Periorbital pigmentation: An alarming sign of metabolic syndrome

Periorbital pigmentation is a commonly encountered condition which presents clinically as bilateral round, oval or semicircular homogenous dark brown pigmented macules in the periocular region. It may influence quality of life of an individual with its strong psychological impact. We present a case of middle-aged female patient, who had periorbital pigmentation as a manifestation of acanthosis nigricans. On evaluation, she was found to have hypertension, hyperglycemia, and dyslipidemia and she fulfilled the criteria for metabolic syndrome. We believe, it is important to evaluate the patients who present as periorbital pigmentation with clinical features of acanthosis nigricans for underlying metabolic syndrome.