A woman in Vadodara, India, experienced an unusual skin condition known as exogenous ochronosis after using a skin-lightening cream, as reported in the New England Journal of Medicine. The 55-year-old woman had been applying a skin-lightening cream containing hydroquinone, a skin-bleaching agent, for a year to address patches of hyperpigmentation or melasma on her cheeks. However, the cream led to the development of bluish-brown patches with background erythema (skin reddening) and telangiectasias (widened blood vessels) on her face.
Doctors Nikita Patel and Hiral Shah of Government Medical College, Vadodara, described the condition, stating that the affected skin appeared yellowish-ochre under microscopic view. However, due to the scattering of light, it appeared blue-brown to the naked eye. Exogenous ochronosis occurs when hydroquinone or phenols are applied to the skin.
Ochronosis, a hyperpigmentation disorder, arises when ochre-colored deposits accumulate in the tissues. The condition is challenging to treat, and most treatments are preventative. Some studies suggest that a Q-switched alexandrite (755 nm) laser can be effective. However, complete reversibility may not be achievable.
The authors emphasized the importance of counseling regarding photoprotection and the cessation of using the skin-lightening cream. They prescribed a topical emollient and retinoid gel for the patient. The case highlights the risks associated with certain skin-lightening agents and underscores the need for awareness about the potential adverse effects of such products.
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