Clinical and Demographic Characteristics of The Patients with Diffuse Hyperpigmentation

• Published in: Southern Clinics of Istanbul Eurasia Vol. 31; no. 3; pp. 272 - 280
• Main Author: AKBAS, Ayse
• Format: Journal Article
• Language: English
• Published: Istanbul Kare Publishing 01.01.2020; KARE Publishing
• Subjects: Age groups; Amyloidosis; Anemia; Cardiovascular disease; Dermatology; epidemiology; erythema discromicum perstans; hyperpigmentation; Erythema; Females; Gender; Laboratories; Localization; Medical diagnosis; Outpatient care facilities; Patients; Skin; Skin diseases; Thyroid gland; Vitamin deficiency
• ISSN: 2587-0998; 2587-1404; 2587-0998
• DOI: 10.14744/scie.2019.43534

INTRODUCTION: Hyperpigmentation is a condition characterized by the accumulation of pigment in the epidermis and dermis. Many dermatological diseases, such as primary cutaneous amyloidosis (PCA), postinflammatory hyperpigmentation (PIH), erythema discromicum perstans (EDP), notalgia paresthetica (NP), drug reaction (DR), may lead to acquired hyperpigmentation on the skin. The aim of this study is to investigate etiologic factors, clinical and demographic features, laboratory findings and treatment options in patients with generalized hyperpigmentation. METHODS: Forty four patients who presented to our outpatient clinic with complaints of hyperpigmentation were evaluated retrospectively. Patients were examined in terms of age, duration and localization of lesions, accompanying symptoms or diseases, laboratory findings and treatment options. RESULTS: When pigmentation-causing diseases are listed; PCA was detected in 50% of the cases. Of these, 72.7% (n=16) were macular amyloidosis, 22.7% (n=5) were lichen amyloidosis, and 4.6% (n=1) were biphasic amyloidosis. Others were 29.5% (n=13) PIH, 13.6% (n=6) EDP, 4.6% (n=2) NP, 2.3% (n=1) DR. The ages of the patients were generally between 20-69 years. The average age was mean 47.8 years (48.8 for females and 45.0 for males). The duration of pigmentation ranged from 3 months to 20 years (mean 6.8 years). 75% (n=33) of the patients had itching. About half of the lesions were located on the back. Half of the patients had a concomitant disease. As treatment options, 9 patients were treated with phototherapy, 9 with isotretinoin, 12 with depigmentation, and one with pregabalin and topical steroids. DISCUSSION AND CONCLUSION: Knowing the conditions that cause hyperpigmentation facilitates the diagnosis of the disease. In this study, PCA was detected in half of the patients with clinically considered hyperpigmentation. Therefore, the diagnosis of PCA should be considered first in patients with pruritic and diffuse pigmentation.