Facial Dermal Melanocytosis

Review Article

Austin J Dermatolog. 2014;1(2): 1006.

Facial Dermal Melanocytosis

Shinichi Watanabe*

Department of Dermatology, Teikyo University School of Medicine, Japan

*Corresponding author: Shinichi Watanabe, Department of Dermatology, Teikyo University School of Medicine, 11-1. Kaga-2, Itabashi, Tokyo 173-8605, Japan

Received: March 29, 2014; Accepted: April 28, 2014; Published: April 30, 2014


From the standpoint of age of onset, there is overlap between classical nevus of Ota and Hori’s or Sun’s nevus. The distribution of pigmentation is identical between nevus of Ota and Hori’s nevi, although mostly unilateral in nevus of Ota. The histology of Hori’s and Sun’s nevi is identical to nevus of Ota. These late-onset dermal melanocytoses appearing on the face can be treated by Q-switched lasers, as is the case with nevus of Ota. Therefore, these dermal melanocytoses are included in the same disorder, which we propose calling facial dermal melanocytosis (FDM). They are more common than infantile onset cases and are frequently observed in Asian countries. In our study of patients who complained of acquired hypermelanosis appearing on the face, 12.2% were diagnosed as FDM. If “dark rings under the eyes” is included in this category, the incidence of FDM is very high. Adult onset FDM is frequently and persistently confused with the other commonly acquired hypermelanosis, suchas melasma, ephelides, and solar lentigines. Misdiagnosis induces malpractice, because FDM can be treated easily by Q–switched lasers. Therefore, FDM signify differential diagnosis from the other acquired hypermelanosis.

Keywords: Facial; Melanocytosis


FDM: Facial Dermal Melanocytosis


Disorders of melanin pigmentation can be divided on morphological grounds into two types. The first is hypermelanosis, where there is an increased amount of melanin in the skin. The second type is hypomelanosis, where there is a lack of pigment in the skin. Furthermore, hypermelanosis can be divided on histological grounds into epidermal hypermelanosis, dermal hypermelanosis, and mixed epidermal and dermal hypermelanosis. Histological features of dermal hypermelanosis include pigment incontinence with accumulation of melanophages and increased melanin in dermal melanocytes. The dermal hypermelanois due to the presence of melanin–producing dendritic melanocytes that lie in the dermis is named dermal melanocytosis, which includes nevus of Ota, nevus of Ito, Mongolian spots.

Pigmentary disorders appearing on the face, even if they are benign, frequently cause cosmetic and psychological problems to many people, especially women and can lead to the appearance of increased facial aging. These are perceived by some to be an inevitable outward sign of the aging process. However, it is felt by others to be an event that should be delayed or prevented if possible. These facial pigmentations include solar lentigines, pigmented seborrheic keratoses, melasma, nevus of Ota, and facial hypermelanosis fromother causes.