Hyperpigmentation
Freckles/Ephelides:
Very common autosomal dominant small (<5mm), dark to light brown macules on sun exposed skin; become more prominent during summer; appear in first 3-5 years; usually have red or blond hair.
Melanocytic naevi/moles:
Benign proliferation of melanocytes.
Post-inflammatory hyperpigmentation:
Many inflammatory conditions may intensify skin pigmentation
Lentigo:
Small, discrete brown to black macule, usually 1-5mm. Resemble freckles.
Café au Lait Spots (CALS)/Café au Lait Macules (CALM):
Well-circumscribed light brown oval macules with irregular border
Diagnostic of neurofibromatosis type 1 (von Recklinghausen’s) – also occurs in other syndromes (eg Silver-Russell syndrome)
Addison’s disease:
Adrenocortical insufficiency skin hyperpigmentation
Haemochromatosis:
Iron deposition disorder bronze, blue-gray or brown-black hyperpigmentation
Haemosiderinosis:
Due to deposition of haemosiderin in skin from extravasation of red blood cells phagocytosis release of pigment skin appears a rusty red brown, especially around lower leg and ankle – sometimes dorsum of foot.
Usually associated with venous disease.
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