Differential diagnosis of hyperpigmentation are :
-POEMS syndrome ( polyneuropathy, organomegaly, endocrinopathy,monoclonal gammopathy and skin changes)
-berloque hyperpigmentation ( phototoxicity from celery or citrus )
-kala azar / visceral leishmaniasis
-exogenous pigment exposure – carotenemia, arsenic,tattooing, gold, argyria
-fixed drug eruption to laxatives – phenolphthalein, NSAIDS, tetracyclines
-topical drugs such as tretinoin, fluorouracil and benzoyl peroxide,
-drugs such as chloroquine, minocycline, amiodarone and chlorpromazine
-folate deficiency
-vitamin B12 deficiency
-scleroderma
-Whipple’s disease
-Wilson’s disease
-porphyria cutanea tarda
-pellagra
-ochronosis
-hyperbilirubinemia
-acanthosis nigricans
-Addison’s disease
-hemochromatosis
-neurofibromatosi
-café au lait spots
-axillary freckling
-melasma / cholasma
-chronic venous insufficiency
-post inflammatory / acne / actopic dermatitis
-lentigines , liver spots, senile freckles
-ephelides / juvenile freckles
-pigmented nevi
-POEMS syndrome ( polyneuropathy, organomegaly, endocrinopathy,monoclonal gammopathy and skin changes)
-berloque hyperpigmentation ( phototoxicity from celery or citrus )
-kala azar / visceral leishmaniasis
-exogenous pigment exposure – carotenemia, arsenic,tattooing, gold, argyria
-fixed drug eruption to laxatives – phenolphthalein, NSAIDS, tetracyclines
-topical drugs such as tretinoin, fluorouracil and benzoyl peroxide,
-drugs such as chloroquine, minocycline, amiodarone and chlorpromazine
-folate deficiency
-vitamin B12 deficiency
-scleroderma
-Whipple’s disease
-Wilson’s disease
-porphyria cutanea tarda
-pellagra
-ochronosis
-hyperbilirubinemia
-acanthosis nigricans
-Addison’s disease
-hemochromatosis
-neurofibromatosi
-café au lait spots
-axillary freckling
-melasma / cholasma
-chronic venous insufficiency
-post inflammatory / acne / actopic dermatitis
-lentigines , liver spots, senile freckles
-ephelides / juvenile freckles
-pigmented nevi