II. Causes: Hyperpigmentation

  1. Localized Lesions (increased Melanin or Melanocytes)
    1. See Brown Skin Lesion
    2. See Black Skin Lesion
    3. Postinflammatory Hyperpigmentation
    4. Melasma
    5. Solar Lentigines
    6. Ephelides (Freckles)
    7. Cafe Au LaitMacules
    8. Peutz-Jeghers Syndrome
      1. Pigmented lesions ("Freckles") on lips that crosses vermilion border
      2. Pigmented lesions are also found on the Buccal mucosa, periorbital face, hands and fingers
  2. Diffuse skin changes
    1. See Skin Discoloration
    2. See Melanism
    3. See Medication Causes of Hyperpigmentation
    4. See systemic causes below

III. Causes: Systemic Conditions with Hyperpigmentation

  1. Cardiovascular
    1. Venous Stasis Dermatitis
  2. Skin
    1. Scleroderma
  3. Endocrine and Metabolic
    1. See Hyperpigmentation in Pregnancy
    2. Grave's Disease
    3. Hyperthyroidism
    4. Addison's Disease (Melanin Deposition)
    5. Porphyria
    6. Diabetic Dermopathy
      1. Hemosiderin deposition in Diabetes Mellitus
  4. Gastrointestinal Disease
    1. Whipple's Disease
    2. Cirrhosis
    3. Felty's Syndrome
    4. Hemochromatosis (Iron deposition)
  5. Genitalia
    1. Heller-Nelson Syndrome
  6. Hematology and Oncology
    1. Pernicious Anemia
    2. Folic Acid Deficiency
    3. Neoplasm
  7. Nutrition
    1. Malnutrition
    2. Starvation
  8. Medications and toxins
    1. See Medication Causes of Hyperpigmentation
    2. Phototoxic Reaction (increased Melanocytes)

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