Face Hyperpigmentation

Facial hyperpigmentation if localised would be a lentigene or Hutchison's melanotic freckle,Melasma in females or part of an epidermal or congenital nevus.Ochronosis can arise from treatment with hydroquinone.Generalised hyperpigmetation is summarised in the overview below.

SIGN DIP MEN  Overview of Hyperpigmentation

 

S-Squamous   Resolved lichen planus

 

I-Infective

 

G-Granulomatous

 

N-Neoplastic  Melanoma metastases,Lung carcinoma,Lymphoma

 

D-Drugs   Melasma, Fixed drug eruption,bleomycin,arsenic,gold and cyclophosphamide,Puva

 

I-Immunological Scleroderma,lupus erythematosus and dermatomyositis

 

P-Physical  Post sunburn,Post taumatic,Racial pigmentary demarcation lines,Phototoxic hyperpigmentation (Plants),Vagabond’s disease

 

M-Metabolic  Addison’s disease,Porphyria cutanea tarda,Hemochromatosis,Renal and hepatic failure,Amyloidosis

 

E-Endocrine   Hyperthyroidism,Pregnancy,Cushings,Acromegally,Thyrotoxicosis,Pheochromocytoma

 

N-Nutritional  Pellagra,Malabsorption

 

Others

Eyelids  Familial,nevoid,metabolic diseases such as ochronosis,chemical such as mercury ointments and psoralens and argyria,lichen planus,lichen aureus,melanoacanthoma and some endocrine diseases.

Reticulate Pigmentation  Dowling Degos(flexures),Zosteriform,Dyskeratosis congenita,Naegeli Franceschetti syndrome(neck axillae,keratoderma),Acropigmentations of Kitamura and Dohi

 

Localised hyperpigmentation  DAMN PIG PAPA

 

Drugs Fixed drug plus antimalarials,minocycline,cytotoxics,bleomycin(reticulate pigmentation),mercury and bismuth.

Autoimmune Scleroderma,lupus erythematosus,dermatomyositis,atrophoderma,

Metabolic Ochronosis,chloasma,gaucher's disease,

Neoplastic Lymphoma,melanoma,mastocytosis,

P erythema dyschromicum perstans,postinflammatory hyperpigmentation lichen planus,

Infective erythrasma,tinea nigra

Granulomatous leprosy,granuloma annulare,syphilis

P Parapsoriasis,A Amyloid,P Pigmented purpuric dermatosis,A acanthosis nigricans