case_images: PMC11273808_01
case_images: (A) Symmetrical dark-brown to grayish hyperpigmentation of the face; note the sparing of the infraorbital region and the nose. (B) Focal dyskeratotic epidermis with spongiosis and keratinocyte necrosis. Perivascular and peri-annexal lymphocytic infiltrate in the dermis with pigment incontinence (Hematoxylin and Eosin, x10). (C) Improvement in the face after the discontinuation of adalimumab.
case_images: 10.1177_23247096241265896-fig1.jpg
case_images: PMC11273808_01_10.1177_23247096241265896-fig1.jpg
case_images: fig1-23247096241265896
case_images: The physical examination revealed diffuse, symmetrical, dark brown to grayish hyperpigmentation of the face, except for the infraorbital region and the nose (Figure 1A). The dermis showed a perivascular and peri-annexal lymphocytic infiltrate with pigment incontinence (Figure 1B). After discontinuing both adalimumab and azathioprine, following the achievement of clinical and endoscopic remission of Crohn's disease, and starting the application of topical steroids along with photoprotection measures, a marked regression of hyperpigmentation was observed after a 1-year interruption (Figure 1C).