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In the past 10\u2009years, new categories have been developed, raising questions about how to classify Riehl's melanosis. The mechanism of this disease remains unclear, although the type IV hypersensitivity response caused by allergic sensitization, as well as genetic, ultraviolet radiation, and autoimmune factors, is to blame. Clinical manifestation, dermoscopy, reflectance confocal microscopy, patch\/photopatch testing, histopathology, and a novel multimodality skin imaging system have been used for the diagnosis. A variety of therapies including topical skin\u2010lightening agents, oral tranexamic acid, glycyrrhizin compound, chemical peels, and lasers and light therapies (intense pulsed light, 1064\u2010nm Q\u2010Switched Nd: YAG laser, 755\u2010nm PicoWay laser, nonablative 1927\u2010nm fractional thulium fiber laser, new pulsed\u2010type microneedling radiofrequency), with improved effectiveness. The latest findings on possible biomarkers and their relationship to other autoimmune diseases were also summarized.<\/jats:p>","DOI":"10.1111\/pcmr.13108","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T12:03:15Z","timestamp":1688472195000},"page":"455-467","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Unveiling the mystery of Riehl's melanosis: An update from pathogenesis, diagnosis to treatment"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1483-4298","authenticated-orcid":false,"given":"Yuecen","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Dermatology, Huashan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8158-0825","authenticated-orcid":false,"given":"Zhongyi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Huashan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2080-0550","authenticated-orcid":false,"given":"Leihong Flora","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Huashan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1302-5667","authenticated-orcid":false,"given":"Chengfeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Huashan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijdvl.IJDVL_603_18"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/0378\u20106323.26722"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15576"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijdvl.IJDVL_373_18"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103\u2010022\u201003620\u20101"},{"issue":"1","key":"e_1_2_11_7_1","first-page":"1","article-title":"A case of an elderly women presented with severe pigmented contact dermatitis (Riehl's melanosis) effectively treated with topical lignin peroxidase cream","volume":"4","author":"Chan K. 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