Periorbital hypermelanosis: A study on clinic-epidemiological profile, common associations and impact on quality of life

Abstract

Introduction Periorbital hypermelanosis (POH) is a common dermatological condition which is characterized clinically by presence of increased pigmentation on the skin around the eyes. Despite its prevalence, there is a paucity of data regarding its clinicoepidemiological profile, risk factors and effects on quality of life.   Methods Epidemiological data was collected and detailed history was taken regarding duration of the complaints, family history, atopic diathesis or drug intake, medical history, sun exposure and lifestyle habits. Clinical assessment included evaluation of distribution, extent, severity of POH eyelid stretch test, Wood’s lamp examination and relevant laboratory investigations. The impact of POH on quality of life was assessed using validated questionnaire (DLQI).   Results POH was most commonly seen in 16-25 age group (53%) with a female preponderance. Family history was present in 29.3% cases with lower lid involvement seen in 62% cases. 53% of the patients were having Grade 2 POM. Constitutional form of POH was most common (44%) and POH appeared to be dermal in 62% of cases. Refractive errors, eye strain, sleep deprivation and frequent eye rubbing, were the common risk factors. Strong association of POH with family history, atopic diathesis and stress was noted. DLQI revealed a significant psychological burden experienced by affected individuals, negatively affecting self-esteem, body image perception and social interactions, leading to increased emotional distress and diminished overall well-being.   Conclusion POH is a multi-factorial entity significantly impacting QOL of affected individuals. By identifying the factors associated with POH, tailored management approaches can be initiated including lifestyle modifications, topical/ systemic therapy and cosmetic interventions to address both physical and psychological aspects of the condition.