Periorbital Hyperpigmentation in Asians: An Epidemiologic Study and a Proposed Classification

Ranu, H; Thng, Steven Tien Guan; Goh, Boon Kee; Burger, Allan; Goh, Chee Leok

doi:10.1111/j.1524-4725.2011.02065.x

Cited by 78 publications

(113 citation statements)

References 15 publications

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“…42.3% cases had a positive family history,but the finding was not statistically significant. This was also highlighted in the study by Ranu et al 11 . Melasma was exclusively seen in females in the study as observed by Bersa et al Among periorbital infections, viral infections outnumbered bacterial infections.…”

Section: Periorbital Miscellaneous Disorderssupporting

confidence: 66%

A Clinical Study of Periorbital Dermatoses

Arjun¹

2017

JMSCR

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Section: Periorbital Miscellaneous Disorderssupporting

confidence: 66%

A Clinical Study of Periorbital Dermatoses

Arjun¹

2017

JMSCR

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“…The available treatment options for POM include topical depigmenting agents, such as hydroquinone, kojic acid, azelaic acid, topical retinoic acid and physical therapies, including chemical peels, surgical corrections, and laser therapy, most of which were already tried scientifically for melisma and found to be successful. 13,14 There is scarcity of data regarding the incidence and prevalence of periorbital melanosis due to its transitory nature and lack of reasonable etiological explanation. In anrecent Indian study, it was found that POH was most prevalent in the age group of 16 to 25 years and it is more common among females.…”

Section: Introductionmentioning

confidence: 99%

A clinico-epidemiological study of periorbital melanosis

2017

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INTRODUCTIONFacial concerns have been the major reason for dermatological consultations in the last few years. 1 Besides the common alterations related to the intrinsic and extrinsic aging processes, there is one that affects individuals of any age, both sexes, and all races the so called dark circles, periorbital darkening or periorbital melanosis (POM).2,3 Studies had shown that many factors had contributed to this condition like melanin deposition, increased vascularity, chronic inflammation, skin redundancy and genetic causes. [4][5][6] Recently, Huang et al classified POM as pigmented, vascular, structural and mixed POM clinically. 7Pigmented type (P) appears as infraorbital brown hue, vascular (V) type appears as infraorbital blue, pink, or ABSTRACT Background: Besides the common alterations related to the intrinsic and extrinsic aging processes, there is one that affects individuals of any age, both sexes, and all races the so called dark circles, periorbital darkening or periorbital melanosis. There is scarcity of data regarding the incidence and prevalence of periorbital melanosis due to its transitory nature and lack of reasonable etiological explanation. Aim: To assess the prevalence of periorbital melanosis and to study the epidemiological factors responsible for the occurrence of periorbital melanosis. Methods: A single centred, cross-sectional, descriptive study was conducted in patients attending the skin OPD of our teaching hospital from Jan 2016 -Dec 2016. A total of 250 patients were included in our study. Patients with hyperpigmentation around the orbital area of all ages and both genders were included in the study. A careful physical examination to detect involvement of upper or lower or both eyelids and extension beyond the periorbital region, colour of hyperpigmented areas (light brown/dark brown/red/blue), presence of any dermatological disease or scar in periorbital region were assessed. A detailed history was taken including duration of the condition, family history, history of atopy or drug intake, associated faulty habit or lifestyle. Results: Based on the type of POM, vascular POM (44%) was found to be the most common type among our patients followed by constitutional (33.2%), post-inflammatory (13.6%) and shadow type (9.2%). Among the various factors for POM watching TV for more than 8 hours/day, usage of spectacles, sleeping habit of less than 6 hours/day, habit of regularly rubbing the eye, family history of POM, associated systemic disease like anaemia and irregular menstruation and associated skin lesion like atopic dermatitis had shown a strong association (odds ratio >0.8) in the development of POM. Conclusions: It is very much essential to classify and grade the peri-orbital melanosis and to determine the causative factors which would help us to intervene earlier and that would result in a better prognosis.

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“…5 In addition, melanosome degradation within the keratinocyte is slower in darkly pigmented skin when compared with lighter skin types. 15 The melanin content and melanosomal dispersion pattern is thought to confer protection from damage induced by UV radiation. 3,16 Kaidbey et al 16 demonstrated that black epidermis, on average, provides a sunprotection factor (SPF) of 13Á4.…”

Section: Discussionmentioning

confidence: 99%

“…20,22 ICHOR is characterized by bilateral darkening of the orbital skin and eyelid, which is not secondary to systemic or local disease. 20 In a study by Ranu et al 15 on 200 patients with periorbital hyperpigmentation, possible causes were delineated according to history, physical examination and assessment by dermatologists measuring with a Mexameter â (Courage-Khazaka Electronics, Cologne, Germany). They found the commonest forms to be the vascular type (41Á8%) characterized by the presence of erythema involving inner aspects of lower eyelids with prominent capillaries/telangiectasia or presence of bluish discoloration due to visible blue veins; constitutional form (38Á6%) characterized by the presence of brown-black hyperpigmentation of the lower eyelid skin along the shape of orbital rim; PIH (12%); and shadow effects (11Á4%) due to an overhanging tarsal muscle or deep tear trough.…”

Section: Periorbital Hyperpigmentationmentioning

confidence: 99%

Facial hyperpigmentation: causes and treatment

2013

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SummaryBy midcentury, the U.S.A. will be more ethnically and racially diverse. Skin of colour will soon constitute nearly one-half of the U.S. population, and a full understanding of skin conditions that affect this group is of great importance. Structural and functional differences in the skin, as well as the influence of cultural practices, produce variances in skin disease and presentation based on skin type. In the skin of colour population, dyschromia is a growing concern, and a top chief complaint when patients present to the physician. A thorough understanding of the aetiology and management strategies of facial hyperpigmentation is of importance in caring for those afflicted and also in the development of new therapies.What's already known about this topic?• In the skin of colour population, facial hyperpigmentation is a common and growing concern when presenting to the physician.• Facial hyperpigmentation can cause significant cosmetic disfigurement with subsequent emotional impact. Therapy continues to be challenging as there is no universally effective treatment. Existing agents have varying degrees of efficacy and potential risk of postinflammatory hyperpigmentation with different treatment protocols.What does this study add?• Persons of colour will soon comprise a majority of the international and domestic populations.• A comprehensive knowledge and approach to assessment and treatment is necessary to care properly for skin of colour patients.• This review thoroughly discusses aetiologies of facial hyperpigmentation and categorizes appropriate treatment strategies.Skin of colour, also known as ethnic skin, constitutes a wide range of racial and ethnic groups traditionally referring to persons of African, Asian, Native American, Middle Eastern and Hispanic backgrounds. By 2050, nearly one-half of the U.S. population will be nonwhite.1 These skin types are generally categorized as Fitzpatrick types IV-VI, and are more richly pigmented. Structural and functional differences in the skin, as well as the influence of cultural practices, produce variances in skin disease, presentation and treatment based on skin type. Darker skin phenotypes are characterized by higher content of melanin, higher eumelanin to pheomelanin ratio, and more effective distribution of melanin for protection against ultraviolet (UV) radiation. 2In skin of colour, the amount and epidermal distribution of melanin is an important biological feature.

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Periorbital Hyperpigmentation in Asians: An Epidemiologic Study and a Proposed Classification

Abstract: The vascular form of POH was the predominant type. We propose a comprehensive classification for POH that we hope will influence the choice of treatment modalities used in managing POH in the future.

Cited by 78 publications

References 15 publications

A Clinical Study of Periorbital Dermatoses

A Clinical Study of Periorbital Dermatoses

A clinico-epidemiological study of periorbital melanosis

Facial hyperpigmentation: causes and treatment

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