Pigmented contact dermatitis: An updated review

Abstract

Pigmented contact dermatitis (PCD) is a disorder brought on by repeated exposure to low-intensity allergens, usually presenting as blotchy or reticulate slate-gray pigmentation affecting Fitzpatrick skin type IV-VI. The pathogenesis remains unclear; however, type IV hypersensitivity reactions due to allergic sensitization, genetics, ultraviolet exposure, and autoimmunity are to blame. Clinical examination, dermoscopy, patch/photo patch testing, histopathology, and recently, a novel reflectance confocal microscopy and multimodality skin imaging system aid in the diagnosis. Several contact allergens have been linked to PCD, but from an Indian perspective, Kumkum and Paraphenylenediamine are the incriminating agents. Patch testing plays an immense role whenever PCD is diagnosed, primarily due to contact allergens. Devastating psychological impacts can result from PCD-related deformity on social acceptance, mental health, and self-esteem. Avoiding allergens, wearing broad-spectrum sunscreen, and engaging in sun-protective behavior are general measures for treating the condition.