Abstract
Background: There are many causes of facial melanosis like melasma, frictional melanosis, acanthosis nigricanis, lichen planus actinicus, and others. But Gazelle eye like facial melanosis was not recognized as a special disease with characteristic features. Objective: To report a new recognized facial pigmentation that is not uncommonly seen among adults especially females which is locally known as a Gazelle eye like facial melanosis. Patients and methods: This case series descriptive study with histopathological examination was conducted in the Department of Dermatology, Baghdad Teaching Hospital; Baghdad, Iraq during the period from January 2009- December 2013.One hundred patients with gazelle eye like facial pigmentation were collected and evaluated by clinical and histopathological examinations. History was obtained from each patient regarding all socio- demographic aspects related to the disease. Also, clinical assessment was done including Wood’s light examination. Incisional or punch biopsy was performed from 10 patients for histopathological examination. Results: One hundred patients were recorded and examined: 88(88%) females and 12(12%) males with a female to male ratio: 6.5:1 .Their ages ranged from 16-48 (28.7 ± 5) years. The duration of the disease ranged from 5-15(8 ± 3.2) years. All patients had characteristic pigmentation that started around the eyes in a symmetrical fashion and descended down to the cheeks which ended with a tail like and there was a well demarcated white band across the cheek’s pigmentation. The pigmentation was dark brown in color that is not delineated from surrounding normal face skin with negative Wood’s light examination. Histopathological study revealed mainly dermal melanosis as many melanophages were seen in the superficial dermis with basal melanosis of the epidermis. On systemic review all patients were apparently healthy apart from facial melanosis as the main complaint. Conclusions: We think this is a new entity that commonly seen in the clinical practice as a cause of facial melanosis but it’s not well recognized. It has a characteristic location, distribution and configuration that deserve the name “Gazelle eye like facial melanosis”.
Highlights
All patients had characteristic pigmentation that started around the eyes in a symmetrical fashion and descended down to the cheeks which ended with a tail like and there was a well demarcated white band across the cheek’s pigmentation
The pigmentation was dark brown in color that is not delineated from surrounding normal face skin with negative Wood’s light examination
Histopathological study revealed mainly dermal melanosis as many melanophages were seen in the superficial dermis with basal melanosis of the epidermis
Summary
Facial melanosis is a major cosmetic problem among people especially in people dark complexion [1,2], and from daily clinical practice we can categorize the commonest causes of facial melanosis as follow [1,2,3]: 1-Melasma: It is probably the commonest cause of facial pigmentation and it has a characteristic light to dark brown color with stuck up on appearance [1,2,3,4,5,6,7,8] It could be defined as chronic disfiguring dermatological disease of females and males , much more common among females that appear during the active reproductive period with the presence of provoking factors like hormonal changes and sunlight that induce brown hyperpigmentation of the face .This may take many shapes but much more commonly a butterfly and a mask appearance [6,7,8,9,10,11,12,13]. Gazelle eye like facial melanosis was not recognized as a special disease with characteristic features
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