Differential Diagnosis for Hyperpigmentation on the Back of the Neck and Chest
Single Most Likely Diagnosis
- Acne-induced post-inflammatory hyperpigmentation (PIH): This condition is common, especially in individuals with a history of acne. The hyperpigmentation is a result of inflammation from acne lesions, which can occur on the back, neck, and chest.
Other Likely Diagnoses
- Melasma: Although more common on the face, melasma can occur on the neck and chest, especially in individuals with a history of sun exposure. It is characterized by patches of hyperpigmentation.
- Tinea versicolor: A fungal infection caused by Malassezia, leading to patches of hyperpigmentation or hypopigmentation, typically on the chest and back. It's more common in warm, humid climates.
- Seborrheic dermatitis: An inflammatory skin condition that can cause hyperpigmentation, especially in areas with high sebaceous gland activity like the chest and back of the neck.
Do Not Miss Diagnoses
- Addison's disease: A rare endocrine disorder characterized by adrenal insufficiency, which can cause generalized hyperpigmentation, including the skin and mucous membranes. Early diagnosis is crucial for treatment.
- Malignancy-associated hyperpigmentation: Certain cancers, like melanoma or lymphoma, can cause hyperpigmentation. Although rare, missing a diagnosis of malignancy can have severe consequences.
Rare Diagnoses
- Erythema dyschromicum perstans: A rare condition characterized by progressive, asymptomatic hyperpigmentation, typically on the face, neck, and upper trunk.
- Dowling-Degos disease: A rare genetic disorder leading to reticular hyperpigmentation of the skin, primarily affecting the flexures and sometimes the neck and chest.
- Berloque dermatitis: A rare condition caused by certain fragrances or perfumes, leading to hyperpigmentation, typically on sun-exposed areas like the neck and chest.