Ochronosislike pigmentation from hydroquinone bleaching creams

Penneys, N. S.

doi:10.1001/archderm.121.10.1239a

Cited by 11 publications

(10 citation statements)

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“…[4] Topical hydroquinone may inhibit homogentisic acid oxidase in the dermis, with the result of a local accumulation of homogentisic acid that polymerizes to form ochronotic pigment. [56] The ochronotic coloration most commonly results from the prolonged use of certain topical agents like hydroquinones, but it also occurs with the use of antimalarials and products containing resorcinol, phenol, mercury, or picric acid. [7]…”

Section: Discussionmentioning

confidence: 99%

Exogenous ochronosis after prolonged use of topical hydroquinone (2%) in a 50-year-old Indian female

2012

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Ochronosis is a rare disease characterized by speckled and diffuse pigmentation symmetrically over the face, neck, and photo-exposed areas. It is characterized histologically by banana-shaped ochre-colored deposits in the dermis. It can present in exogenous or endogenous form. We report a case of exogenous ochronosis in a 50-year-old Indian woman after prolonged use of topical hydroquinone which is a rare complication with a commonly used drug which is available over the counter.

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Section: Discussionmentioning

confidence: 99%

Exogenous ochronosis after prolonged use of topical hydroquinone (2%) in a 50-year-old Indian female

2012

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“…However, the most accepted theory till date for the pathogenesis of EO was put forth by Penneys[ 37 ] stating that the hyper-pigmentation is due to local competitive inhibition of the enzyme homogentisic oxidase by hydroquinone, which leads to local accumulation of homogentisic acid and its metabolic products that polymerizes to form the so-called typical ochronotic pigment in the papillary dermis [ Flow diagram 1 ].…”

Section: Pathogenesismentioning

confidence: 99%

Exogenous Ochronosis

Bhattar

Zawar²,

Godse

et al. 2015

Indian J Dermatol

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Exogenous ochronosis (EO) is a cutaneous disorder characterized by blue-black pigmentation resulting as a complication of long-term application of skin-lightening creams containing hydroquinone but may also occur due to topical contact with phenol or resorcinol in dark-skinned individuals. It can also occur following the use of systemic antimalarials such as quinine. EO is clinically and histologically similar to its endogenous counterpart viz., alkaptonuria, which, however, exhibits systemic effects and is an inherited disorder. Dermoscopy and in vivo skin reflectance confocal microscopy are noninvasive in vivo diagnostic tools. It is very difficult to treat EO, a cosmetically disfiguring and troubling disorder with disappointing treatment options.

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“…In practice, the exogenous variant is encountered far more frequently than the endogenous, and no microscopic criteria exist to reliably differentiate the two. 5 We received two biopsies from the chest and back of a 57-year-old white man to evaluate for dysplastic nevi. No further clinical history was supplied at the time.…”

Section: Discussion Follows On Page 898mentioning

confidence: 99%

“…The biochemical and structural features of exogenous ochronosis are well described, and many authors have concluded that the histopathologic features are identical to that of the endogenous form. 5,13,14 The first cutaneous manifestations of alkaptonuria usually appear around 40 years of age and are almost always accompanied by arthropathy, which is the most frequent manifestation of the disease. 15,16 The mean age for joint replacement among patients with alkaptonuria is 55 years.…”

Section: Discussion Follows On Page 898mentioning

confidence: 99%