Poster presentation, P95

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

Periorbital hyperpigmentation amongst the Singaporean population: a proposed classification and epidemiological review

BACKGROUND: Periorbital hyperpigmentation refers to a condition that presents with a dark area on the lower and occasionally on the upper eyelids. It is an ill-defined condition. Numerous attempts have been made to classify the condition but the pathogenesis of this condition remains unknown. AIMS: This study was conducted to assess the prevalence and characteristics of periorbital hyperpigmentation in patients attending a tertiary dermatology referral centre in Singapore. We also propose a classification for periorbital hyperpigmentation. MATERIALS AND METHODS: 1000 consecutive patients aged 18-70 years old, attending the tertiary dermatology referral centre in Singapore were enrolled into the study to assess for periorbital hyperpigmentation. 200 consecutive patients who reported having periorbital hyperpigmentation were examined and investigated to define the causes of their periorbital hyperpigmentation. Of the 200, 16 cases were excluded from the study because of refusal to be photographed or absence of periorbital hyperpigmentation visible on examination. The causes of periorbital hyperpigmentation were determined by taking a detailed history,clinical examination and assessment of photographs by all 3 authors. The mexameter was used to measure the degree of melanin and erythema on the affected parts of the eyelids. RESULTS: The commonest type of periorbital hyperpigmentation observed was the “vascular” type (41.8%) followed by the “constitutional” type (38.6%), “post inflammatory hyperpigmentation” type (12%) and lastly by “shadow effects” (11.4%). Subgroup analysis of the “vascular” type showed that 66.2% were due to “capillaries”, 15.6% were due to prominent underlying blue “veins” and 18.2% were due to a combination of prominent capillaries and veins. The “vascular” type of periorbital hyperpigmentation was predominantly seen in the lighter skin type I-IV eg the Chinese, where-as the constitutional type was most commonly seen in the darker skin type V-VI eg the Indians and Malays. These findings were statistically tested using Tukey’s multiple comparisons test among proportions and found to be statistically significant. CONCLUSION: In conclusion, with this study we propose a classification for periorbital hyperpigmentation. This was a preliminary study to identify the predominant type of periorbital hyperpigmentation in the local population. Larger studies are needed before embarking on clinical trials to address the cond

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