INFILTRATIVE DISEASES
Amyloidosis, macular
BJD 145:851–852, 2001; Rook
p.2628–2630, 1998, Sixth Edition; primary cutaneous
amyloidosis – periorbital hyperpigmentation
Clin Exp Derm
8:195–197, 1983; lichen and macular amyloidosis AD
133:381–386, 1997; BJD 84:199–209, 1971; primary localized
cutaneous amyloid
AD 123:1557–1562, 1987
Mastocytosis – urticaria pigmentosa
Ghatan p.6, 2002, Second
Edition
INFLAMMATORY DISEASES
Celiac disease – darkening of hair
BJD 146:325–329, 2002
Interstitial granulomatous dermatitis – hyperpigmented and/or
poikilodermatous plaques
JAAD 46:892–899, 2002; Am J
Dermatopathol 21:320–323, 1999
Post-inflammatory hyperpigmentation – in blacks especially in
acne vulgaris, dermatitis, lichenification, sarcoidosis, psoriasis,
CTCL, lichen planus, fixed drug eruptions, lupus erythematosus
Rook p.1786, 1998, Sixth Edition; Cutis 32:352–360, 1983;
post-inflammatory darkening of hair
BJD 146:325–329, 2002;
vulvar
Genital Skin Disorders, Fischer and Margesson, CV
Mosby, 1998, p.189
Sarcoid
Am J Med 35:67–89, 1963
METABOLIC DISEASES
Addison’s disease – darkening of hair and nevi
Rook
p.1779,2706, 1998, Sixth Edition; perianal hyperpigmentation
Rook p.3179, 1998, Sixth Edition; linear brown hyperpigmention
of nails
Ghatan p.78, 2002, Second Edition
Androgen excess – hyperpigmentation of areolae, axillae,
external genitalia, perineum
Ghatan p.165, 2002,
Second Edition
Carcinoid syndrome – pellagrous dermatitis (skin fragility,
erythema, and hyperpigmentation over knuckles), flushing,
patchy cyanosis, hyperpigmentation, telangiectasia, pellagrous
dermatitis, salivation, lacrimation, abdominal cramping,
wheezing, diarrhea
BJD 152:71–75, 2005; AD 77:86–90, 1958
Cirrhosis – circumscribed areas of hyperpigmentation with
accentuation of freckling, areolar pigmentation, perioral and
periorbital pigmentation
JAAD 43:1–16, 2000
Cryoglobulinemia – reticulated pigmentation due to resolved
livedo reticularis
Fanconi’s anemia
Folic acid deficiency – hyperpigmentation of the flexures; finger
and palmar creases, knuckles; spotty pigmentation of palms
and soles
JAAD 12:914–917, 1985
Gaucher’s disease – melasma-like pigmentation of face, neck,
hands; symmetric pigmentation of lower legs with sharp lower
margin and irregular upper margin; hyperpigmented wedge-
shaped thickening of bulbar conjunctiva
Rook p.1778–1779,
1998, Sixth Edition
Hemochromatosis
Medicine 34:381–430, 1955
Hemolytic anemia – hyperpigmentation and hemosiderosis of
lower legs
Rook p.1783,1794, 1998, Sixth Edition
Hyperthyroidism – patchy hyperpigmentation or diffuse
Addisonian hyperpigmentation sparing oral mucosa
JAAD
26:885–902, 1992; hyperpigmentation of eyelids (Jellinek’s
sign); melasmic hyperpigmentation
BJD 76:126–139, 1964
Idiopathic thrombocytopenic purpura with iron overload – legs
Kwashiorkor – facial pigmentation; vitamin B complex
deficiency, folic acid deficiency, iron deficiency, tryptophan
Cutis
67:321–327, 2001
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