Monday, October 28

Skin discoloration

› Skin discoloration
Skin discoloration is the most common dermal condition experienced by us. Though skin discoloration usually may not pose as a problem, in some cases serious diseases may be associated with it.

Normally skin coloration and skin pigmentation are dependent on the ethnicity of an individual. On many instances the normal human skin color gets changed in patches or in great areas due to many factors including environment, hormones, foods, immune responses and diseases. The following pages discuss individual skin discolorations and their causes.

Types of skin discoloration

Changes in skin color usually appear as small irregular patches. However sometimes a greater area may show change in color. These skin discolorations can take up different hues. Changes in melanin pigment, pregnancy, hormonal imbalances and immune diseases can cause hypopigmentation or hyperpigmentation leading to pale, white, dark or brown color change.

Hypervascularization, inflammation or infections can cause red or pinkish color change in the affected area. Cyanosis, diet, hypercarotenemia, mineral overload, medicines and jaundice can also cause skin discolorations.

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Skin discoloration pictures

The pictures of dermal color changes gives us a clear comparative idea about the medical conditions and help us in diagnosis and treatment of diseases. Addison's disease is a disorder of adrenal gland insufficiency. Addison disease primarily manifests as hyperpigmentation showing symptoms of patchy tanning.

Patients affected by type 2 diabetes develop scleroderma diabeticorum, a rare disorder of epidermis causing its thickening with excess black or dark brown melanin deposits. Mostly the skin on the upper back and the back of the neck is affected.

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White discoloration on skin

Though the human color is hereditary, pale or white patchy color changes can occur due to hypopigmentation or hypomelanosis. The reduced pigmentation may occur due to avitaminosis, certain congenital disorders, injuries or infections. Genetic disorders as in albinism and defective embryonic development as in leucism can cause complete or high level of whitening.

Color changes due to vitiligo are mostly brought about by autoimmune diseases causing death of melanin pigment producing cells (melanocytes). These hypopigmentation patches occur usually on the extremities like fingers. Color changes also occur around body orifices like umbilicus, mouth, genitalia, nostrils and eyes.

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Dark brown or black discoloration of skin

Excess production and deposition of melanin pigment (hyperpigmentation) on the epidermis gives rise to black or dark brown color changes. The appearance of dark brown or black patches may be due excess sun exposure, sun damage, excess tanning, diseases, hormones or injuries. It is found that persons of Mediterranean, African or Asian origin are more prone to excess pigmentation.

Melanocytic nevus, commonly known as birthmark, is a common dark brown or black growth of the epidermis. Melanocytic nevus may form subdermally or form as a pigmented growth on the skin. Birthmarks are congenital being present at the time of birth and melanocytic nevi may appear in the later stages of life. Moles and birthmarks which change color, shape or size and those which are painful may have to be medically investigated as some can turn into melanoma (a type of cancer).

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Reddish skin discoloration

Reddish color change is due to increased blood flow to dermis (hyperemia), bleeding underneath epidermis or formation of carboxyhemoglobin in the blood. The hyperemia of dermis is also known as erythema wherein there is increased blood flow in capillaries. Inflammations, injuries, cellulitis or infections can cause increased blood flow in the affected area. These color changes usually disappear with the resolution of the medical problem.

When there is bleeding underneath the dermis purple or reddish discoloration change occurs which is known as purpura. Purpura does not blanch on applying finger pressure while erythema disappears. Inhalation of carbon monoxide can form carboxyhemoglobin in the blood giving reddish coloration. Carbon monoxide inhalation causes debilitating effects at low levels and is fatal in high levels.

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Bluish discoloration of skin

Bluish coloration is usually due to oxygen depleted blood as in cyanosis, Raynaud's Syndrome and methemoglobinemia. Oxygen depleted blood appears dark red in color and generates shift in optical effects leading to bluish appearance. Mongolian spots appear as bluish patches with irregular shape and wavy borders.

Mongolian spots are due to melanocytes being entrapped and embedded deep in the dermis during their embryonic development and accumulation of melanin. Argyria is the bluish coloration due to accumulation of silver on the dermis caused by ingesting silver compounds as health potions.

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Yellow discoloration of skin

Yellow coloration can be due to the buildup of bilirubin in the blood and the onset of jaundice. Many diseases and conditions lead to buildup of bilirubin in the blood. Yellow coloration requires medical evaluation as it may be due to very serious life threatening diseases.

Increased rate of breakdown of red blood cells can cause pre-hepatic jaundice. Hepatocellular jaundice is caused when the bile does not flow to duodenum. Post-hepatic jaundice is usually due to interruption to the flow of bile inside liver as well as to duodenum.

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Reddened skin

Reddened skin can be due to thin epidermal layer and/or lack of pigment as in the case of lips. It can be also due to benign growths, swellings or tumors caused by endothelial cells involution as in the case of hemangioma. Hemangioma are benign infancy tumors and they usually resolve by the age of ten years.

Nevus flammeus, a birthmark, produces reddened coloration due to dilation of superficial and deeper capillaries. Nevus flammeus usually persists throughout the life. Salmon patches (nevus simplex) are again highly prevalent birthmarks appearing on the forehead, eyelids, knees, on lips or back of neck. Salmon patches are due to dilation of superficial blood vessels and resolve as the child grows.

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Orange skin discoloration

β-Carotene, a carotenoid antioxidant, imparts yellow-orange coloration to fruits and vegetables. When excess of fruits and vegetables, especially carrots, are consumed the carotenoids are deposited in the intercellular lipids of the stratum corneum imparting yellow-orange color (carotenemia).

The coloration is more pronounced where the stratum corneum is thicker as in palms, soles and nasolabial folds. Secondary carotenemia occurs when there is decreased metabolism or excretion of carotenoids requiring medical treatment. Normally orange coloration resolves over a few days when excess consumption of carrots is stopped.

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