Melanosis of the malar area2121 Abdel-Naser MB, Verma SB, Abdallah MA. Common dermatoses in moderately pigmented skin: uncommon presentations. Clin Dermatol. 2005;23:446-56.
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Equal regarding gender; older than 50 years |
Unknown. In young women, it seems to be related to atopy |
Hyperchromia, with imprecise borders, symmetrically distributed in the malar regions |
Perioral hyperpigmentation2121 Abdel-Naser MB, Verma SB, Abdallah MA. Common dermatoses in moderately pigmented skin: uncommon presentations. Clin Dermatol. 2005;23:446-56.
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Higher in females |
Unknown. It does not seem to be a consequence of inflammation |
Hyperchromia in the skin adjacent to the angles of the mouth |
Periorbital melanosis2222 Vashi NA, Wirya SA, Inyang M, Kundu RV. Facial hyperpigmentation in skin of color: special considerations and treatment. Am J Clin Dermatol. 2017;18:215-30.
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Higher in the female sex |
Multifactorial: genetics, post-inflammatory hyperpigmentation, periorbital edema, hypervascularization and shadowing |
Bilateral periorbital and eyelid hyperchromia, sometimes compromising the upper part of the nose and glabella. There is an increase in the amount of melanin in the papillary dermis, melanophages and vasodilation in the reticular dermis |
Maturational hyperpigmentation2222 Vashi NA, Wirya SA, Inyang M, Kundu RV. Facial hyperpigmentation in skin of color: special considerations and treatment. Am J Clin Dermatol. 2017;18:215-30.
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4‒5th decades of life. Fitzpatrick skin phototypes IV‒V |
Chronic sun exposure and possibly obesity and diabetes |
Hyperchromic patches, with ill-defined edges that eventually disappear into normal skin, affecting areas exposed to the sun, including the sides of the face and the back of the hands and feet. On histopathology, proliferation of melanocytes with reports of papillomatous epidermal proliferation |
Voigt-Futcher lines77 Zaid Z. Skin of colour: characteristics and disease. J Pak Med Assoc. 2017;67:292-9.,2323 Zieleniewski Ł, Schwartz RA, Goldberg DJ, Handler MZ. Voigt-Futcher pigmentary demarcation lines. J Cosmet Dermatol. 2019;18:700-2.
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17% to 40% of blacks; higher in women |
Unknown. Congenital or acquired (hormonal -pregnancy) |
Well-defined bilateral lines, which separate more pigmented areas from lighter areas. It can occur on the limbs, chest or abdomen, along the dermatomes |
Midline hypopigmentation77 Zaid Z. Skin of colour: characteristics and disease. J Pak Med Assoc. 2017;67:292-9.
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30% to 40% of blacks; higher in males; less visible with age |
Autosomal dominant inheritance |
Hypochromic linear band on the sternal region, which may extend to the linea alba and infraclavicular region |
Palmoplantar hyperpigmentation77 Zaid Z. Skin of colour: characteristics and disease. J Pak Med Assoc. 2017;67:292-9.
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Common and more frequent with greater skin pigmentation |
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Small, well-defined hyperchromic macules, variable in number and size, on the palmoplantar surfaces |
Melanonychia striata77 Zaid Z. Skin of colour: characteristics and disease. J Pak Med Assoc. 2017;67:292-9.,2424 Leung AKC, Lam JM, Leong KF, Sergi CM. Melanonychia striata: clarifying behind the Black Curtain. A review on clinical evaluation and management of the 21st century. Int J Dermatol. 2019;58:1239-45.
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More frequent with greater skin pigmentation; up to 77% of young African-American adults and nearly 100% of those over 50 years, increasing in intensity with age |
Melanocytic activation in the matrix, with melanin deposition on the nail plate. Less commonly, melanocytic hyperplasia in the nail matrix or bed |
Pigmentation in longitudinal or diffuse bands on the nail, from the matrix to the tip, more common in the 1st and 2nd fingers. On dermoscopy, homogeneous grayish background, with longitudinal parallel grayish lines. Pseudo-micro-Hutchinson sign (cuticle pigmentation) may be seen |
Hyperpigmentation of the oral mucosa77 Zaid Z. Skin of colour: characteristics and disease. J Pak Med Assoc. 2017;67:292-9.
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Develops during the first 2 decades of life |
Melanocytic activation with melanin deposition in the epithelium |
Hyperchromic patches, localized or disseminated. In the gums, they are more common and unaesthetic, especially when there is a high smile line |
Mongolian spot2525 Alimi Y, Iwanaga J, Loukas M, Oskouian RJ, Rizk E, Oakes WJ, et al. A comprehensive review of Mongolian spots with an update on atypical presentations. Childs Nerv Syst. 2018;34:2371-6.
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40% to 90% of black newborns. Usually disappears by the age of 7 |
Unknown. When extensive, it is associated with systemic conditions, such as congenital errors of metabolism |
Blue-gray spot, usually single, on the lumbosacral region. Melanocytes in the dermis. |
Oral leukoedema2626 Madani FM, Kuperstein AS. Normal variations of oral anatomy and common oral soft tissue lesions: evaluation and management. Med Clin North Am. 2014;98:1281-98.
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70% to 90% of black adults and 50% of children; more frequent in men |
Physiological, but irritation caused by smoking or poor oral hygiene are factors. There is accumulation of fluid in the epithelial cells |
Grayish-white, edematous plaques on the buccal mucosa, seen bilaterally, which disappear if the mucosa is distended. White folds or lines may cross the affected area |
Pearly penile papules2727 Aldahan AS, Brah TK, Nouri K. Diagnosis and management of pearly penile papules. Am J Mens Health. 2018;12:624-627.
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14% to 48% of black men; in post-pubertal age or early adulthood, diminishing with age |
They are believed to be vestigial structures |
Asymptomatic, benign, pearly-white, dome-shaped or filiform papules, measuring 1 to 4 mm, around the glans, in single or double row. Dermoscopy shows a cobblestone or bunch of grapes pattern with dotted or comma-shaped central vessels. Histopathology shows it to be angiofibroma |