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Acquired dermal macular hyperpigmentation: a unified spectrum of dermal pigmentary dermatoses

Vignesh Narayan R1, Vishal Thakur2, Anuradha Bishnoi3,4

  • 1Department of Dermatology, New Varalakshmi Hospital, Bangalore, India.

Clinical and Experimental Dermatology
|February 17, 2026
PubMed

Insights

Acquired Dermal Macular Hyperpigmentation (ADMH) is a group of skin pigment disorders. This review unifies these conditions, discussing their causes, diagnosis, and treatments.

Area of Science:

  • Dermatology
  • Pathology

Background:

  • Acquired Dermal Macular Hyperpigmentation (ADMH) comprises lichen planus pigmentosus, erythema dyschromicum perstans, and Riehl's melanosis.
  • These conditions are characterized by grey-brown macules and patches from dermal melanin deposition.
  • ADMH is a unifying term due to overlapping clinical, dermoscopic, and histopathological features.

Purpose of the Study:

  • To provide a focused review of Acquired Dermal Macular Hyperpigmentation (ADMH).
  • To discuss the pathogenesis, clinical presentation, diagnostic approaches, and therapeutic strategies for ADMH.

Main Methods:

  • Literature review of existing studies on ADMH.
  • Synthesis of information on clinical, dermoscopic, and histopathological findings.
  • Analysis of current understanding of ADMH pathogenesis and treatment.

Main Results:

  • ADMH conditions share significant overlapping features, justifying a unified classification.
  • Understanding the pathogenesis is key to differentiating and managing ADMH.
  • Various diagnostic methods are available, including clinical examination and histopathology.

Conclusions:

  • ADMH represents a spectrum of related pigmentary disorders.
  • Further research into pathogenesis may reveal targeted therapies.
  • A comprehensive approach integrating clinical and histopathological data aids diagnosis and management.

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