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Periorbital hyperpigmentation
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Periorbital hyperpigmentation

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Contributors: Ailia Ali MD, Susan Burgin MD
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Synopsis

Periorbital hyperpigmentation (POH), or periorbital melanosis, is a benign and very common dermatological condition that is characterized by dark circles located around the eyes, most often seen on the inferior eyelids. POH is present nearly equally in males and females but may affect more women due to hormonal influences. It is seen more frequently in individuals with darker skin phototypes, and it tends to worsen with age.

Many endogenous and exogenous factors can contribute to POH including genetics, postinflammatory hyperpigmentation (allergies, periorbital eczema), drug-related causes (vasodilatory medications, glaucoma medications such as latanoprost, hormonal therapy), procedures (blepharoplasty, rhinoplasty, chemical peels), and environmental / lifestyle changes (sun exposure, lack of sleep, stress, alcohol, caffeine, smoking).

The underlying pathogenetic mechanisms can be summarized as follows: increased melanocyte or melanophage density or increased melanin production; changes in vasculature; or mechanical changes in skin laxity, muscle, or tear trough that contribute to shadowing effect.

Codes

ICD10CM:
L81.4 – Other melanin hyperpigmentation

SNOMEDCT:
238703005 – Periorbital hypermelanosis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 09/19/2018
Last Updated: 10/05/2018
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Periorbital hyperpigmentation
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Periorbital hyperpigmentation : Bilateral
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