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LETTER TO EDITOR
Year : 1998  |  Volume : 64  |  Issue : 1  |  Page : 44-45

Photodynamic hyperpigmentation light- induced cumulative insult dermatitis - A new nomenclature



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PMID: 20921714

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How to cite this article:
. Photodynamic hyperpigmentation light- induced cumulative insult dermatitis - A new nomenclature. Indian J Dermatol Venereol Leprol 1998;64:44-5

How to cite this URL:
. Photodynamic hyperpigmentation light- induced cumulative insult dermatitis - A new nomenclature. Indian J Dermatol Venereol Leprol [serial online] 1998 [cited 2019 Oct 17];64:44-5. Available from: http://www.ijdvl.com/text.asp?1998/64/1/44/4644



  To the Editor Top


We often see patients having silent hyperpigmentation i.e. not preceded by any photosensitive or acute phototoxic reaction, seen over sun exposed areas like extensor arms and forearms, upper back, neck and occasionally over forehead and temples. They often give history of application of cosmetics, perfumed or antibacterial soaps, ingestion of carrot, fig, citrus fruits - especially lime. The condition is more often reported by females, probable because of their more concern for complexion. There is wide individual variation in susceptibility and the reaction occurs in only a small proportion of those exposed.

All the substances mentioned contain photoactive chemicals like petrolactum, lanolin, tar derivatives, and perfume in cosmetics; psoralen in bergamot oil in perfumed soaps; salicylanilide and hexachlorophene antibacterial soaps. Pigmentation may follow systemic absorption or topical application of these substances.

Mechanism of pigmentation can be attributed to light-induced cumulative insult dermatitis resulting in slow and silent hyperpigmentation by photoactive chemicals, which because of their low concentration in the substances mentioned, do not readily produce any acute phototoxic reaction.

It closely resembles Riehl's melanosis where pigmentation is confined usually over face. However, horny follicular plugging and scaling, a feature of Riehl's melanosis, is not seen in photodynamic hyperpigmentation.[1]

Pigmentation gradually fades over months when the offending agent is identified and removed.

Hydroquinone and other depigmenting agents like hydrocortisone or retinoic acid do not help much.

Progressive and persistent pigmentation is due to either systemic absorption of the chemicals or when the offending agent can not be identified.

Probably, we are all aware of this clinical condition but there is lack of proper nomenclature of this entity in our Literature.



 
  References Top

1.Bleehen S S, Ebling F J G, Champion R H. Disorders of skin colour. In: Champion R H, Burton JL, Ebling FJG (eds). Text book of Dermatology, Blackwell scientific Publication, Oxford, 1922, P 1597.  Back to cited text no. 1    




 

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