Oral communication, CS3 / C9

Official XXIst International Pigment Cell Conference website - 21-24 Sept 2011, Bordeaux - France | updated: September 04 2011

Diagnostic utility of dermatoscopy in hydroquinone induced exogenous ochronosis

SPEAKER R. Dhurat #whois submiter ?
AUTHOR(s) R. Dhurat, S. Mishra, C. Nayak, D. Deshpande

Hydroquinone is the preferred topical bleaching agent used in the treatment of melasma. The adverse effects of its chronic use are confetti-like depigmentation and exogenous ochronosis. Exogenous ochronosis manifests clinically with gray-brown or blue-black hyperpigmentation, as well as pinpoint hyperchromic caviar like papules over the malar region. Dermatoscopic findings of ochronosis are unique and point towards a clue for its diagnosis. We report three cases of hydroquinone-induced exogenous ochronosis while treating melasma. Dermatoscopy performed in patients on the areas of caviar like hyperpigmentation revealed accentuation of the normal pseudo-rete of the facial skin with amorphous densely pigmented structures obliterating some follicular opening and multiple thin, short arciform structures. On histopathological examination, curved ochre-colored structures, ‘banana-shaped’ fibers, were seen in the dermis of all patients. Exogenous ochronosis is an avoidable dermatosis and is difficult to treat. Dermatologists should be able to differentiate it from melasma and immediately discontinue hydroquinone. Exogenous ochronosis can be easily diagnosed on dermatoscopy which obviates the need of an invasive procedure of cutaneous biopsy.



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Université de Bordeaux 2 & Conseil Régional Aquitaine