Acquired, Idiopathic, Patterned Facial Pigmentation (AIPFP) including periorbital pigmentation and pigmentary demarcation lines on face follows the Lines of Blaschko on face

Abstract

Background:Acquired, non-nevoid, apparently idiopathic facial pigmentation are distributed over some specific locations like periorbital area, zygomatic area, malar area, root of nose, perioral and mandibular area. Periorbital pigmentation is the most well known entity in this group. These are bilaterally distributed homogenously diffuse gray to dark gray or slate-gray colored patches showing progressive intensification of pigmentation. These are often considered as physiologic or constitutional pigmentation. Some portions of the margins of these patches were described previously as pigmentary demarcation line (PDL- F, G, H).Aim:To analyze the distributional patterns of acquired, apparently idiopathic facial pigmentations and to evaluate the etiologic aspects of these conditions.Materials and Methods:Spatial patterns, distribution, and orientation were analyzed among 187 individuals with idiopathic non-nevoid, facial pigmentation. Observed patterns were compared with various pigmentary nevi and Blaschko's lines on face.Results:It was found that most of the idiopathic facial pigmentary alterations including periorbital pigmentation and PDL on face had specific patterned distribution that had high similarity to that of the pigmentary nevi and Blaschko's lines on face.Conclusion:It is hypothesized here that phenotypic expression of acquired patterned pigmentation (AIFPFP) is due to genetically determined increased pigmentary functional activity to various known and unknown yet natural factors like UV rays and aging. Mosaicism was a definite possibility. We also consider that the patterns actually reflected the normal patterns of embryological human pigmentation on face.

Periorbital hyperpigmentation: A study of its prevalence, common causative factors and its association with personal habits and other disorders

“…[11] have proposed that all the described PDLs on face including PDL-F,G,H actually represent the margins of pigmentary patches which closely conforms with Blaschko's lines on face and have proposed that mosaicism may play a role in development of PDL. Malakar et al .…”

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“…Characteristics of the Population: A Total number of 70 HP patients, males 28 (40%) and females 42 (60%) and 22 controls (17 males and 5 females) were included in the study Table 1. 18.96% showed haemoglobin level between 7 to 10 gm %, 46.55 % patients showed haemoglobin level between 10 to 13 gm %, and 29.31% patients showed haemoglobin more than 13 gm %. The haemoglobin level in the HP group (11.81 ± 2.414 gm %) was found to be lower than the control group (13.58 ± 8.744 gm %) Table 5.…”

“…Human skin presents in a variety of common pigmentary conditions depending on various environmental factors, nutritional, metabolic causes, and some medications 17 . It also depends on Genetics, Physiological, Physical, endocrine, inflammation, systemic diseases, infective, postinflammatory, pregnancy, and miscellaneous 18 . Many forms of hyperpigmentation are caused by an excess production of melanin [19][20] .…”

A Clinico Epidemiological Study of Periocular Hyperpigmentation

“…12 Our study revealed only one patient who had pigmentation confined to upper eyelid alone, which is in contrast to results obtained by Sarma et al who found upper eyelid pigmentation to be much more common in occurrence. 13 The above observations may be due to the genetic variations among different populations in the architecture of the periocular region.…”