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Thursday, May 25, 2017

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PIREDCME
xTHIS ACTIVITY HAS EXPIRED

Practical Approaches to Medical

Medical and
Cosmetic Dermatology in Skin of
 Color Patients: Postinflammatory
Hypopigmentation
Postinflammatory Hypopigmentation
Postinflammatory hypopigmentation is a frequently encountered concern,
especially in patients with skin of color because of the contrasting color. It
often represents sequelae of both primary cutaneous conditions as well as
secondary to therapeutic interventions, signifying the importance of
providing informed consent when performing any intervention that could
potentially cause postinflammatory hypopigmentation. Skin lightening is
thought to be due to a decrease in the amount of melanin and, interestingly,
there tends to be a variable response depending on the degree of the
inflammation, as well as on the patients individual tendency, which may be
genetically predetermined based on the lability of an individuals
melanocytes.[71] Postinflammatory hypopigmentation is frequently seen as a
sequela of seborrheic dermatitis, tinea versicolor, atopic dermatitis, psoriasis,
lichen planus, lichen striatus, thermal injury, pityriasis lichenoides and
mycosis fungoides, to name a few.

The pathogenesis of the postinflammatory hypopigmentation likely varies in

the varying conditions. For example, in tinea versicolor, the proposed
pathogenesis of the postinflammatory hypopigmentation is a result of the
inhibition of tyrosinase by dicarboxylic acids formed by Malasezzia furfur,[72]
whereas in other disorders, loss of functional melanocytes has been
attributed. Usually, the patients biggest concern is when and if the pigment
will return. Unfortunately, treatment remains a challenge, and in addition to
treating the underlying condition, reassurance and time are sometimes the
best interventions. Depending on the severity of the hypopigmentation,
repigmentation can likely take weeks to years. Cosmetic camouflage can be
maintained until repigmentation goals are met. UV light exposure has also
been reported to expedite repigmentation.[73] Anecdotally, the use of NB-
UVB or the 308-nm excimer laser may be useful in hastening repigmentation.
 BACK
Page 7 of 17

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VITILIGO

CME INFORMATION
Table of Contents
1. Abstract and Introduction
2. The Biological & Structural Differences in Skin of Color
3. Skin Cancer
4. Photoaging
5. Dyschromias Including Postinflammatory Hyperpigmentation & Melasma
6. Erythema Dyschromicum Perstans
7. Postinflammatory Hypopigmentation
8. Vitiligo
9. Keloids
10. Melanonychia
11. Pseudofolliculitis Barbae
12. Hirsutism
13. Traction Alopecia
14. Central Centrifugal Cicatricial Alopecia
15. Expert Commentary
16. Five-year View
17. Key Issues

References
Print

References

Expert Review of Dermatology. 2011;6(2):1-13. 2011 Expert Reviews Ltd.

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