Introduction: Acquired dermal hyperpigmentation (ADMH) presenting on periorbital region has been described as individual case reports. We tried to characterize the features of periorbital ADMH.
Materials and methods: This was a retrospective case-control study among our patients who attended the pigmentary clinic during January 2016-December 2017. Clinical, dermoscopic, and histopathological features of subjects who were recruited during the study period were prospectively evaluated.
Results: Total 19 subjects (11%) were identified among 177 ADMH patients. Periorbital ADMH patients had a relatively younger age of onset (23.26 ± 11.06 vs. 36.16 ± 13.41, P < 0.001). Dermoscopy of early periorbital ADMH showed only imperceptible speckled blue-gray dots that accentuated at outer-corner creases of eyes (the "outer-corner crease sign"). Clinicopathological features and prognosis of periorbital ADMH were similar to that of ADMH per se.
Conclusion: Periorbital ADMH should be considered as a differential diagnosis of periorbital hyperpigmentation in children and young adults. Outer-corner crease sign on dermoscopy may help to rule out other differentials in its early presentation.
Keywords: Acquired dermal macular hyperpigmentation; dermoscopy; lichen planus pigmentosus; outer corner crease sign; periorbital hyperpigmentation.
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