POST INFLAMMATORY HYPERPIGMENTATION

Dian UtamiArsyi AdliahArie Rhoediyat

dr. Meutia Sara

dr. Dirmawati Kadir, Sp. KK

Definition• Post Inflammatory Hyperpigmentation

is (PIH) is the accumulation of melanine on the skin layer caused by numerous preceeding cutaneous insults.• Post inflammatory epidermal melanin

hyperpigmentation is a major problem for patients with skin phototypes IV, V, and VI

Etiology

Allergy

Drug

Physical Injury

Phototoxic Reaction

Infection

Inflammatory Disease

Patophysiology

Patophysiology LT-C4 & LT-D4

PGE2 & PGD2

Tromboksan 2

IL-1 & IL-6

TNF alpha

Epidermal Growth Factor

Reactive Oxygen

Some leukotrien component that can stimulate melanocyte

Clinical Manifestation

Epidermal Hyperpigmentation• Brown or dark brown macula• Disappear on months to

years

Dermal Hyperpigmentation• Greyish blue macula• Disappear on a longer time

or even permanent

Diagnosis

Anamnesis

Hytopathology

Wood LampExaminatio

n

Histopathology

Fontana Masson staining of the lighter colored skin shows normal pigmentation of the

basal layer

Fontana Masson staining of the darker colored skin shows

hyperpigmentation of the basal layer (arrows) without

pigmentary incontinence or dermal melanophages

Differential Diagnosis

Melasma Ephelides Lentigo

Prevention & Treatment

• Sun protection is the cornerstone of prevention of PIHPatients should use a sunscreen SPF 30 or higher every day and re-apply as needed throughout the day.

• Photoprotection with a broad-spectrum sunscreen (UVA and UVB), protective clothing, and avoidance of peak UV exposure times are all important

• In addition, topical hydroquinone 1,5% ; tretinoin, and azelaic acid 15-20% may be tried.

THANK YOU