hyperpigmentation


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Hyperpigmentation

 

Definition

Hyperpigmentation is the increase in the natural color of the skin.

Description

Melanin, a brown pigment manufactured by certain cells in the skin called melanocytes, is responsible for skin color. Melanin production is stimulated by a pituitary hormone called melanocyte stimulating hormone (MSH). Other pigments appear in the skin much less often.

Causes and symptoms

Darkened spots on the skin come in several varieties. The most ominous is malignant melanoma, a very aggressive cancer that begins as an innocent mole. The majority of moles (nevus), however, are and remain benign (harmless). The average person has several dozen, and certain people with a hereditary excess may have hundreds. Freckles, age spots, and cafe au lait spots, known as ephelides, are always flat and not as dark. Cafe au lait spots are seen mostly in people with another hereditary disorder called neurofibromatosis. "Port wine stains" are congenital dark red blotches on the skin. Other common dark colorations on the skin are called keratosis and consist of locally overgrown layers of skin that are dark primarily because there is more tissue than normal. A few of these turn into skin cancers of a much less dangerous kind than melanoma.
Darkened regions of the skin occur as a result of abnormal tanning when the skin is sensitive to sunlight. Several diseases and many drugs can cause photosensitivity. Among the common drugs responsible for this uncommon reaction are birth control pills, antibiotics (sulfonamides and tetracyclines), diuretics, nonsteroidal anti-inflammatory drugs (NSAID), pain relievers, and some psychoactive medications. Some of the same drugs may also cause patches of discolored skin known as localized drug reactions and representing an allergy to that drug. Sunlight darkens an abnormal chemical in the skin of patients with porphyria cutanea tarda. Several endocrine diseases, some cancers, and several drugs abnormally stimulate melanocytes, usually through an overproduction of MSH. Arsenic poisoning and Addison's disease are among these causes. A condition known as acanthosis nigricans is a velvety darkening of skin in folded areas (arm pits, groin, and neck) that can signal a cancer or hormone imbalance.
Of particular note is a condition called melasma (dark pigmentation of the skin), caused by the female hormone estrogen. Normal in pregnancy, this brownish discoloration of the face can also happen with birth control pills that contain estrogen.
Overall darkening of the skin may be due to pigmented chemicals in the skin. Silver, gold, and iron each have a characteristic color when visible in the skin. Several drugs and body chemicals, like bilirubin, can end up as deposits in the skin and discolor it.
There are a number of other rare entities that color the skin, each in its own peculiar way. Among these are strange syndromes that seem to be birth defects and vitamin and nutritional deficiencies.

Diagnosis

The pattern of discoloration is immediately visible to the trained dermatologist, a physician specializing in skin diseases, and may be all that is required to name and characterize the discoloration. Many of these pigment changes are signs of internal disease that must be identified. Pigmentation changes may also be caused by medication, and the drug responsible for the reaction must be identified and removed.

Treatment

Skin sensitive to sunlight must be protected by shade or sunscreens with an SPF of 15 or greater. Skin cancers must be, and unsightly benign lesions may be, surgically removed. Laser surgery is an effective removal technique for many localized lesions. Because it spreads so rapidly, melanoma should be immediately removed, as well as some of the surrounding tissue to prevent regrowth.

Prevention

Sunlight is the leading cause of dark spots on the skin, so shade and sunscreens are necessary preventive strategies, especially in people who burn easily.

Resources

Periodicals

Bernstein L. J., et al. "The Short- and Long-term Side Effects of Carbon Dioxide Laser Resurfacing." Dermatologic Surgery 23 (July 1997): 519-525.

Key terms

Addison's disease — A degenerative disease that is characterized by weight loss, low blood pressure, extreme weakness, and dark brown pigmentation of the skin.
Dermatologist — A physician specializing in the study of skin conditions and diseases
Diuretic — A cause of increased urine flow.
Keratosis — A skin disease characterized by an overgrowth of skin, which usually appears discolored.
Lesion — Any localized abnormality.
Melasma — Dark pigmentation of the skin.
Neurofibromatosis — Otherwise known as von Recklinghausen's disease, consists of pigmented skin spots and numerous soft tumors all over the body.
Nevus — Birthmark or mole.
NSAID — Nonsteroidal anti-inflammatory drugs—aspirin, ibuprofen, naproxen, and many others.
Porphyria cutanea tarda — An inherited disease that results in the overproduction of porphyrins.
Syndrome — Common features of a disease or features that appear together often enough to suggest they may represent a single, as yet unknown, disease entity.

hyperpigmentation

 [hi″per-pig″men-ta´shun]
abnormally increased pigmentation.

hy·per·pig·men·ta·tion

(hī'pĕr-pig'men-tā'shŭn),
An excess of pigment in a tissue or part.

hyperpigmentation

/hy·per·pig·men·ta·tion/ (-pig″men-ta´shun) abnormally increased pigmentation.

hyperpigmentation

(hī′pər-pĭg′mən-tā′shən)
n.
Excess pigmentation, especially of the skin.

hyperpigmentation

[-pig′məntā′shən]
Etymology: Gk, hyper + L, pigmentum, paint
a darkening of the skin. Causes include heredity, drugs, exposure to the sun, trauma, and adrenal insufficiency. Compare hypopigmentation. See also chloasma, melanocyte-stimulating hormone.

hy·per·pig·men·ta·tion

(hī'pĕr-pig-men-tā'shŭn)
An excess of pigment in a tissue or part.

hyperpigmentation

Abnormally increased numbers of pigment cells (melanocytes) in a particular area of the body.

hyperpigmentation

excess pigmentation; characteristic of sun-exposed skin in vitamin-deficiency states (e.g. pellagra) and amiodarone medication

hy·per·pig·men·ta·tion

(hī'pĕr-pig-men-tā'shŭn)
An excess of pigment in a tissue or part.

hyperpigmentation,

n an unusual darkening of the skin. Causes include heredity, drugs, exposure to the sun, and adrenal insufficiency.

hyperpigmentation

abnormally increased pigmentation.
References in periodicals archive ?
It's important to avoid undertreating patients, especially darker-skinned patients, where ongoing subclinical inflammation may contribute to hyperpigmentation.
It was noted that only hyperpigmentation and half-and-half nails were more frequent in patients with CKD of [greater than or equal to]3 year duration (P<0.
The lesions may result in long standing hyperpigmentation, especially in dark skinned patients.
leprae leading to phlebitis and subsequent minocycline induced hyperpigmentation at the site of inflammation, since the patient developed these lesions after he was started on minocycline and the lesions improved after stopping it.
BRIGHTEN: Thiotaine[R] - a natural antioxidant amino acid (Ergothionine) that prevents collagen degradation and hyperpigmentation by chelating copper, inhibiting Melanin and Tyrosinase production and stimulating cellular repair.
She did not begin any new medication or vaccines prior to onset of the hyperpigmentation and denied ever having chlorpromazine, tricyclics, tetracyclines, amiodarone, hormone replacement therapy, aspirin, chemotherapy or minocycline.
Photodistribution of blue-gray hyperpigmentation after amiodarone treatment: molecular characterization of amiodarone in the skin.
To make sure you prevent any further hyperpigmentation, wear SPF 50 every day.
Somabella Laboratories LLC's Specific Beauty brand offers a line of skin care products that deal with uneven skin tone, or hyperpigmentation, a major concern among women of color.
The most common complaint among her patients is hyperpigmentation, or uneven skin tone, she says.