There is a variation of pigmentation in Scleroderma. Patient may develop diffuse hyperpigmentation with accentuation in sunexposed and pressure areas, there may be depigmented patch with perifollicular retention of pigment. There are reports of reticulate hyperpigmentation. Why in a same disease so many pigmentary alterations are there?
Clinical and Biological Characterization of Skin Pigmentation Diversity and Its Consequences on UV Impact
Int J Mol Sci. 2018 Sep; 19(9): 2668
Article Clinical and Biological Characterization of Skin Pigmentatio...
Dear Dr. Harasit Kumar Paul,
Thank you for the interesting question.
M.Chuamanochan et al. write:
"The pathogenesis of these hyperpigmentation abnormalities [in systemic sclerosis, SSc - G.T.] remains unclear, but some proposed hypotheses include increased keratinocyte-derived endothelin-1 (ET-1), increased melanin synthesis; increased secretion of melanocytic growth factors by fibroblasts and endothelial cells; and a thermoregulatory mechanism which results in a hyperpigmentation over vessels (“streaky hyperpigmentation”) on a background of depigmented patches [4, 7–9]. Histopathological findings to explain hyperpigmentation in SSc have been previously reported as increased epidermal melanin and pigmentary incontinence with an increased number of dermal melanophages in the superficial dermis [10]".
I think so many skin pigmentary alterations in the same disease are attributable to various pahogenetic mechanisms involved in SSc.
Reference quotes and whole article is available on:
Article Reticulate hyperpigmentation in systemic sclerosis: A case r...
Best regards, G.T.
The cause is unknown. Both hypo and hyoerpigmentation are seen, often with salt and pepper appearance. Vitiligo occurs, which is an autoimmune marker
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