Acquired Bilateral Dyspigmentation on Face and Neck: Clinically Appropriate Approaches

Area of Science:

• Dermatology
• Pathology

Background:

• Facial dyspigmentation presents significant diagnostic and therapeutic challenges, particularly in Asian women.
• A specific bilateral facial and neck hyperpigmentation has been increasingly observed.

Purpose of the Study:

• To investigate the clinico-pathological features of acquired bizarre facial and neck hyperpigmentation.
• To determine effective treatment strategies for this condition.

Main Methods:

• Retrospective analysis of 31 patients with acquired bizarre hyperpigmentation on the face and neck.
• Inclusion of clinical data, routine laboratory tests, histopathologic studies (lesional and peri-lesional skin), and patch tests.
• Evaluation of treatment outcomes for patients managed with a step-by-step approach.

Main Results:

• The average patient age was 52.3 years, with a mean duration of dyspigmentation of 24.2 months.
• Histopathology revealed increased basal layer liquefactive degeneration, pigmentary incontinence, and lymphocytic infiltration.
• Topical anti-inflammatory agents, moisturizers, and laser therapy demonstrated clinical benefits in treated patients.

Conclusions:

• The findings suggest a distinct acquired hyperpigmentary disorder associated with subclinical inflammation.
• A systematic evaluation and management of underlying subclinical inflammation are crucial for successful treatment.
• This approach can lead to significant clinical improvement in patients with this condition.