 

  71. Kundu RV, Joshi SS, Suh KY, Boone SL, Huggins RH, Alam M, et al. Comparison of electrodesiccation and potassium-titanyl-phosphate laser for treatment of dermatosis papulosa nigra. Dermatol Surg. 2009;35(7):1079–83.

    Article  CAS  PubMed  Google Scholar 

  72. Ali FR, Bakkour W, Ferguson JE, Madan V. Carbon dioxide laser ablation of dermatosis papulosa nigra: high satisfaction and few complications in patients with pigmented skin. Lasers Med Sci. 2016;31(3):593–5.

    Article  PubMed  Google Scholar 

  73. Bruscino N, Conti R, Campolmi P, Bonan P, Cannarozzo G, Lazzeri L, et al. Dermatosis Papulosa Nigra and 10,600-nm CO2 laser, a good choice. J Cosmet Laser Ther. 2014;16(3):114–6.

    Article  PubMed  Google Scholar 

  74. Katz TM, Goldberg LH, Friedman PM. Dermatosis papulosa nigra treatment with fractional photothermolysis. Dermatol Surg. 2009;35(11):1840–3.

    Article  CAS  PubMed  Google Scholar 

  75. Hori Y, Kawashima M, Oohara K, Kukita A. Acquired, bilateral nevus of Ota-like macules. J Am Acad Dermatol. 1984;10(6):961–4.

    Article  CAS  PubMed  Google Scholar 

  76. Park JM, Tsao H, Tsao S. Acquired bilateral nevus of Ota-like macules (Hori nevus): etiologic and therapeutic considerations. J Am Acad Dermatol. 2009;61(1):88–93.

    Article  PubMed  Google Scholar 

  77. Ee HL, Wong HC, Goh CL, Ang P. Characteristics of Hori naevus: a prospective analysis. Br J Dermatol. 2006;154(1):50–3.

    Article  CAS  PubMed  Google Scholar 

  78. Murakami F, Soma Y, Mizoguchi M. Acquired symmetrical dermal melanocytosis (naevus of Hori) developing after aggravated atopic dermatitis. Br J Dermatol. 2005;152(5):903–8.

    Article  CAS  PubMed  Google Scholar 

  79. Lee B, Kim YC, Kang WH, Lee ES. Comparison of characteristics of acquired bilateral nevus of Ota-like macules and nevus of Ota according to therapeutic outcome. J Korean Med Sci. 2004;19(4):554–9.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Lam AY, Wong DS, Lam LK, Ho WS, Chan HH. A retrospective study on the efficacy and complications of Q-switched alexandrite laser in the treatment of acquired bilateral nevus of Ota-like macules. Dermatol Surg. 2001;27(11):937–41 (discussion 41–2).

    CAS  PubMed  Google Scholar 

  81. Kunachak S, Kunachakr S, Sirikulchayanonta V, Leelaudomniti P. Dermabrasion is an effective treatment for acquired bilateral nevus of Ota-like macules. Dermatol Surg. 1996;22(6):559–62.

    Article  CAS  PubMed  Google Scholar 

  82. Lee WJ, Han SS, Chang SE, Lee MW, Choi JH, Moon KC, et al. Q-Switched Nd:YAG Laser therapy of acquired bilateral mevus of ota-like macules. Ann Dermatol. 2009;21(3):255–60.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Cho SB, Park SJ, Kim MJ, Bu TS. Treatment of acquired bilateral nevus of Ota-like macules (Hori’s nevus) using 1064-nm Q-switched Nd:YAG laser with low fluence. Int J Dermatol. 2009;48(12):1308–12.

    Article  PubMed  Google Scholar 

  84. Manuskiatti W, Sivayathorn A, Leelaudomlipi P, Fitzpatrick RE. Treatment of acquired bilateral nevus of Ota-like macules (Hori’s nevus) using a combination of scanned carbon dioxide laser followed by Q-switched ruby laser. J Am Acad Dermatol. 2003;48(4):584–91.

    Article  PubMed  Google Scholar 

  85. Tian BW. Novel treatment of Hori’s nevus: a combination of fractional nonablative 2,940-nm Er:YAG and low-fluence 1,064-nm Q-switched Nd:YAG laser. J Cutan Aesthet Surg. 2015;8(4):227–9.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Ee HL, Goh CL, Khoo LS, Chan ES, Ang P. Treatment of acquired bilateral nevus of ota-like macules (Hori’s nevus) with a combination of the 532 nm Q-Switched Nd:YAG laser followed by the 1,064 nm Q-switched Nd:YAG is more effective: prospective study. Dermatol Surg. 2006;32(1):34–40.

    Article  CAS  PubMed  Google Scholar 

  87. Yamaguchi K, Watanabe C, Kawaguchi A, Sato T, Naka I, Shindo M, et al. Association of melanocortin 1 receptor gene (MC1R) polymorphisms with skin reflectance and freckles in Japanese. J Hum Genet. 2012;57(11):700–8.

    Article  CAS  PubMed  Google Scholar 

  88. Ezzedine K, Mauger E, Latreille J, Jdid R, Malvy D, Gruber F, et al. Freckles and solar lentigines have different risk factors in Caucasian women. J Eur Acad Dermatol Venereol. 2013;27(3):e345–56.

    Article  CAS  PubMed  Google Scholar 

  89. Rhodes AR, Albert LS, Barnhill RL, Weinstock MA. Sun-induced freckles in children and young adults. A correlation of clinical and histopathologic features. Cancer. 1991;67(7):1990–2001.

    Article  CAS  PubMed  Google Scholar 

  90. Bastiaens M, ter Huurne J, Gruis N, Bergman W, Westendorp R, Vermeer BJ, et al. The melanocortin-1-receptor gene is the major freckle gene. Hum Mol Genet. 2001;10(16):1701–8.

    Article  CAS  PubMed  Google Scholar 

  91. Gold MH, Gallagher C. An evaluation of the benefits of a topical treatment in the improvement of photodamaged hands with age spots, freckles, and/or discolorations. J Drugs Dermatol. 2013;12(12):1468–72.

    PubMed  Google Scholar 

  92. Mradula PR, Sacchidanand S. A split-face comparative study of 70% trichloroacetic acid and 80% phenol spot peel in the treatment of freckles. J Cutan Aesthet Surg. 2012;5(4):261–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  93. Huang YL, Liao YL, Lee SH, Hong HS. Intense pulsed light for the treatment of facial freckles in Asian skin. Dermatol Surg. 2002;28(11):1007–12 (discussion 12).

    PubMed  Google Scholar 

  94. Ho SG, Yeung CK, Chan NP, Shek SY, Chan HH. A comparison of Q-switched and long-pulsed alexandrite laser for the treatment of freckles and lentigines in oriental patients. Lasers Surg Med. 2011;43(2):108–13.

    Article  CAS  PubMed  Google Scholar 

  95. El Zawahry B, Zaki N, Hafez V, Abdel Hay R, Fahim A. Efficacy and safety of fractional carbon dioxide laser for treatment of unwanted facial freckles in phototypes II-IV: a pilot study. Lasers Med Sci. 2014;29(6):1937–42.

    Article  PubMed  Google Scholar 

  96. Andersen WK, Labadie RR, Bhawan J. Histopathology of solar lentigines of the face: a quantitative study. J Am Acad Dermatol. 1997;36(3 Pt 1):444–7.

    Article  CAS  PubMed  Google Scholar 

  97. Ortonne JP, Pandya AG, Lui H, Hexsel D. Treatment of solar lentigines. J Am Acad Dermatol. 2006;54(5 Suppl 2):S262–71.

    Article  PubMed  Google Scholar 

  98. Dlova NC. Frontal fibrosing alopecia and lichen planus pigmentosus: is there a link? Br J Dermatol. 2013;168(2):439–42.

    Article  CAS  PubMed  Google Scholar 

  99. Rao R, Sarda A, Khanna R, Balachandran C. Coexistence of frontal fibrosing alopecia with lichen planus pigmentosus. Int J Dermatol. 2014;53(5):622–4.

    Article  PubMed  Google Scholar 

  100. Berliner JG, McCalmont TH, Price VH, Berger TG. Frontal fibrosing alopecia and lichen planus pigmentosus. J Am Acad Dermatol. 2014;71(1):e26–7.

    Article  PubMed  Google Scholar 

  101. Patel AB, Kubba R, Kubba A. Clinicopathological correlation of acquired hyperpigmentary disorders. Indian J Dermatol Venereol Leprol. 2013;79(3):367–75.

    Article  PubMed  Google Scholar 

  102. Rieder E, Kaplan J, Kamino H, Sanchez M, Pomeranz MK. Lichen planus pigmentosus. Dermatol Online J. 2013;19(12):20713.

    PubMed  Google Scholar 

  103. Chen S, Sun W, Zhou G, Chen S, Lu X. Lichen planus pigmentosus-inversus: report of three Chinese cases and review of the published work. J Dermatol. 2015;42(1):77–80.

    Article  CAS  PubMed  Google Scholar 

  104. Nijhawan RI, Borkin MS, Wilentz SW. Lichen planus pigmentosus-inversus involving the post-auricular sulci. Dermatol Online J. 2013;19(6):18571.

    PubMed  Google Scholar 

  105. Al-Mutairi N, El-Khalawany M. Clinicopathological characteristics of lichen planus pigmentosus and its response to tacrolimus ointment: an open label, non-randomized, prospective study. J Eur Acad Dermatol Venereol. 2010;24(5):535–40.

    Article  CAS  PubMed  Google Scholar 

  106. Verma P, Pandhi D. Topical tacrolimus and oral dapsone combination regimen in lichen Planus pigmentosus. Skinmed. 2015;13(5):351–4.

    PubMed  Google Scholar 

  107. Kim JE, Won CH, Chang S, Lee MW, Choi JH, Moon KC. Linear lichen planus pigmentosus of the forehead treated by neodymium:yttrium-aluminum-garnet laser and topical tacrolimus. J Dermatol. 2012;39(2):189–91.

    Article  PubMed  Google Scholar 

  108. Han XD, Goh CL. A case of lichen planus pigmentosus that was recalcitrant to topical treatment responding to pigment laser treatment. Dermatol Ther. 2014;27(5):264–7.

    Article  PubMed  Google Scholar 

  109. Muthu SK, Narang T, Saikia UN, Kanwar AJ, Parsad D, Dogra S. Low-dose oral isotretinoin therapy in lichen planus pigmentosus: an open-label non-randomized prospective pilot study. Int J Dermatol. 2016;55(9):1048–54.

    Article  CAS  PubMed  Google Scholar 

  110. Vega ME, Waxtein L, Arenas R, Hojyo T, Dominguez-Soto L. Ashy dermatosis and lichen planus pigmentosus: a clinicopathologic study of 31 cases. Int J Dermatol. 1992;31(2):90–4.

    Article  CAS  PubMed  Google Scholar 

  111. Correa MC, Memije EV, Vargas-Alarcon G, Guzman RA, Rosetti F, Acuna-Alonzo V, et al. HLA-DR association with the genetic susceptibility to develop ashy dermatosis in Mexican Mestizo patients. J Am Acad Dermatol. 2007;56(4):617–20.

    Article  PubMed  Google Scholar 

  112. Torrelo A, Zaballos P, Colmenero I, Mediero IG, de Prada I, Zambrano A. Erythema dyschromicum perstans in children: a report of 14 cases. J Eur Acad Dermatol Venereol. 2005;19(4):422–6.

    Article  PubMed  Google Scholar 

  113. Srivastava N, Solanki LS, Chand S, Garbyal RS, Singh S. Ashy dermatosis-like pigmentation due to ethambutol. Indian J Dermatol Venereol Leprol. 2008;74(3):281–2.

    Article  PubMed  Google Scholar 

  114. Tlougan BE, Gonzalez ME, Mandal RV, Kundu RV, Skopicki D. Erythema dyschromicum perstans. Dermatol Online J. 2010;16(11):17.

    PubMed  Google Scholar 

  115. Zaynoun S, Rubeiz N, Kibbi AG. Ashy dermatoses–a critical review of the literature and a proposed simplified clinical classification. Int J Dermatol. 2008;47(6):542–4.

    Article  PubMed  Google Scholar 

  116. Silverberg NB, Herz J, Wagner A, Paller AS. Erythema dyschromicum perstans in prepubertal children. Pediatr Dermatol. 2003;20(5):398–403.

    Article  PubMed  Google Scholar 

  117. Mahajan VK, Chauhan PS, Mehta KS, Sharma AL. Erythema Dyschromicum Perstans: response to Topical Tacrolimus. Indian J Dermatol. 2015;60(5):525.

    Article  PubMed  PubMed Central  Google Scholar 

  118. Baranda L, Torres-Alvarez B, Cortes-Franco R, Moncada B, Portales-Perez DP, Gonzalez-Amaro R. Involvement of cell adhesion and activation molecules in the pathogenesis of erythema dyschromicum perstans (ashy dermatitis). The effect of clofazimine therapy. Arch Dermatol. 1997;133(3):325–9.

    Article  CAS  PubMed  Google Scholar 

  119. Piquero-Martin J, Perez-Alfonzo R, Abrusci V, Briceno L, Gross A, Mosca W, et al. Clinical trial with clofazimine for treating erythema dyschromicum perstans. Evaluation of cell-mediated immunity. Int J Dermatol. 1989;28(3):198–200.

    Article  CAS  PubMed  Google Scholar 

  120. Fabbrocini G, Cacciapuoti S, Izzo R, Mascolo M, Staibano S, Monfrecola G. Efficacy of narrowband UVB phototherapy in erythema dyschromicum perstans treatment: case reports. Acta Dermatovenerol Croat. 2015;23(1):63–5.

    PubMed  Google Scholar 

  121. Chandran V, Kumarasinghe SP. Macular pigmentation of uncertain aetiology revisited: two case reports and a proposed algorithm for clinical classification. Australas J Dermatol (Epub 1 Feb 2016).

  122. Dedhia A, Someshwar S, Jerajani HR. Idiopathic eruptive macular pigmentation: what is it actually? Int J Dermatol. 2015;54(12):1462–5.

    Article  PubMed  Google Scholar 

  123. Verma S, Thakur BK. Idiopathic eruptive macular pigmentation with papillomatosis. Indian Dermatol Online J. 2011;2(2):101–3.

    Article  PubMed  PubMed Central  Google Scholar 

  124. Riyaz N, Riyaz A, Abdul Latheef EN, Anitha PM, Aravindan KP, Nair AS, et al. Cutaneous manifestations of chikungunya during a recent epidemic in Calicut, north Kerala, south India. Indian J Dermatol Venereol Leprol. 2010;76(6):671–6.

    Article  PubMed  Google Scholar 

  125. Kandhari R, Khunger N, Singh A. Flagellate pigmentation and exacerbation of melasma following chikungunya fever: a less frequently reported finding. Indian J Dermatol Venereol Leprol. 2012;78(6):774.

    Article  PubMed  Google Scholar 

  126. Khandelwal K, Aara N, Ghiya BC, Bumb RA, Satoskar AR. Centro-facial pigmentation in asymptomatic congenital chikungunya viral infection. J Paediatr Child Health. 2012;48(6):542–3.

    Article  PubMed  Google Scholar 

  127. Perez-Bernal A, Munoz-Perez MA, Camacho F. Management of facial hyperpigmentation. Am J Cli Dermatol. 2000;1(5):261–8.

    Article  CAS  Google Scholar 

  128. Luna PC, Abad ME, Gonzalez VM, Vigovich F, Casas JG, Larralde M. Erythrosis pigmentosa peribuccalis in an adolescent: dermoscopic description and management. Pediatric Dermatol. 2016;33(2):e65–8.

    Article  Google Scholar 

  129. Bovenschen HJ, Seyger MM. Erythrosis pigmentosa mediofacialis: familial occurrence. Acta Dermatovenereol. 2009;89(2):210–1.

    Google Scholar 

  130. Al Hawsawi K, Aljuhani O, Niaz G, Fallatah H, Alhawsawi A. Erythromelanosis follicularis faciei: a case report and review of the literature. Case Rep Dermatol. 2015;7(3):335–9.

    Article  PubMed  PubMed Central  Google Scholar 

  131. Hawayek LH, Rubeiz N. Poikiloderma of civatte workup. Medscape; 2014.

  132. Katoulis AC, Stavrianeas NG, Georgala S, Bozi E, Kalogeromitros D, Koumantaki E, et al. Poikiloderma of Civatte: a clinical and epidemiological study. J Eur Acad Dermatol Venereol. 2005;19(4):444–8.

    Article  CAS  PubMed  Google Scholar 

  133. Katoulis AC, Stavrianeas NG, Georgala S, Katsarou-Katsari A, Koumantaki-Mathioudaki E, Antoniou C, et al. Familial cases of poikiloderma of Civatte: genetic implications in its pathogenesis? Clin Exp Dermatol. 1999;24(5):385–7.

    Article  CAS  PubMed  Google Scholar 

  134. Salman SM, Kibbi AG, Zaynoun S. Actinic lichen planus. A clinicopathologic study of 16 patients. J Am Acad Dermatol. 1989;20(2 Pt 1):226–31.

  135. Salman SM, Khallouf R, Zaynoun S. Actinic lichen planus mimicking melasma. A clinical and histopathologic study of three cases. J Am Acad Dermatol. 1988;18(2 Pt 1):275–8.

  136. Wang L, Xu AE. Four views of Riehl’s melanosis: clinical appearance, dermoscopy, confocal microscopy and histopathology. J Eur Acad Dermatol Venereol. 2014;28(9):1199–206.

    Article  CAS  PubMed  Google Scholar 

  137. Mohan RP, Verma S, Singh AK, Singh U. ‘Nevi of Ota: the unusual birthmarks’: a case review. BMJ Case Rep. 2013;2013:PII:BCR2013008648.

  138. Goyal S, Uwaydat SH, Phillips PH, Schaefer GB. Bilateral familial nevus of Ota. J AAPOS. 2014;18(6):609–10.

    Article  PubMed  Google Scholar 

  139. Trese MT, Pettit TH, Foos RY, Hofbauer J. Familial Nevus of Ota. Ann Ophthalmol. 1981;13(7):855–7.

    CAS  PubMed  Google Scholar 

  140. Lindsey SF, Sanchez MI, Elgart GW, Milikowski C, Civantos FJ, Goldberg J, et al. Malignant melanoma from a nevus of Ota in a pediatric patient with fatal outcome. J Am Acad Dermatol. 2013;69(4):e195–7.

    Article  PubMed  Google Scholar 

  141. Samadian M, Nejad AM, Bakhtevari MH, Sabeti S, Sharifi G, Jabbari R, et al. Primary meningeal melanocytoma in the left temporal lobe associated with nevus ota: a case report and review of the literature. World Neurosurg. 2015;84(2):567–73.

    Article  PubMed  Google Scholar 

  142. Goldman-Levy G, Rigau V, Blechet C, Bens G, Muckensturm B, Delage M, et al. Primary melanoma of the leptomeninges with BAP1 expression-loss in the setting of a nevus of ota: a clinical, morphological and genetic study of 2 cases. Brain Pathol. 2016;26(4):547–50.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Dermatology, Boston University School of Medicine, Boston, MA, USA

    Neelam A. Vashi & Stephen A. Wirya

  2. Howard University College of Medicine, Washington, DC, USA

    Meyene Inyang

  3. Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 1600, Chicago, IL, 60611, USA

    Roopal V. Kundu

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  1. Neelam A. Vashi
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Correspondence to Roopal V. Kundu.

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Neelam A Vashi, Stephen A Wirya, Meyene Inyang, and Roopal V. Kundu have no conflicts of interest.

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Vashi, N.A., Wirya, S.A., Inyang, M. et al. Facial Hyperpigmentation in Skin of Color: Special Considerations and Treatment. Am J Clin Dermatol 18, 215–230 (2017). https://doi.org/10.1007/s40257-016-0239-8

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