Postinflammatory hyperpigmentation

Burns R, Prevost-Blank PL, Lawry MA, Lawry TB, Faria DT, Fivenson DP (1999) Glycolic acid peels for postinflammatory hyperpigmentation in black patients. Dermatol Surg 25 18-22... 

Azelaic acid is useful for mild to moderate acne in patients who do not tolerate benzoyl peroxide. It is also useful for postinflammatory hyperpigmentation because it has skin-lightening properties. 

She was treated with an oral antihistamine and a topical glucocorticoid. Two days later, the lesions worsened and systemic glucocorticoid therapy was needed. The lesions started to heal, leaving slight postinflammatory hyperpigmentation. Patch-testing was performed with a European standard series and commercial laurel oil 1 month later. There was a reaction to the oil... 

Maculopapular drug eruptions usually fade with desquamation and, occasionally, postinflammatory hyperpigmentation, in about 2 weeks. They invariably recur on rechallenge. 

Joshi SS, Boone SL, Alam M et al (2009) Effictiveness, safety, and effect on quality of life of topical salicylic acid peels for treatment of postinflammatory hyperpigmentation in dark skin. Dermatol Surg 35 638-644... 

Fig. 7.3 (a) Patient with postinflammatory hyperpigmentation, (b) Patient after treatment with a series of two Jessner s peels... 

Common and immediate side effects of micro-dermabrasion are erythema, which usually subsides within 24 h but may occasionally be prolonged, and a slight burning sensation [13]. Purpura and petechiae may develop, especially on more delicate areas of skin, but these usually resolve spontaneously. Other potential complications are postinflammatory hyperpigmentation and, if excessive pressure is used, streaking marks. One unusual case of a severe urticarial response to miCTodermabrasion has been reported, which may... 

Complications of hydroquinone therapy include acute and chronic reactions. Common acute reactions are irritant and allergic contact dermatitis, and postinflammatory hyperpigmentation. Lesional and perile-sional hypopigmentation may occur. This is usually a temporary complication. With repeated application, hydroquinone may cause destruction of melanosomes, melanocyte organelles, and melanocyte necrosis [32]. A novel formulation of hydroquinone 4% plus retinol 0.15%, in which most of the hydroquinone and all of the retinol are encapsulated into macroporous beads, allows gradual delivery of hydroquinone into the skin, minimizing the effects of skin irritation [34-36]... 

Postinflammatory Hyperpigmentation (PIH) Hypermelanosis usually seen on areas of previous inflammatory or traumatic event symmetry may or may not be present... 

Photoprotection is useful to reduce the risk of postinflammatory hyperpigmentation tretinoin and the exfoliants reduce skin thickness, improving the efficacy of TCA (better and more homogeneous penetration). 

Postinflammatory hyperpigmentation is the acquired presence of darker macules and patches of skin occurring at sites of previous cutaneous inflammatory conditions. The processes preceding the altered skin color include mechanical injuries, allergic reactions, primary inflammatory skin disorders, and therapeutic interventions. 

Postinflammatory hyperpigmentation is one of the most common causes of altered skin color. Although it can manifest in various skin types, it is more frequently seen with greater intensity and persistence in darker skin types [1, 2] (Fig. 17.1). Its incidence is equal in males and females. 

Postinflammatory hyperpigmentation can be seen after endogenous or exogenous inflammatory conditions. Essentially any disease with cutaneous inflammation can potentially result in postinflammatory hyperpigmentation in individuals capable of producing melanin. 

Fig. 17.1 Severe postinflammatory hyperpigmentation caused by acne vulgaris...

Several skin disorders such as acne, atopic dermatitis, allergic contact dermatitis, incontinenti pigmenti, lichen planus, lupus erythematosus, and morphea have postinflammatory hyperpigmentation as a predominant feature. Exogenous stimuli, both physical and chemical, can cause injury to the skin followed by PIH. These include mechanical trauma, ionizing and nonionizing radiation, heat, contact dermatitis, and phototoxic reactions and laser therapies [2, 3,4]. 

In postinflammatory hyperpigmentation, there appears to be an increase in melanin production and/or an abnormal distribution of pigment. However, the exact... 

The diagnosis of postinflammatory hyperpigmentation is often made by history and clinical presentation. It is characterized by macules and patches of varying shades of hyperpigmentation limited to the sites of inflammed skin lesions. Lesions of the preceding inflammatory process may be present at various stages of evolution and at other anatomic areas, and thus, helpful with the diagnosis. 

Chemical peeling can be a useful adjunct in treating cases of persistent postinflammatory hyperpigmentation and those unresponsive to topical bleaching agents... 

Fig. 17.3 (a) Severe recalcitrant postinflammatory hyperpigmentation secondary to acne excorians. (b) After a series of four salicylic acid 20% and 30% peels and 10% hydroquinone cream... 

Superficial salicylic acids have been shown to be safe and efficacious for treatment of postinflammatory hyperpigmentation. In a study of five patients with... 

Cook-Bolden FE (2004) The efficacy and tolerability of a combination cream containing 4% hydroquinone in the treatment of postinflammatory hyperpigmentation in skin types IV-VI. J Cosmet Dermatol 17(3) 149-155... 

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