Diagnosis: Exogenous ochronosis (from hydroquinone in "Ambi")
Also see Case of the Month for August 1997.
Histopathology: reveals yellow-brown inclusions in the papillary dermis. These have been said to resemble "bananas".
Discussion: Exogenous ochronosis is a well-recognized side effect from the use of topical hydroquinone. It is most commonly seen in darkly pigmented individuals, however, caucasians may also develop the condition. Hydroquinone is readily available in over the counter preparations and from the internet. "Ambi" cream contains the active ingredient of Hydroquinone 2%.
Treatment consists of stopping the offending agent; a gradual improvement may occur over time. Recently the use of a Q-switched laser has been reported to be beneficial.
References:
Kramer KE, Lopez A, Stefanato CM, Phillips TJ. Exogenous ochronosis. J Am Acad Dermatol
2000;42:869-7 1.
Learn more about available OTC hydroquinones at drugstore.com.
http://www. drugstore. com/templates/stdplist/default. asp?catid= 13564
My thanks to Dr. Brent Moody for his help in the preparation of this
case.
