Titanium pigmentation. An electron probe microanalysis study.

Area of Science:

• Dermatology
• Toxicology
• Materials Science

Background:

• Titanium dioxide (TiO2) is a widely used compound in sunscreens and cosmetics.
• Pigmentary diseases can arise from exogenous substances.
• Balanitis is inflammation of the glans penis.

Observation:

• A patient presented with a xanthoma-like (yellowish, lipid-rich deposit) appearance on the penis.
• This condition developed after the application of a topical cream containing titanium dioxide.
• The clinical presentation mimicked a lipid disorder but was localized to the application site.

Findings:

• Electron probe microanalysis (EPM) identified titanium dioxide particles within the affected skin.
• EPM confirmed that the topical titanium dioxide was the causative agent of the pigmentary change and balanitis.
• Histopathological examination supported the diagnosis of a TiO2-induced pigmentary deposition.

Implications:

• This case highlights a rare adverse reaction to topical titanium dioxide.
• It underscores the importance of considering exogenous substances in the differential diagnosis of pigmentary disorders.
• Electron probe microanalysis is a valuable tool for identifying inorganic material-induced skin conditions.