Topical Treatments for Melasma and Postinflammatory Hyperpigmentation

Postinflammatory Hyperpigmentation (PIH)

PIH represents a pathophysiologic response to cutaneous inflammation, such as acne, atopic dermatitis, lichen planus, and psoriasis. Similar to melasma, it is more obvious in patients with brown or black skin.[8] It has no gender or age predominance.[10] The lesions are characteristically limited to the site of the preceding inflammation and have indistinct, feathered borders.[7] Melanocytes can either be stimulated by the inflammatory process to become hypertrophic, thus secreting more melanin, or the number of melanocytes can increase. Epidermal hyperpigmentation (e.g., associated with acne) occurs when increased melanin is transferred to keratinocytes while dermal pigmentation (e.g., associated with lichen planus and cutaneous lupus erythematosus) occurs when the basement membrane is disrupted and melanin falls into the dermis and resides within melanophages.[8]

Any inflammatory disorder can be associated with PIH, including: Acne vulgaris

Atopic dermatitis

Discoid lupus erythematosus

Erythema dyschromicum perstans

Fixed drug eruption

Generalized drug eruption

Idiopathic eruptive macular pigmentation

Impetigo

Insect bites

Irritant and allergic contact and photocontact-dermatitis

Lichen planus

Lichen simplex chronicus

Morphea

Pityriasis rosea

Polymorphous light eruption

Psoriasis

Trauma (i.e., burns, abrasions, postsurgical)

Viral exanthem  Printer- Friendly Email This

Skin Therapy Lett.  2006;11(9):1-6.  ©2006 SkinCareGuide.com
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