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Facial discoloration around the eye.
Facial discoloration is concern to all as it is cosmetically unacceptable. pigmentation of the face can be hypo or hyper pigmentaition. Pityriasis alba, pityriasis versiocolor, chemical leukoderma and vitiligo are some of the more frequent causes of hyper melanosis. Other Blemishes like riehl and crythema dycromicum persants are characteristically known to produce darkeing of the countenance.
Many of these diseases have overlapping features. Clinical pattern of different forms of pigmentation very according to etiolog. Facial pigmentation can be epidermal or dermal. Cause of both types of pigmentation melanotic (no increase in number of melanocytes) or Melanocytec (increase in number of Melanocytes) it can also be epiderm-dermal with melanphages in dermis. Dermal Hyper pigmentation can be secondary to :
- Melanin is formed in epidermal melanocytes and subsequently drps todermis.
- to be engulfed by melanophages. eg IP
- Melanosomes are formed in dermal melanophages but fail to reach dermoepidrmal junction during developmental migration eg Nof OTA.
- Presence of Metastatic malignant pigment cells in dermiss e.g metastatic malignant melanoma.
- Deposition of non-melanin substances endogenous (HEM SIDERIN CAROTENE, BILIRUBINE) oxogenous ( SILVER, MERCURY, ARSENIC, MINOCY-CLINIE). Naevus of Ota presents as bluish pigmentation around the eyes, conjuctive, cheek and plate.
Drug causes facial pigmentation in many causes. Chlorpromazine produces bluish grey pigmentation in sun exposed areas. Post inflammatory hyper pigmentation makeup significant number of all cases of pigmentation. Physician must be aware of the different varieties of pigmentation for correct diagnosis and subsequent management.
