A Lady with Facial Pigmentation

  • Dhiraj Kumar
Part of the Clinical Cases in Dermatology book series (CLIDADE)


Pigmented contact dermatitis (Riehl’s melanosis) is a non-eczematous variant of contact dermatitis commonly caused by fragrances and dyes. A 36-year-old woman presented with reddish-brown to slate grey pigmentation on face in a reticulate pattern for last 2 years. Diagnosis is made based on a detailed history with emphasis on temporal correlation of exposure to a possible sensitizer, and patch test. The cornerstone of treatment consists of complete avoidance of the suspected allergen, broad spectrum sunscreens, judicious use of anti-pigmentary agents, glycolic acid peels, and lasers.


Pigmented contact dermatitis Riehl’s melanosis Allergens Fragrances Patch test 


  1. 1.
    Shenoi SD, Rao R. Pigmented contact dermatitis. Indian J Dermatol Venereol Leprol. 2007;73:285–7.CrossRefGoogle Scholar
  2. 2.
    Osmundsen PE. Pigmented contact dermatitis. Br J Dermatol. 1970;83:296–301.CrossRefGoogle Scholar
  3. 3.
    Nagao S, Iijima S. Light and electron microscopic study of Riehl’s melanosis. Possible mode of its pigmentary incontinence. J Cutan Pathol. 1974;1:165–75.CrossRefGoogle Scholar
  4. 4.
    Nakayama H, Matsuo S, Hayakawa K, Takashi K, Shigematsu T, Ota S. Pigmented cosmetic dermatitis. Int J Dermatol. 1984;23:299–305.CrossRefGoogle Scholar
  5. 5.
    Forester HR, Schwartz L. Industrial dermatitis and melanosis due to photosensitization. Arch Derm Syphilol. 1939;39:55–68.CrossRefGoogle Scholar
  6. 6.
    Nakayama H. Pigmented contact dermatitis and chemical depigmentation. In: Rycroft R, Menne T, Frosch P, Lepoittevin J, editors. Textbook of contact dermatitis. 3rd ed. New York: Springer; 2001. p. 319–33.Google Scholar
  7. 7.
    Leow YH, Tan SH, Ng SK. Pigmented contact cheilitis from ricinoleic acid in lipsticks. Contact Dermatitis. 2003;49(1):48–9.CrossRefGoogle Scholar
  8. 8.
    On HR, Hong WJ, Roh MR. Low-pulse energy Q-switched Nd:YAG laser treatment for hair-dye-induced Riehl’s melanosis. J Cosmet Laser Ther. 2015;17(3):135–8.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Dhiraj Kumar
    • 1
  1. 1.All India Institute of Medical SciencesPatnaIndia

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