1313 Characterization of exogenous ochronosis in skin of color: A case series of 10 patients

Background: Exogenous ochronosis (EO) is a rare cutaneous disorder that disproportionately impacts skin of color and can be very challenging to treat. EO most commonly occurs secondary the continual chronic use hydroquinone resulting in an accumulation homogentisic acid polymerized ochre-colored pigment papillary dermis. There are few US cases date discussing clinicopathology color. From 1983 2020, approximately 39 were reported literature. Methods: We present ten reviewed with Fitzpatrick types IV-VI clinical or histopathological diagnosis ochronosis. Results: The majority female (9/10, 90%) type V (7/10, 70%). All identified as Black African American. mean age at time was 69 years (range 53-82). Past medical history significant for melasma (6/10, 60%) 4-10% (5/10, 50%). One case commercial fade cream. unremarkable phenol, resorcinol, antimalarials, benzene mercury derivatives endogenous systemic effects. Physical exam findings included blue black speckled patches bluish gray pigmentation on bilateral cheeks. 80% (8/10) had biopsy proven between 2017 2021 histological features pathognomonic EO, including sharply-defined fibers, banana-shaped collagen bundles, sickle-shaped ochronotic bodies irregularly-shaped golden-colored deposits Conclusion: Our demonstrate characterization Hydroquinone occurred 5 10 demonstrating histologically confirmed EO. As treatment has demonstrated inconsistent results, further studies warranted characterize inform prevention strategies.