{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:32:19Z","timestamp":1791160339238,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2007,12,17]],"date-time":"2007-12-17T00:00:00Z","timestamp":1197849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2008,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hydroquinone is the first choice of topical bleaching agents used in treatment of melasma. In Brazil, hydroquinone is widely prescribed by physicians and often used by patients without a prescription. The principal adverse effects of its chronic use are confetti\u2010like depigmentation and exogenous ochronosis. The latter manifests clinically with gray\u2010brown or blue\u2010black hyperpigmentation, as well as pinpoint hyperchromic papules that look like caviar, and therefore called caviar\u2010like. On histopathology, curved ochre\u2010colored structures, \u2018banana\u2010shaped\u2019 fibers, appear in the papillary dermis. No description of dermoscopy in ochronosis is found in the literature. We report four cases of hydroquinone\u2010induced exogenous ochronosis. Dermoscopy was performed in two patients on the areas with ochronosis, and in addition to the melasma findings, amorphous densely pigmented structures obliterating some follicular openings were observed. Exogenous ochronosis is an avoidable dermatosis that is difficult to treat. Dermatologists should be able to differentiate it from melasma and immediately discontinue hydroquinone. Dermoscopy might become a valuable resource in approaching exogenous ochronosis.<\/jats:p>","DOI":"10.1111\/j.1365-4632.2007.03351.x","type":"journal-article","created":{"date-parts":[[2010,8,12]],"date-time":"2010-08-12T16:01:52Z","timestamp":1281628912000},"page":"19-23","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":82,"title":["Hydroquinone\u2010induced exogenous ochronosis: a report of four cases and usefulness of dermoscopy"],"prefix":"10.1111","volume":"47","author":[{"given":"Ra\u00fal","family":"Charl\u00edn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos B.","family":"Barcaui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard Kawa","family":"Kac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah Brazuna","family":"Soares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Rabello\u2010Fonseca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luna","family":"Azulay\u2010Abulafia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,12,17]]},"reference":[{"key":"e_1_2_5_2_2","article-title":"Ein Fall von allegemeiner ochronose der knorpel aud knorpelahnlichen theile","volume":"37","author":"Virchow R.","year":"1866","journal-title":"Virchows Arch (Pathol Anat)"},{"key":"e_1_2_5_3_2","first-page":"11","article-title":"Exogenous ochronosis from hydroquinone bleaching cream","volume":"62","author":"Fisher AA","year":"1998","journal-title":"Cutis"},{"key":"e_1_2_5_4_2","first-page":"1371","volume-title":"The Metabolic and Molecular Bases of Inherited Disease","author":"La Du BN","year":"2001"},{"key":"e_1_2_5_5_2","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1080\/17843286.1995.11718475","article-title":"The clinical manifestations of ochronosis: a review","volume":"50","author":"Van Offel JF","year":"1995","journal-title":"Acta Clin Belg"},{"key":"e_1_2_5_6_2","first-page":"1841","volume-title":"Dermatology in General Medicine","author":"Goldsmith LA","year":"1993"},{"key":"e_1_2_5_7_2","first-page":"505","article-title":"A further note on ochronosis associated with carboluria","volume":"5","author":"Beddard AP","year":"1912","journal-title":"Q S Med"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)47147-3"},{"key":"e_1_2_5_9_2","first-page":"258","article-title":"Case of exogenetic ochronosis from carbolic acid compresses","volume":"32","author":"Brogren N.","year":"1952","journal-title":"Acta Derm Venereol (Stockholm)"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1975.tb05110.x"},{"key":"e_1_2_5_11_2","first-page":"234","article-title":"Ochronosis\u2010like pigmentation associated with the use of atabrine","volume":"89","author":"Sugar HS","year":"1946","journal-title":"Ill Med J"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-59-3-378"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1963.01590220051006"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.236.4.385"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(83)80022-X"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.1990.tb00326.x"},{"key":"e_1_2_5_17_2","first-page":"33","article-title":"Soleil et peau","volume":"2","author":"Fitzpatrick TB","year":"1975","journal-title":"J Med Esthet"},{"key":"e_1_2_5_18_2","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1001\/archderm.1985.01660010109032","article-title":"Ochronosis\u2010like pigmentation from hydroquinone bleaching creams in Americans blacks","volume":"121","author":"Hoshaw RA","year":"1985","journal-title":"Arch Dermatol"},{"key":"e_1_2_5_19_2","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/archderm.1985.01660100019003","article-title":"Ochronosis\u2010like pigmentation from bleaching creams","volume":"121","author":"Penneys NS","year":"1985","journal-title":"Arch Dermatol"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(83)80287-4"},{"key":"e_1_2_5_21_2","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1097\/00000372-199108000-00015","article-title":"Transepidermal elimination in exogenous ochronosis. 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