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Pigmented contact dermatitis
Other Resources UpToDate PubMed

Pigmented contact dermatitis

Contributors: Alexis E. Carrington MD, Scarlett Boulos MD, Vivian Wong MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Pigmented contact dermatitis, also known as Riehl melanosis, pigmented cosmetic dermatitis, and melanosis faciei feminae (female facial melanosis), is a nonpruritic pigmented contact dermatitis of rapid onset characterized by reticulated, brownish-gray pigmentation of the face and neck. It particularly affects the forehead, temples, and zygomatic regions.

While some aspects of the etiology remain unclear, investigations, particularly in Japan, have found that the hyperpigmentation stems from sensitivity to certain chemicals in cosmetics. In these investigations, hundreds of patients were shown to have positive patch tests to cosmetics and their ingredients, and their hyperpigmentation significantly improved after avoiding cosmetics with those allergens.

Common chemicals implicated in pigmented contact dermatitis include:
  • Fragrances – hydroxycitronellal, benzyl salicylate, jasmine absolute, ylang-ylang oil, cananga oil, sandalwood oil, eugenol, cinnamic derivatives, hydroperoxides of limonene, and balsam of Peru
  • Pigments – D & C Red 31, Red 225; D & C Yellow 11, Yellow 10; and pigments containing phenyl-azo-e-naphthol, aniline dyes, kumkum (a red powder commonly used by Hindu women), and henna
  • Optical whiteners
  • Coal tar derivatives, which increase photosensitivity
  • Bactericidals – carbanilides such as trichlocarban and halocarban
Pigmented cosmetic contact dermatitis most commonly affects women, especially women of Asian and Hispanic descent. Women with very light skin phototypes and very dark skin phototypes do not show the same skin color changes. Men and children can also be affected by pigmented contact dermatitis.

Codes

ICD10CM:
L81.4 – Other melanin hyperpigmentation

SNOMEDCT:
24285001 – Riehl's melanosis

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Last Reviewed:09/21/2020
Last Updated:09/21/2020
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Pigmented contact dermatitis
A medical illustration showing key findings of Pigmented contact dermatitis : Reticular - netlike, Hyperpigmented macules, Hyperpigmented patches
Clinical image of Pigmented contact dermatitis - imageId=93789. Click to open in gallery.  caption: 'Hyperpigmented and reddish patches on the neck.'
Hyperpigmented and reddish patches on the neck.
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