Determination of melanin and haemoglobin in the skin of idiopathic cutaneous hyperchromia of the orbital region (ICHOR): A study of Indian patients

Abstract

Background:Idiopathic cutaneous hyperchromia at the orbital region (ICHOR) is a cutaneous hyperchromia characterised by bilateral darkening of the eyelid and orbital skin that contrasts with the adjoining facial skin. ICHOR is frequent in dark skin. It interferes with the face appearance which often causes difficulties in societal acceptance and may impact quality of life.Objective:The aim of this investigation was to study the epidemiology, clinical features and risk factors associated with ICHOR in Indian patients and also to study the distribution of melanin and haemoglobin in ICHOR patients. This study also assessed the relevance of SIAscopy technique (spectrophotometric intracutaneous analysis (SIA)), a new objective non-invasive method to measure melanin and haemoglobin concentration in vivo.Materials and Methods:Thirty-three patients diagnosed with ICHOR at the All India Institute of Medical Sciences, New Dehli, India, were included in the study. Epidemiological data were collected through a self-administrated questionnaire. Standard photographs were taken from each patient and SIAscopy measurements were done on dark circles and normal skin.Results:Surprisingly our study showed no significant correlation between ICHOR prevalence and family history, atopic and contact dermatitis, contemporaneous melasma and hormonal factors. The study confirms that sun exposure is a risk factor of dark circles aggravation. Indeed patients tend to reduce sun exposure after the onset of dark circles. SIAscopy analysis reveals significant differences in the concentration of total melanin, of dermal melanin and of haemoglobin between ICHOR skin and normal skin of the same patient.Conclusion:This study confirms that melanin deposits and blood stasis in dark circles may play a role in ICHOR pathogenesis and cause the darkening of skin under eyes. SIAscopy provides objective diagnostic information about ICHOR.

Physiological and lifestyle factors contributing to risk and severity of peri-orbital dark circles in the Brazilian population

“…Vershoore et al, for example, used a SIAscopy technique in 33 Indian subjects and concluded that the total melanin and dermal melanin content was higher in dark circles than in normal skin. 8 Watanabe et al examined the periorbital biopsies of 12 Japanese subjects and concluded that the visible color was due to dermal melanosis. 9 The authors of another study in which biopsy specimens were collected from 28 subjects who had had DUEC for an average of 26 years concluded that an increase in melanin content was the primary difference between the eye area and a control area.…”

“…Vershoore et al reported higher hemoglobin content in DUEC skin compared with normal skin. 8 Some investigators have suggested that at least some periorbital dark circles can be attributed primarily to postinflammatory hemodynamic congestion, which produces a bruising effect on the lower eyelids. 12 …”

“…Although Vershoore et al did not find any association with family history in their study of 33 subjects, others have reported strong evidence of inheritance. 8 , 11 …”

Periorbital Hyperpigmentation, a Dermatologic Condition Having a Strong Geographic and Ethnic Determinism

“…Michèle Verschoore et al, in a study conducted on patients, assessing hemoglobin and melanin mexametry in the subocular region in patients with POH, fore melanic cause not excluding endogenous processes, like specific aging factors [17].…”

An approach to dark circles under the eyes

“…As people grow older, the skin gets thinner and collagen fibers are lost, at times augmenting the advent of tiny blood vessels beneath the eyes, thus making the area seems darker. While lack of sleep and aging certainly play a role in under-eye discoloration, so do genetics, allergies, hormonal abnormalities, and accumulated skin damage [4,5] .…”