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Melanin imparts color to one's skin, which in turn depends on a host of factors eg ethnicity, heredity, environment etc. Changes in skin pigmentation, both diffuse or patchy, may occur both due to disease and drugs.

Diffuse pigmentation: Common causes are

  • Addison disease
  • Haemochromatosis
  • Hyperthyroidism
  • Chloasma, both of pregnancy and menopause
  • Icterus

Patchy pigmentation

  • Melanotic carcinoma, occasionally causing a deeply pigmented skin
  • Tinea versicolor, which produces patchy yellow-brown pigmented area over the trunk.
  • Any dermatitis that takes a long time to heal
  • Café au lait spots of neurofibromatosis
  • Stasis dermatitis from chronic thrombophlebitis and varicose veins
  • Pellagra - pigmentation of the dorsal surfaces of the hands and face
  • Carcinoid syndrome
  • Porphyria
  • Gaucher disease
  • Ochronosis - bluish black or bluish brown pigment of the sclera, ears, skin, and nails.
  • Vitiligo (idiopathic type) - patchy depigmentation
  • Drug reactions