Pigmentation around the Eyes in Singapore

-The pathogenesis of peri-orbital hyperpigmentation (POH) can be multifactorial.
-Prof Goh CL and colleagues conducted an epidemiological study to assess the prevalence of POH in Asians in an attempt to propose a classification

METHODS
-1000 consecutive patients attending a general dermatology clinic in Singapore were enrolled into the study (for information Singapore has a multiethnical society consisting of Han Chinese, Malays, Indians, Eurasiams, Caucasians….)
-200 patients with POH were examined and investigated to define the causes of POH. The possible causes were determined by a detailed history and clinical examination:

RESULTS
-60% of the 200 patients with POH were males
-Results by type:

• Constitutional (38.6%): most common in Indians and Malays
• Post-inflammatory Hyperpigmentation (PIH) (12%)
• Shadow effects (11.4%)
• Vascular (41.8%): most common in Chinese. Vessels are seen and the color change is more of an aberration of the vasculature:
  • 66% of the vessel type were veins
    15%: capillary
    15%: mixed

-There was no correlation with lack of sleep

CONCLUSION
-The vascular form of POH was the predominant type. The classifcation of POH may have an influence on the treatments chosen (although treatments presently available overall do NOT seem to work well):

• Vascular POH could respond to lasers or a vasoconstrictor (such as Brimodinine)
• PIH could respond to topical anti-inflammatories or skin whiteners.
• Constitutional POH could respond to Pigment lasers (Picolaser ?)
• Shadow type could respond to fillers

-Such a systemic approach may result in a better outcome for treatment of POH

 
Goh CL. Periorbital hyperpigmentation in Asians. Global Chinese Dermatology Summit (GCDS) Symposium. World Congress of Dermatology 2015 –  Vancouver, Canada