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Hyperpigmentation is a topic covered in the Diagnosaurus.

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Emergency Central

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  • Pigmented nevi
  • Ephelides (juvenile freckles)
  • Lentigines (senile freckles, liver spots)
  • Postinflammatory (eg, acne, atopic dermatitis)
  • Chronic venous insufficiency
  • Melasma (chloasma)
  • Neurofibromatosis (café au lait spots, axillary freckling)
  • Hemochromatosis
  • Addison's disease
  • Acanthosis nigricans
  • Hyperbilirubinemia (eg, primary biliary cirrhosis)
  • Ochronosis (alkaptonuria)
  • Pellagra (niacin deficiency)
  • Porphyria cutanea tarda
  • Wilson's disease
  • Whipple's disease
  • Scleroderma
  • Vitamin B12 deficiency
  • Folate deficiency
  • Medications: chloroquine, chlorpromazine, minocycline, amiodarone
  • Topicals: benzoyl peroxide, tretinoin, fluorouracil
  • Fixed drug eruption to laxatives (phenolphthalein), trimethoprim-sulfamethoxazole, NSAIDs, tetracyclines
  • Exogenous pigment exposure: carotenemia, argyria, gold, tattooing, arsenic
  • Berloque hyperpigmentation (phototoxicity from citrus or celery)
  • Visceral leishmaniasis (kala azar)
  • POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes)

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Last updated: December 1, 2014


Zeiger, Roni F.. "Hyperpigmentation." Diagnosaurus, 4th ed., McGraw-Hill Education, 2014. Emergency Central, emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114223/all/Hyperpigmentation.
Zeiger RF. Hyperpigmentation. Diagnosaurus. 4th ed. McGraw-Hill Education; 2014. https://emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114223/all/Hyperpigmentation. Accessed April 22, 2019.
Zeiger, R. F. (2014). Hyperpigmentation. In Diagnosaurus. Available from https://emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114223/all/Hyperpigmentation
Zeiger RF. Hyperpigmentation [Internet]. In: Diagnosaurus. McGraw-Hill Education; 2014. [cited 2019 April 22]. Available from: https://emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114223/all/Hyperpigmentation.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Hyperpigmentation ID - 114223 A1 - Zeiger,Roni F, Y1 - 2014/12/01/ BT - Diagnosaurus UR - https://emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114223/all/Hyperpigmentation PB - McGraw-Hill Education ET - 4 DB - Emergency Central DP - Unbound Medicine ER -