Pigmentary disorders, including cutaneous hyperpigmentation, are among the most common dermatologic diagnoses in individuals with SOC, particularly individuals with African, Asian, or Hispanic heritage. The principal hyperpigmentation conditions include melasma, post-inflammatory hyperpigmentation (PIH), solar lentigines, drug-induced and infectious pigmentary changes, maturational dyschromia, and acquired dermal macular hyperpigmentation (ADMH). In a cross-sectional analysis of 41,283 patients, melasma was significantly more prevalent in Asian and Hispanic populations, and was strongly comorbid with rosacea and atopic dermatitis.
For the clinician, the central difficulty is rarely diagnosis; it is the management of a chronic and relapsing condition, the disproportionate burden carried by patients with deeply pigmented skin, and the gap between the populations enrolled in clinical trials and those encountered in practice. This review summarizes the state-of-the-science on hyperpigmentation, with a particular focus on SOC patients, that should help guide treatment approaches.
