A case report on hydroquinone induced exogenous ochronosis

Authors

  • Hari Priya Sunkara Department of Pharmacy Practice, Chebrolu Hanumaiah Institute of Pharmaceutical Sciences, Chowdavarm, Guntur, Andhra Pradesh, India
  • Krishna Rajesh Kilaru Department of Dermatology, Venereology and Leprosy, NRI Medical college and General Hospital, Chinakakani, Guntur, Andhra Pradesh, India
  • Adusumilli Pramod Kumar Department of Pharmacy Practice, Chebrolu Hanumaiah Institute of Pharmaceutical Sciences, Chowdavarm, Guntur, Andhra Pradesh, India
  • Hari Babu Ramineni Department of Pharmacy Practice, Chebrolu Hanumaiah Institute of Pharmaceutical Sciences, Chowdavarm, Guntur, Andhra Pradesh, India
  • Puvvada Rahul Krishna Department of Physiology, Anatomy and Microbiology, College of Science Health and Engineering, La Trobe University, Australia

DOI:

https://doi.org/10.18203/2349-3933.ijam20200091

Keywords:

Bluish-black pigmentation, Hydroquinone, Ochronosis, Skin brightening

Abstract

Exogenous ochronosis is an infrequent skin disorder characterised by bluish-black or grayish brown pigmentation on dermis. It is the most common condition caused due to long term application of Hydroquinone skin preparations for melasma, skin brightening, cholasma, acne induced pigmentation etc. This report refers to a case of 39-year-old female patient who presented to the hospital with chief complaints of progressive formation of dark lesions over face, neck since one and half-year. She had history of usage of hydroquinone (4%) cream for skin brightening for a period of three months. Based on clinical findings and history she was diagnosed to have acquired exogenous ochronosis and was treated with microdermabrasion, cosmelan peel, yellow peel, glutathione tablets, topical sunscreen and kojic acid cream. Patient noted 50% improvement in her condition after 4 months of treatment. It is believed that application of high concentrations of hydroquinone for a prolonged period causes exogenous ochronosis. This case report suggests that exogenous ochronosis can occur after three months of application.

References

Schwartz C, Jan A. Hydroquinone. In: StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK539693. Accessed 10 October 2019.

Jimbow K, Obata H, Pathak MA, Fitzpatrick TB. Mechanism of depigmentation by hydroquinone. J Investig Dermatol. 1974;62(4):436-49.

Gandhi V, Verma P, Naik G. Exogenous ochronosis after prolonged use of topical hydroquinone (2%) in a 50-year-old Indian female. Indian J Dermatol. 2012;57(5):394.

Ribas J, Schettini AP, Cavalcante MD. Exogenous ochronosis hydroquinone induced: a report of four cases. Anais Brasileiros Dermatol. 2010;85(5):699-703.

Sindhu CS, Babitha C, Priyadarshini A, Veeraraghavan M. Exogenous ochronosis in an elderly Indian male: A case report. Pigment Inter. 2019;6(1):33.

Kulandaisamy S, Thappa DM, Gupta D. Exogenous ochronosis in melasma: A study from south India. Pigment Inter. 2014;1(1):17.

Dar IH, Farooq O, Mir SR, Dar GH, Beg A. Exogenous ochronosis superimposed on chronic kidney disease: A case report and review of literature. Sahel Med J. 2018;21(1):55.

Tse TW. Hydroquinone for skin lightening: safety profile, duration of use and when should we stop?. J Dermatol Treat. 2010;21(5):272-5.

Lee MD, Weiss E. Treatment of exogenous ochronosis with advanced fluorescence technology. Dermatologic Surgery 2014;40(9):1046-8.

Bhattar PA, Zawar VP, Godse KV, Patil SP, Nadkarni NJ, Gautam MM. Exogenous ochronosis. Indian J Dermatol. 2015;60(6):537.

Uppsala Monitoring Centre. Available at: Who-umc.org/vigibase/vigilyze. Accessed on 7 October 2019.

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Published

2020-01-23

Issue

Section

Case Reports