Skip to main content

Gender Dermatology: Pigmentation Disorders

  • Chapter
  • First Online:
  • 879 Accesses

Abstract

The fact that men and women are genetically different goes without saying. How does this factor affect various aspects of skin pigmentation is an extensive area of study.

This chapter will focus on gender influence on skin pigmentation in health and disease.

In health, the influence of sex hormones on melanocyte homeostasis and melanogenesis will be discussed.

In disease: disorders that cause altered skin tone will be discussed, that are not a part of a known dermatologis condition.

Vitiligo is a prototype of hypopigmentation disorders. Even though no difference in incidence of vitiligo exist between men and women, the quality of life impairment in women affected with vitiligo is greater than that in men with same disease severity. Other disorders of hypopigmenation will be discussed briefly.

Melasma is a prototype of hyperpigmanation disorders.

When talking about gender differences in dermatology, melasma is one of the firs conditions to be discussed because of its much higher prevalence among women. There are some features of melasma in men that seem to different. These differences and other disorders of hyperpigmenataion will be discussed in this chapter.

In summary, better understanding of gender differences in skin pigmentation can shed a new light on the pathogenesis of pigmentation disorders and aid in discovering a more effective treatment.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Friedmann PS, Gilchrest BA. Ultraviolet radiation directly induces pigment production by cultured human melanocytes. J Cell Physiol. 1987;133(1):88–94.

    Article  CAS  PubMed  Google Scholar 

  2. Pears JS, Jung RT, Bartlett W, Browning MC, Kenicer K, Thody AJ. A case of skin hyperpigmentation due to alpha-MSH hypersecretion. Br J Dermatol. 1992;126(3):286–9.

    Article  CAS  PubMed  Google Scholar 

  3. Ranson M, Posen S, Mason RS. Human melanocytes as a target tissue for hormones: in vitro studies with 1 alpha-25, dihydroxyvitamin D3, alpha-melanocyte stimulating hormone, and beta-estradiol. J Invest Dermatol. 1988;91(6):593–8.

    Article  CAS  PubMed  Google Scholar 

  4. McLeod SD, Ranson M, Mason RS. Effects of estrogens on human melanocytes in vitro. J Steroid Biochem Mol Biol. 1994;49(1):9–14.

    Article  CAS  PubMed  Google Scholar 

  5. Jee SH, Lee SY, Chiu HC, Chang CC, Chen TJ. Effects of estrogen and estrogen receptor in normal human melanocytes. Biochem Biophys Res Commun. 1994;199(3):1407–12.

    Article  CAS  PubMed  Google Scholar 

  6. Kim NH, Cheong KA, Lee TR, Lee AY. PDZK1 upregulation in estrogen-related hyperpigmentation in melasma. J Invest Dermatol. 2012;132(11):2622–31.

    Article  CAS  PubMed  Google Scholar 

  7. Jian D, Jiang D, Su J, Chen W, Hu X, Kuang Y, et al. Diethylstilbestrol enhances melanogenesis via cAMP-PKA-mediating up-regulation of tyrosinase and MITF in mouse B16 melanoma cells. Steroids. 2011;76(12):1297–304.

    Article  CAS  PubMed  Google Scholar 

  8. Kippenberger S, Loitsch S, Solano F, Bernd A, Kaufmann R. Quantification of tyrosinase, TRP-1, and Trp-2 transcripts in human melanocytes by reverse transcriptase-competitive multiplex PCR—regulation by steroid hormones. J Invest Dermatol. 1998;110(4):364–7.

    CAS  PubMed  Google Scholar 

  9. Wiedemann C, Nagele U, Schramm G, Berking C. Inhibitory effects of progestogens on the estrogen stimulation of melanocytes in vitro. Contraception. 2009;80(3):292–8.

    Article  CAS  PubMed  Google Scholar 

  10. Tadokoro T, Rouzaud F, Itami S, Hearing VJ, Yoshikawa K. The inhibitory effect of androgen and sex-hormone-binding globulin on the intracellular cAMP level and tyrosinase activity of normal human melanocytes. Pigment Cell Res. 2003;16(3):190–7.

    Article  CAS  PubMed  Google Scholar 

  11. Whiteman DC, Parsons PG, Green AC. Determinants of melanocyte density in adult human skin. Arch Dermatol Res. 1999;291(9):511–6.

    Article  CAS  PubMed  Google Scholar 

  12. Giacomoni PU, Mammone T, Teri M. Gender-linked differences in human skin. J Dermatol Sci. 2009;55(3):144–9.

    Article  CAS  PubMed  Google Scholar 

  13. Mehrai H, Sunderland E. Skin colour data from Nowshahr City, northern Iran. Ann Hum Biol. 1990;17(2):115–20.

    Article  CAS  PubMed  Google Scholar 

  14. Banerjee S. Pigmentary fluctuation and hormonal changes. J Genet Hum. 1984;32(5):345–9.

    CAS  PubMed  Google Scholar 

  15. Roh K, Kim D, Ha S, Ro Y, Kim J, Lee H. Pigmentation in Koreans: study of the differences from caucasians in age, gender and seasonal variations. Br J Dermatol. 2001;144(1):94–9.

    Article  CAS  PubMed  Google Scholar 

  16. Green A, Martin NG. Measurement and perception of skin colour in a skin cancer survey. Br J Dermatol. 1990;123(1):77–84.

    Article  CAS  PubMed  Google Scholar 

  17. Kalla AK, Tiwari SC. Sex differences in skin colour in man. Acta Genet Med Gemellol. 1970;19(3):472–6.

    Article  CAS  PubMed  Google Scholar 

  18. Kalla AK. Ageing and sex differences in human skin pigmentation. Z Morphol Anthropol. 1973;65(1):29–33.

    CAS  PubMed  Google Scholar 

  19. Tur E. Physiology of the skin—differences between women and men. Clin Dermatol. 1997;15(1):5–16.

    Article  CAS  PubMed  Google Scholar 

  20. Kelly RI, Pearse R, Bull RH, Leveque JL, de Rigal J, Mortimer PS. The effects of aging on the cutaneous microvasculature. J Am Acad Dermatol. 1995;33(5 Pt 1):749–56.

    Article  CAS  PubMed  Google Scholar 

  21. Frost P. Human skin color: a possible relationship between its sexual dimorphism and its social perception. Perspect Biol Med. 1988;32(1):38–58.

    Article  CAS  PubMed  Google Scholar 

  22. Ortonne JP. Normal and abnormal skin color. Ann Dermatol Venereol. 2012;139(Suppl 4):S125–9.

    Article  PubMed  Google Scholar 

  23. Picardo M, Dell’Anna ML, Ezzedine K, Hamzavi I, Harris JE, Parsad D, et al. Vitiligo. Nat Rev Dis Primers. 2015;1:15011.

    Article  PubMed  Google Scholar 

  24. Ngo ST, Steyn FJ, McCombe PA. Gender differences in autoimmune disease. Front Neuroendocrinol. 2014;35(3):347–69.

    Article  CAS  PubMed  Google Scholar 

  25. Jin Y, Andersen G, Yorgov D, Ferrara TM, Ben S, Brownson KM, et al. Genome-wide association studies of autoimmune vitiligo identify 23 new risk loci and highlight key pathways and regulatory variants. Nat Genet. 2016;48(11):1418–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Howitz J, Brodthagen H, Schwartz M, Thomsen K. Prevalence of vitiligo. Epidemiological survey on the Isle of Bornholm, Denmark. Arch Dermatol. 1977;113(1):47–52.

    Article  CAS  PubMed  Google Scholar 

  27. Kyriakis KP, Palamaras I, Tsele E, Michailides C, Terzoudi S. Case detection rates of vitiligo by gender and age. Int J Dermatol. 2009;48(3):328–9.

    Article  PubMed  Google Scholar 

  28. Patil S, Gautam M, Nadkarni N, Saboo N, Godse K, Setia MS. Gender differences in clinicoepidemiological features of vitiligo: a cross-sectional analysis. ISRN Dermatol. 2014;2014:186197.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Talsania N, Lamb B, Bewley A. Vitiligo is more than skin deep: a survey of members of the Vitiligo Society. Clin Exp Dermatol. 2010;35(7):736–9.

    Article  CAS  PubMed  Google Scholar 

  30. Ongenae K, Van Geel N, De Schepper S, Naeyaert JM. Effect of vitiligo on self-reported health-related quality of life. Br J Dermatol. 2005;152(6):1165–72.

    Article  CAS  PubMed  Google Scholar 

  31. Borimnejad L, Parsa Yekta Z, Nikbakht-Nasrabadi A, Firooz A. Quality of life with vitiligo: comparison of male and female muslim patients in Iran. Gend Med. 2006;3(2):124–30.

    Article  PubMed  Google Scholar 

  32. Kleck RE, Christopher Strenta A. Gender and responses to disfigurement in self and others. J Soc Clin Psychol. 1985;3(3):257–67.

    Article  Google Scholar 

  33. Vachiramon V, Thadanipon K. Postinflammatory hypopigmentation. Clin Exp Dermatol. 2011;36(7):708–14.

    Article  CAS  PubMed  Google Scholar 

  34. Miazek N, Michalek I, Pawlowska-Kisiel M, Olszewska M, Rudnicka L. Pityriasis alba—common disease, enigmatic entity: up-to-date review of the literature. Pediatr Dermatol. 2015;32(6):786–91.

    Article  PubMed  Google Scholar 

  35. Blessmann Weber M, Sponchiado de Avila LG, Albaneze R, Magalhaes de Oliveira OL, Sudhaus BD, Cestari TF. Pityriasis alba: a study of pathogenic factors. J Eur Acad Dermatol Venereol. 2002;16(5):463–8.

    Article  CAS  PubMed  Google Scholar 

  36. Relyveld GN, Menke HE, Westerhof W. Progressive macular hypomelanosis: an overview. Am J Clin Dermatol. 2007;8(1):13–9.

    Article  PubMed  Google Scholar 

  37. Juntongjin P, Laosakul K. Idiopathic guttate hypomelanosis: a review of its etiology, pathogenesis, findings, and treatments. Am J Clin Dermatol. 2016;17(4):403–11.

    Article  PubMed  Google Scholar 

  38. Kim SK, Kim EH, Kang HY, Lee ES, Sohn S, Kim YC. Comprehensive understanding of idiopathic guttate hypomelanosis: clinical and histopathological correlation. Int J Dermatol. 2010;49(2):162–6.

    Article  PubMed  Google Scholar 

  39. Grimes PE. Melasma. Etiologic and therapeutic considerations. Arch Dermatol. 1995;131(12):1453–7.

    Article  CAS  PubMed  Google Scholar 

  40. Hiletework M. Skin diseases seen in Kazanchis health center. Ethiop Med J. 1998;36(4):245–54.

    CAS  PubMed  Google Scholar 

  41. Werlinger KD, Guevara IL, Gonzalez CM, Rincon ET, Caetano R, Haley RW, et al. Prevalence of self-diagnosed melasma among premenopausal Latino women in Dallas and Fort Worth, Tex. Arch Dermatol. 2007;143(3):424–5.

    Article  PubMed  Google Scholar 

  42. Vazquez M, Maldonado H, Benmaman C, Sanchez JL. Melasma in men. A clinical and histologic study. Int J Dermatol. 1988;27(1):25–7.

    Article  PubMed  Google Scholar 

  43. Sarkar R, Jain RK, Puri P. Melasma in Indian males. Dermatol Surg. 2003;29(2):204.

    Article  PubMed  Google Scholar 

  44. Pichardo R, Vallejos Q, Feldman SR, Schulz MR, Verma A, Quandt SA, et al. The prevalence of melasma and its association with quality of life in adult male Latino migrant workers. Int J Dermatol. 2009;48(1):22–6.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Sheth VM, Pandya AG. Melasma: a comprehensive update: part I. J Am Acad Dermatol. 2011;65(4):689–97; quiz 98.

    Article  PubMed  Google Scholar 

  46. Sarkar R, Puri P, Jain RK, Singh A, Desai A. Melasma in men: a clinical, aetiological and histological study. J Eur Acad Dermatol Venereol. 2010;24(7):768–72.

    Article  CAS  PubMed  Google Scholar 

  47. El-Essawi D, Musial JL, Hammad A, Lim HW. A survey of skin disease and skin-related issues in Arab Americans. J Am Acad Dermatol. 2007;56(6):933–8.

    Article  PubMed  Google Scholar 

  48. Sialy R, Hassan I, Kaur I, Dash RJ. Melasma in men: a hormonal profile. J Dermatol. 2000;27(1):64–5.

    Article  CAS  PubMed  Google Scholar 

  49. Vachiramon V, Suchonwanit P, Thadanipon K. Melasma in men. J Cosmet Dermatol. 2012;11(2):151–7.

    Article  PubMed  Google Scholar 

  50. Sanchez NP, Pathak MA, Sato S, Fitzpatrick TB, Sanchez JL, Mihm MC Jr. Melasma: a clinical, light microscopic, ultrastructural, and immunofluorescence study. J Am Acad Dermatol. 1981;4(6):698–710.

    Article  CAS  PubMed  Google Scholar 

  51. Kang WH, Yoon KH, Lee ES, Kim J, Lee KB, Yim H, et al. Melasma: histopathological characteristics in 56 Korean patients. Br J Dermatol. 2002;146(2):228–37.

    Article  CAS  PubMed  Google Scholar 

  52. Jang YH, Sim JH, Kang HY, Kim YC, Lee ES. The histopathological characteristics of male melasma: comparison with female melasma and lentigo. J Am Acad Dermatol. 2012;66(4):642–9.

    Article  PubMed  Google Scholar 

  53. Fried RG. Esthetic treatment modalities in men: psychologic aspects of male cosmetic patients. Dermatol Ther. 2007;20(6):379–84.

    Article  PubMed  Google Scholar 

  54. Keeling J, Cardona L, Benitez A, Epstein R, Rendon M. Mequinol 2%/tretinoin 0.01% topical solution for the treatment of melasma in men: a case series and review of the literature. Cutis. 2008;81(2):179–83.

    PubMed  Google Scholar 

  55. Ikino JK, Nunes DH, Silva VP, Frode TS, Sens MM. Melasma and assessment of the quality of life in Brazilian women. An Bras Dermatol. 2015;90(2):196–200.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Callender VD, St Surin-Lord S, Davis EC, Maclin M. Postinflammatory hyperpigmentation: etiologic and therapeutic considerations. Am J Clin Dermatol. 2011;12(2):87–99.

    Article  PubMed  Google Scholar 

  57. Combemale P, Faisant M, Guennoc B, Dupin M, Heyraud JD. Erythema dyschromicum perstans: report of a new case and critical review of the literature. J Dermatol. 1998;25(11):747–53.

    Article  CAS  PubMed  Google Scholar 

  58. Tamraz H, Raffoul M, Kurban M, Kibbi AG, Abbas O. Confluent and reticulated papillomatosis: clinical and histopathological study of 10 cases from Lebanon. J Eur Acad Dermatol Venereol. 2013;27(1):e119–23.

    Article  CAS  PubMed  Google Scholar 

  59. Boer A, Misago N, Wolter M, Kiryu H, Wang XD, Ackerman AB. Prurigo pigmentosa: a distinctive inflammatory disease of the skin. Am J Dermatopathol. 2003;25(2):117–29.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Pavlovsky, M. (2018). Gender Dermatology: Pigmentation Disorders. In: Tur, E., Maibach, H. (eds) Gender and Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-72156-9_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-72156-9_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-72155-2

  • Online ISBN: 978-3-319-72156-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics