Dyschromia L81.9

Especially in the Anglo-American literature differently defined term for an endogenous or exogenous, solitary or multiple, localized, disseminated or universal (diffuse), caused by differently colored, endogenous or exogenous pigments(not melanin pig ments), not fading color change of the skin (coloration), the mucous membranes, the hair, the nails (see below chromonychia) and possibly the teeth.

A "melanotic discoloration of the skin" is not called dyschromia but hyperpigmentation (melanin pigmentation) (see there).

Dyschromias can be subdivided according to color, type (e.g., metal salts), and origin (endogenous or exogenous) of the pigments, or according to their localization:

Dyschromias due to metal salts:

• Bismuth (bismuth salts play a role in the therapy of Helicobacter duodeni infection) .
• Hydrargyrosis (mercury)
• Hemosiderin deposition due to hematomas (e.g. black heel), in hemochromatosis; purpura jaune d'ocre, purpura pigmentosa progressiva
• Iron oxide deposition in tissue after local application of iron-III-chloride
• Chrysiasis (gold)
• Argyrosis (silver - localized/generalized)
• Amalgam (oral mucosa)
• Cobalt/chrome in metallosis

Dyschromias due to medications:

• Amalgam
• Amiodarone (darkening of the skin)
• Minocycline (largely reversible blue-black pigmentation of the face, lower legs and oral mucosa due to iron-containing pigment when taken in high doses over a long period of time)
• Clofazimine (reddish to brown-violet skin discoloration)
• Imipramim
• Hydroxychloroquine (malaria prophylaxis; therapy of lupus erythematosus)

Dyschromia due to metabolic products:

• Hemosiderosis (deposition of hemosiderin)
• Amyloidosis, macular
• Aurantiasis cutis (carotene)
• Hypothyroidism (carotene?)
• Bilirubin(icterus; bronze baby syndrome)
• ochronosis (endogenous) - due to storage of homogentisic acid in the tissue
• Renal failure, chronic terminal.

Exogenous (circumscribed) dyschromia:

• Ochronosis, exogenous: after application of creams containing such ingredients as hydroquinone or phenol, used by colored people to bleach the skin of the face, pigment may be deposited in the skin, usually on the cheek.
• Argentum nitricum (caustic)
• Iron-III-chloride (brushings for local haemostasis)
• Dyes applied for local disinfection (e.g. potassium permanganate, quinolinol, fuchsin, eosin, methylrosanilinium chloride (gentian violet)) or other therapeutic measures (e.g. dithranol for psoriasis therapy).
• dyes (applied for cosmetic purposes e.g. henna)
• jewellery (=black dermographism: discolouration of the skin at the contact point of the jewellery)
• Tattoos (jewellery or dirt tattoos)
• Temporary tattoos (e.g. henna)
• Dirt tattoos (after injuries of the skin)
• Sideroses (rust formation) of the skin, after penetration of ferrous metal splinters into the skin.