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Abstract
Pigmentary changes in Asians are larger problems and more important features of aging
than wrinkles. Melasma is a commonly observed epidermal hypermelanosis of the face
in Asians. The altered dermal structures and impaired basement membrane are thought
to have an influence on the development of epidermal hyperpigmentation of melasma.
Dermal hyperpigmentary diseases are particularly common in Asians. Acquired bilateral
melanosis of the neck is a characteristic dermal melanotic condition primarily of
the neck in peri-menopausal women. It is characterized by marked accumulation of dermal
pigment with perivascular lymphocytic infiltration. The cases seem to represent a
continuum of Riehl's melanosis. Subclinical injury or inflammation may play a role
as possible causative factors for the development of the pigmentation.