Management of Pigmentary Disorders

Disorders of pigmentation, both hyper- and hypopigmentation, are common entities encountered in dermatology. They can be caused by a variety of underlying systemic diseases and infections, as well as present as primary cutaneous disorders and secondary to injury or trauma. Contributing factors leading to both types of pigmentary alterations include both an effect on melanocytes and the activity and rate of melanin production. The most common disorders of hypopigmentation that will be discussed in this chapter include post-inflammatory hypopigmentation, hypopigmented mycosis fungoides, pityriasis alba, tinea versicolor, progressive macular hypomelanosis, idiopathic guttate hypomelanosis, and vitiligo. Hyperpigmentation disorders to be discussed include post-inflammatory hyperpigmentation, melasma, lichen planus pigmentosus, erythema dyschromicum perstans, and drug-induced and metabolic conditions causing hyperpigmentation.