Exogenous ochronosis: an epidemiological study

A survey was conducted to investigate the relationship between exogenous ochronosis and the use of skin lightening preparations amongst black individuals attending general outpatient departments in two South African hospitals. In the sample, 15% of males and 42% of females were found to have exogenous ochronosis. The prevalence amongst users of skin lighteners was 69%. The main demographic associations with ochronosis were an inverse relationship to education, and predominance of the female sex. Clinical and behavioural aspects were also recorded. Even products limited to 2% hydroquinone or less, and combined with a sunscreen, were found to cause ochronosis.