Levin C Y, Maibach H
University of California, San Francisco Medical Center, Department of Dermatology, San Francisco, California, USA.
Am J Clin Dermatol. 2001;2(4):213-7. doi: 10.2165/00128071-200102040-00002.
Exogenous ochronosis is clinically and histologically similar to its endogenous counterpart; however, it exhibits no systemic effects and is not an inherited disorder. It is characterized by an asymptomatic hyperpigmentation of the face, sides and back of the neck, back, and extensor surfaces of the extremities. The associated ochronotic discoloration most commonly results from use of products containing hydroquinone. It also occurs following use of antimalarials and products containing resorcinol, phenol, mercury or picric acid. The etiology of hydroquinone-induced hyperpigmentation in exogenous ochronosis remains speculative. The majority of patients with this condition are Black, but it has been reported to occur in Hispanics and Caucasians. Exogenous ochronosis is prevalent among South African Blacks, but is believed relatively uncommon within the US. The reasons for this phenomenon are not clear, but it could be a result of the use of skin care products containing resorcinol in combination with hydroquinone or the use of hydroquinone in a hydroalcoholic lotion. Treatment of this condition is difficult. The offending agent must be avoided, but improvement occurs only slowly. A number of topical agents have been studied as have dermabrasion and the use of lasers. Controlled studies in larger numbers of patients are require to determine the true efficacy of newer treatments.
外源性褐黄病在临床和组织学上与其内源性对应物相似；然而，它没有全身影响，也不是遗传性疾病。其特征是面部、颈部两侧和后部、背部以及四肢伸侧出现无症状的色素沉着。相关的褐黄病变色最常见于使用含对苯二酚的产品后。使用抗疟药以及含间苯二酚、苯酚、汞或苦味酸的产品后也会发生。外源性褐黄病中对苯二酚诱导色素沉着的病因仍存在推测。大多数患有这种疾病的患者是黑人，但据报道在西班牙裔和白种人中也有发生。外源性褐黄病在南非黑人中很普遍，但在美国相对少见。这种现象的原因尚不清楚，但可能是由于使用了含间苯二酚与对苯二酚的护肤品，或在水醇洗剂中使用了对苯二酚。这种疾病的治疗很困难。必须避免使用致病剂，但改善过程缓慢。已经研究了多种局部用药以及皮肤磨削术和激光的使用。需要对更多患者进行对照研究以确定新治疗方法的真正疗效。
