2. Incontinentia pigmenti
3. Secondary to skin diseases a. Chronic discoid lupus erythematosus b. Tinea versicolor c. Stasis dermatitis d. Lichen planus e. Fixed drug eruption f. Many cases of dermatitis in African-Americans and other dark-skinned individuals (see Fig.: 2.4:3.)
g. Scleroderma h. Porphyria cutanea tarda (Fig 2.4:4)
Figure 24-4. Pigmentary dermatoses. (Neutrogena Skin Care Institute) Porphyria cutanea tarda hyperpigmentation.
i. Dermatitis herpetiformis 4. Secondary to external agents a. X-radiation b. Ultraviolet light c. Sunlight d. Tars e. Photosensitizing chemicals, as in cosmetics, causing development of clinical entities labeled as Riehl's melanosis, poikiloderma of Civatte on the sides of the neck due to chronic sun exposure, berlock dermatitis (Fig..24:5), and others
Figure 24-5. Pigmentary dermatoses. (Neutrogena Skin Care Institute) Berlock dermatitis: photosensitivity reaction from mother's perfume, age 7 years.
5. Secondary to internal disorders a. Addison's disease (see Fig..26:1)
b. Chronic liver disease c. Pregnancy d. Hyperthyroidism e. Internal carcinoma causing malignant form of acanthosis nigricans f. Hormonal influence on benign acanthosis nigricans g. Intestinal polyposis causing mucous membrane pigmentation (Peutz-Jeghers syndrome)
h. Albright's syndrome i. Schilder's disease j. Fanconi's syndrome, ie., HIV-positive patients
6. Secondary to drugs such as adrenocorticotropic hormone, estrogens, progesterone, melanocyte-stimulating hormone
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