Hyperpigmentation L81.89

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Hypermelanosis; Hyperpigmentations

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Hyperpigmentation in the broader sense is a pathological, congenital or acquired, brown coloration of the skin or mucous membrane (see below pigmentation, pigmentation, melanosis) as a result of pathological accumulation of an endogenous or exogenous pigment.

Hyperpigmentation in the narrower sense (melanotic hyperpigmentation, see also melanosis) is a pathological, clinical colour symptom caused by a congenital or acquired, solitary or multiple, localised or disseminated, in rare cases also generalised or universal, melanotic colour intensification (brown/black/blue colouring) of the skin/mucosa, caused by an increased number of melanocytes or an increased localised melanin formation, or by deposition of melanin formed at a distance from the focal point (e.g. in metastasised malignant melanoma) or by a combination of the various types of melanoma. mechanisms.

The opposite of hyperpigmentation is depigmentation (loss or absence of pigment cells).

If hyperpigmentation occurs as a consequence of inflammatory skin diseases, it is called inflammatory or post-inflammatory hyperpigmentation.

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It is difficult to classify the different disease patterns, whose only common feature is the phenomenon of "hyperpigmentation". The term "hyperpigmentation" describes a pathological brown discoloration of the skin or mucous membrane. Physiological pigmentation of the skin, e.g. caused by the influence of the sun, is not called hyperpigmentation but generally called "tanning".

Basically one can distinguish between:

  • localized hyperpigmentations
  • generalized hyperpigmentations.

Furthermore between:

  • inflammatory (post-inflammatory) hyperpigmentations
  • non-inflammatory hyperpigmentations

Furthermore between:

  • congenital hyperpigmentations (genodermatoses)
  • acquired hyperpigmentations

Furthermore between:

  • diffuse hyperpigmentations
  • reticular hyperpigmentations

Classification according to underlying diseases/causes:

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Hyperpigmentation in the broader sense is caused by the inclusion of exogenous or endogenous pigments.

  • Endogenous pigments: Increased melanin deposition, increased deposition of hemosiderin, bile dyes, carotene, etc.
  • Exogenous pigments: deposition of carbon (tattoo) and various substances which are administered by medication. These include: silver and gold particles, bismuth, tetracyclines, amiodarone, clofazimine, phenacetin, carotene, levodopa, phenothiazines
  • The main stimulus of (melanotic) hyperpigmentation in the narrower sense is mainly UV radiation. However, hormones, mediators of inflammation such as interleukin-1, prostaglandins, mechanical factors (constant local irritation) or chemical photosensitizers (see phototoxic dermatitis below) can also lead to an increase in melanocyte activity (see post-inflammatory hyperpigmentation below).

From a clinical-etiological point of view, the following classification is made:

  • genetic (congenital or acquired)
  • numerical (solitary or multiple)
  • Localization (light accentuated, inverse)
  • extension (localized, disseminated, generalized or universal) and
  • Patterning of hyperpigmentations (segmental, nevoid following the Blaschko lines, random)
  • etiological (post-inflammatory, drug-induced; physical: caloric, mechanical; endocrine; chemical)
  • Location of pigments (epidermal or superficial: brown; dermal: greyish blue to deep blue and blue-black; combination of epidermal and dermal: brown-black).

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Treatment of the underlying disease. S.u. Chloasma.

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Included in the definition of hyperpigmentation is the term melanosis. This is understood to mean melanotic hyperpigmentation of the skin and/or the mucous membrane. Thus, the term is to be understood as a synonym for the term "hyperpigmentations in a narrower sense". S.a. Dyschromia.

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  1. Giehl K et al (2010) Genetically caused pigmentation disorders. Dermatologist 61:567-577
  2. Hallermann C et al (2011) Diffuse brown coloration of skin, mucosa and urine. Dermatologist 62: 51-54


Please ask your physician for a reliable diagnosis. This website is only meant as a reference.


Last updated on: 29.10.2020