Updated: 12/28/2021

Hyperpigmentation Disorders

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  • Overview
    • Freckle
      • Caused by normal number of melanocytes but increased melanin within basal keratinocytes
      • Darkens with sun exposure

      Lentigo
      • Pigmented macule caused by melanocyte hyperplasia
      • Does not darken with sun exposure
      Common mole
      • A benign tumor derived from melanocytes

      Photo

      Blue nevus
      • Form of common mole, a benign tumor derived from melanocytes
      • Black and blue nodule usually present at birth
      • Often mistaken for melanoma

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      Spitz nevus
      • Form of common mole, a benign tumor derived from melanocytes
      • Red-pink nodule
      • Often seen in children
      • Confused with hemangioma

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      Dysplastic nevus
      • Atypical, irregularly pigmented lesion
      • Increased risk of transformation into malignant melanoma

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      Dysplastic nevus synrome
      • Autosomal dominant inherited disease

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      Melasma
      • Mask-like hyperpigmentation seen in pregnancy on the face
      • Sunlight accentuates, soavoid sunlight
      • Treat with hydroquinone cream
      • Usually fades postpartum

      Xanthoma
      • Yellowish papules
      • Often accumulations of histiocytes
      • Can be idiopathic or associated with hyperlipidemia
      • Called xanthelasma when on eyelids
      • Treat by decreasing lipidemia
      • Surgically excise as needed

      Photo

      Acanthosis nigricans
      • Black, velvety plaques on flexor surfaces
      • Seen in obesity and endocrine disorders, namely insulin resistance
      • Can mark underlying malignancy

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      Seborrheic keratosis
      • Black or brown benign plaques
      • Appear to be stuck on skin
      • "Coin lesions"
      • Commonly seen in the elderly
      • Runs in families
      • Can be mistaken for melanoma
      • Liquid nitrogen freezing, if not too many

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(M2.DM.15.4691) A 32-year-old obese man visits your dermatology clinic after his barber saw a darkened area on the back of his neck. He has not seen his primary care physician in many years and does not know if he has diabetes. A rapid blood glucose test showed a normal glucose level. Otherwise, he reports recent loss of appetite with slight weight loss. What could be causing this patient’s newly-discovered dermatologic change?

QID: 107645
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Diabetes insipidus

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