Exogenous ochronosis secondary to the use of hydroquinone. About a case.

Abstract

We present the case of an Cuban patient of 56 years evaluated in the provincial hospital of Ibarra, Imbabura for having spots on the face predominantly on cheeks and front of several years of evolution. Treated for a long time with hydroquinone for diagnosis of facial chloasma. Several differential diagnoses, such as hemochromatosis and exogenous ochronosis, were proposed as complications of prolonged hydroquinone use. Skin biopsy is performed and it is concluded as ochronosis to rule out etiology. This entity constitutes a syndrome caused by the accumulation of homogenous acid in the connective tissues, it may be endogenous or exogenous, the latter being very rare. The condition is frequently associated with alkaptonuria but may also occur with the exogenous administration of phenolic complexes, such as hydroquinone. The presentation of this case is important because at present there is a large number of depigmenting creams that contain this drug in its formula, are sold to the public, so its use and abuse is common, and can lead to the development of ochronosis.