外源性褐黄病的临床和皮肤镜特征：国际皮肤镜协会皮肤色素沉着工作组多中心研究结果

Clinical and dermoscopic characteristics of exogenous ochronosis: results of a multicentre study by the International Dermoscopy Society Dermoscopy in Skin of Color Task Force.

作者信息

Vinay Keshavamurthy, Mehta Hitaishi, Bhat Yasmeen J, Khare Soumil, Enechukwu Nkechi Anne, Chauhan Payal, Ankad Balachandra S, Awatef Kelati, Rani Sudha, Kaliyadan Feroze, Errichetti Enzo

机构信息

Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Department of Dermatology, Government Medical College, Srinagar, Jammu & Kashmir, India.

出版信息

Clin Exp Dermatol. 2025 Aug 22;50(9):1777-1785. doi: 10.1093/ced/llaf159.

DOI:10.1093/ced/llaf159

PMID:40186504

Abstract

BACKGROUND

Exogenous ochronosis (EO) is an acquired pigmentary disorder usually characterized by blue-black or grey-blue skin discoloration owing to prolonged use of topical hydroquinone (HQ).

OBJECTIVES

To characterize the clinicoepidemiological and dermoscopic features of EO in Fitzpatrick skin types III-VI.

METHODS

This retrospective study involved the Dermoscopy in Skin of Color Task Force of the International Dermoscopy Society. Inclusion criteria included confirmed or suspected EO diagnosis in patients with skin of colour and availability of complete clinical history and high-quality clinical and dermoscopic images. Patients' cases were classified as definitive EO if histopathologically confirmed and as probable EO based on characteristic clinical features in users of HQ without histopathological confirmation.

RESULTS

The study included 29 patients (93%, 27/29 women, mean age 40.04 years, SD 9.74). EO was classified as definitive in 41% (12/29) and probable in 59% (17/29) of patient cases. The malar region was involved in all patients. The mean duration of HQ usage was 15.96 months (SD 19.67). Common dermoscopic features observed included obliteration of follicular openings (86%, 25/29), pigment dots (72%, 21/29) and brown amorphous areas (72%, 21/29). Additional features included telangiectasias (52%, 15/29), accentuation of the pigment network (48%, 14/29), arciform or comma-shaped structures (45%, 13/29), white structureless areas (45%, 13/29) and rimming of eccrine openings (31%, 9/29). Histopathological findings in 12 patients confirmed EO, with banana bodies present in all.

CONCLUSIONS

Dermoscopy is a valuable noninvasive diagnostic tool in EO, with obliteration of follicular openings, brown amorphous areas and comma-shaped structures a key feature. Further research is needed to optimize dermoscopic diagnostic criteria and treatment strategies.

摘要

背景

外源性褐黄病（EO）是一种获得性色素沉着紊乱疾病，通常因长期外用对苯二酚（HQ）导致蓝黑色或灰蓝色皮肤变色。

目的

描述 Fitzpatrick III - VI型皮肤中EO的临床流行病学和皮肤镜特征。

方法

这项回顾性研究由国际皮肤镜协会皮肤颜色皮肤镜工作组开展。纳入标准包括有色人种患者确诊或疑似EO诊断，以及完整临床病史和高质量临床及皮肤镜图像。若经组织病理学确诊则患者病例分类为确诊EO，若在未进行组织病理学确诊的HQ使用者中基于特征性临床特征则分类为疑似EO。

结果

该研究纳入29例患者（93%，27/29为女性，平均年龄40.04岁，标准差9.74）。41%（12/29）的患者病例EO被分类为确诊，59%（17/29）为疑似。所有患者的颧部均受累。HQ使用的平均时长为15.96个月（标准差19.67）。观察到的常见皮肤镜特征包括毛囊开口闭塞（86%，25/29）、色素点（72%，21/29）和棕色无定形区域（72%，21/29）。其他特征包括毛细血管扩张（52%，15/29）、色素网增粗（48%，14/29）、弧形或逗号状结构（45%，13/29）、白色无结构区域（45%，13/29）和小汗腺开口边缘（31%，9/29）。12例患者的组织病理学检查结果确诊为EO，所有患者均有香蕉小体。