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Hyperpigmentary disorders in children: A hospital-based study in a tertiary care center

Indian Dermatology Online Journal
Medknow Publications
Publication Date
DOI: 10.4103/2229-5178.110641
  • Letters To The Editor
  • Medicine


Sir, Pigmentary disorders encompass a commonly encountered group of dermatoses in the pediatric age group. Presence of hyperpigmented skin lesions in children, besides being an insignificant or isolated finding, may be indicative of more serious underlying systemic or genetic disorder. We carried out a study in our dermatology out patient department (OPD) over a period of 22 months (August 2007-June 2009) with the objective of evaluating the pattern of hyperpigmentary disorders in children with an emphasis on whether the skin changes were early markers of any systemic or genetic disorder. There were 58 children (32 boys, and 26 girls) in our study. A total of 34392 children attended the Dermatology OPD during the study period. The frequency of hyperpigmentary disorders was 1.54 per 1000 children. The mean age of the children was 6.89 years and mean of age of onset was 3.89 years (birth to 13 years). Twenty six out of 58 (44.8%) children had onset at birth. The mean duration of the disorders was 3 years (range of 1 day to 14 years). The most common hyperpigmentary disorder in our study was café-au-lait macule (CALM) [Figure 1] seen in 12 children (20.6%), followed by post-inflammatory hyperpigmentation (9/58, 15.5%), pigmentary mosaicism (8/58, 13.8%) [Figures 2 and 3], congenital melanocytic nevus (7/58, 12%), lichen planus (5/58, 8.6%), Mongolian spots (4/58, 6.8%) [Figure 4] and fixed drug eruption (FDE) (3/58, 5.2%) [Figure 5]. Two (3.4%) children each had urticaria pigmentosa [Figure 6] and Becker's nevus [Figure 7]. One child each (1.7%) had Chédiak-Higashi Syndrome (CHS), discoid lupus erythematosus, incontinentia pigmenti [Figure 8], lentigines [Figure 9], lichen striatus, nevus of Ota, pityriasis rubra pilaris and speckled lentiginous nevus. Table 1 shows the hyperpigmentary disorders (with systemic associations) noted in our study. Chest and lower limb were the most commonly affected sites (16.2%), followed by face (15.3%), upper limb (11.7%), back (9.9%), and abdomen (8.1%). Parental co

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