Facial hyperpigmentation if localised would be a lentigene or Hutchison's melanotic freckle,Melasma in females or part of an epidermal or congenital nevus. Ochronosis can arise from treatment with hydroquinone.
Localised hyperpigmentation DAMN PIG PAPA View GlobalSkinAtlas for Images
Drugs Fixed drug plus antimalarials, minocycline, cytotoxics, bleomycin(reticulate pigmentation), mercury and bismuth, psoralens, dithranol in psoriasis,
Autoimmune Scleroderma,lupus erythematosus, dermatomyositis, atrophoderma,
Metabolic Ochronosis, chloasma, gaucher's disease, kwashiorkor, pellagra, linea nigra, acanthosis nigricans,
Neoplastic Lymphoma, melanoma, mastocytosis,
P erythema dyschromicum perstans, post inflammatory hyperpigmentation, erythema ab igne, lichen planus,
Infective erythrasma, tinea nigra
Granulomatous leprosy, granuloma annulare, syphilis
P Parapsoriasis,
A Amyloid,
P Pigmented purpuric dermatosis,
A acanthosis nigricans
Hyperpigmentation in the neonate
Blue grey Mongolian spot, Nevus of Ota (Face), Nevus of Ito (Shoulder,neck), Phakomatosis pigmentovascularis(Trunk plus port wine stain)
Brown Cafe au lait spots, Congenital nevus
Small brown macules Peutz Jeghers syndrome, LEOPARD syndrome, Generalised lentiginosis, Inherited patterned lentiginosis, Carney syndrome, Neurofibromatosis(axillae), Centrofacial lentiginosis(central face)Segmental lentiginosis, Mosaicism, Speckled lentiginous nevus, Nevus spilus, Transient neonatal pustular melanosis
Labial brown macules Peutz Jeghers syndrome, Carney syndrome, Laugier Hunziger syndrome, post fixed drug
Swirled or Blaschko pattern Linear and whorled nevoid hyperpigmentation, Incontinentia pigmenti, Epidermal nevus, Goltz syndrome, Conradi Hunermann syndrome, Mosaicism
