Hyperpigmentation disorders of the skin are common. Three of the more common forms include melasma, lentigines, and post-inflammatory hyperpigmentation. Significant negative psychological consequences can result.
Hori's nevus, also known as acquired bilateral nevus of Ota-like macules (ABNOM), or acquired dermal melanocytosis (ADM), presents as bilateral facial bluish-gray macules. Seen in 0.8% of the Asian population, Hori's nevus typically affects the malar region, but the lateral temples, alae nasi, eyelids, and forehead can also be involved. Unlike nevus of Ota, the pigmentation in Hori's nevus is acquired and does not involve the mucosa. Not uncommonly, melasma and Hori's nevus can present concurrently.
Post-inflammatory hyperpigmentation (PIH) is a common pigmentary disorder in melanin-rich Asian skin. PIH can be considered the default pathophysiologic response to cutaneous injury in such individuals. Several factors contribute to the development of PIH, including increased melanocytic activities, dermal melanophages, and hemosiderin deposition secondary to hemorrhage.
Melasma is an acquired symmetric hypermelanosis involving sun-exposed areas commonly seen in Asian middle-aged women. Genetics, UV radiation, pregnancy, hormonal therapies, and other phototoxic drugs are all thought to be contributing etiologic factors and melasma remains a difficult condition to treat. Melasma was formerly classified histopathologically as epidermal, dermal, or mixed type depending on the location of the pigment.
Freckles and lentigines are common benign pigmented lesions seen in Asians. As the cultural trend in Asians moves towards fair porcelain skin, these pigmented lesions can often present in dermatology outpatients as a cosmetic concern.Freckles or ephelides occur in adolescence and are relatively uniform in distribution, size, and color. Histopathologically, epidermal hypermelanosis without an increase in melanocyte number is seen. Lentigines increase in number and prevalence with age. They tend to vary in size and color and are non-uniformly distributed.
• Specific laser for specific pigmentation treatment is mandatory
• Combination with other modalities like supplement, skin care, hydration, lifestyle changes will fasten the result and effects.