Alcaptonuria and ochronosis; with a report of three patients and metabolic studies in two.
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A patient who had masses in the breasts clinically suggestive of neoplasia had fibrous mastopathy and striking deposition of ochronotic pigment within the soft tissue of the breast. The gross appearance and light microscopic features are illustrated. The histochemical features of ochronotic pigment and the difficulty in differentiating it from melanin are discussed.
Skin-lightening preparations containing hydroquinone are used extensively by black South Africans. In some instances these preparations produce severe and irreversible cutaneous damage. Clinically, the deleterious effects begin with darkening and coarsening of the skin, followed by a hyperpigmented papular condition. Histologically, there is increased basophilia of the collagen, followed by the formation of yellow fibers. These yellow fibers swell and break down to form an amorphous eosinophilic material. Electron microscopy shows that the changes arise from a breakdown of normal collagen.