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
Blue nevus	Form of common mole, a benign tumor derived from melanocytes Black and blue nodule usually present at birth Often mistaken for melanoma
Spitz nevus	Form of common mole, a benign tumor derived from melanocytes Red-pink nodule Often seen in children Confused with hemangioma
Dysplastic nevus	Atypical, irregularly pigmented lesion Increased risk of transformation into malignant melanoma
Dysplastic nevus synrome	Autosomal dominant inherited disease
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
Acanthosis nigricans	Black, velvety plaques on flexor surfaces Seen in obesity and endocrine disorders, namely insulin resistance Can mark underlying malignancy
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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Questions (2)

(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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Hypothyroidism

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Gastric adenocarcinoma

71%

(5/7)

Diabetes insipidus

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Diabetes mellitus

29%