Postinflammatory Hyperpigmentation Following Mohs Micrographic Surgery: An Observational Study

Area of Science:

• Dermatology
• Surgical Oncology
• Cosmetic Science

Background:

• Functional and cosmetic outcomes of Mohs micrographic surgery (MMS) in skin of color (SOC) are understudied.
• Postinflammatory hyperpigmentation (PIH) can be a significant and distressing outcome for SOC patients following dermatologic procedures.

Purpose of the Study:

• To identify and characterize factors contributing to the development of PIH after Mohs micrographic surgery in individuals with skin of color.

Main Methods:

• Retrospective study of 72 SOC individuals undergoing Mohs micrographic surgery for keratinocyte carcinoma.
• Data collected from August 2020 to August 2021 at a single medical center.

Main Results:

• PIH was more frequent in Fitzpatrick skin types IV-V (48.0%) compared to I-III (18.2%).
• Grafts and granulation led to higher PIH rates (87.5%) than linear repairs/flaps (30.7%).
• Postoperative complications (81.8%) and specific sutures (polyglactin 910, 46.2%) also increased PIH risk.

Conclusions:

• Individuals with SOC, particularly Fitzpatrick skin types IV-V, face a higher risk of PIH post-MMS.
• Surgical techniques (grafts, granulation) and postoperative complications are significant risk factors for PIH.
• Surgeons should consider these factors to mitigate PIH in SOC patients undergoing Mohs surgery.