During a consultation, your doctor will use various techniques in his assesment of the symptom: Dark skin. These may include a physical examination or other medical tests. Your doctor may ask several questions when assessing your condition. It is important to remember that your consultation is a two-way process and any extra information you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
Why: to determine if acute or chronic.
Why: if generalized should consider jaundice (yellow discoloration), chronic liver disease and hemochromatosis ( bronze discoloration).
Why: may assist in diagnosis e.g. "sun kissed" pigmentation of the nipples, palmar creases, pressure area and mouth in Addison's disease; isolated dark-brown to light brown patches which tend to remain on one side of the midline especially on the back, buttocks or scalp are characteristic of McCune-Albright syndrome; darkened skin on cheeks and forehead called cloasma in pregnancy; hyperpigmented eyelids with atopic dermatitis (eczema); reddish purple flush around the eyes associated with swelling is characteristic of dermatomyositis; blotchy brown pigmentation on one shoulder of teenage boys is characteristic of Becker's nevus; velvety thickened hyperpigmentation in axilla is characteristic of acanthosis nigricans.
Why: exposure to ultraviolet radiation increases the melanin in the skin and causes darkening of skin in exposed areas called tanning.
Why: e.g. peripheral vascular disease may suggest gangrene if black dead skin in extremities; hemochromatosis; systemic sclerosis; systemic sclerosis; Addison's disease; neurofibromatosis and phaeochromocytoma are associated with Café au lait patches; Diabetes mellitus, Cushing's disease, Addison's disease, hypothyroidism, bowel cancer and obesity may be associated with acanthosis nigricans.
Why: the following are some of the drugs capable of inducing increased pigmentation of the skin:- amiodarone, chloroquine, quinine, minocycline, zidovudine, silver, gold, estrogen hormones, chlorpromazine, phenytoin, bleomycin, cyclophosphamide, doxorubicin, 5-fluorouracil, iron intramuscular injections.
Why: e.g. ingestion of large quantities of beta-carotene containing vegetables e.g. carrots can cause darkening of the skin.
Why: relevant if jaundice is diagnoses.
Why: e.g. hemochromatosis, atopic dermatitis (eczema), malignant melanoma, acanthosis nigricans.
Sometimes, other symptoms may be present and may help your doctor analyse your condition. These may include:
Why: may suggest eczema, malignant change in a mole.
Why: may suggest Becker's nevus.
Why: e.g. pigmentation on the nipples, palmar creases, pressure areas and mouth, tiredness, weight loss, reduced appetite, nausea, diarrhea, passing urine at night.
Why: e.g. bronze pigmentation, fatigue, loss of libido, painful joints, symptoms of diabetes, symptoms of congestive cardiac failure.
Why: e.g. plaques of thickened reddened skin that cause darkened skin patches on resolution, symptoms of Raynaud's syndrome, heartburn, acid reflux, pain with swallowing.
Why: e.g. shortness of breath, cough, tiredness, skin symptoms occur in 10% of cases and may include purple or brown plaques or nodules on face, nose, ears and neck in chronic sarcoidosis.
Why: e.g. dead tissue (black skin that gradually contracts into a crinkled, withered, hard mass) in most distal parts of the limbs with defined border (line of demarcation) where blood supply is sufficient to maintain tissue viability.
Why: e.g. increase in size, shape or thickness, itch, change in color, bleeding, enlarged local lymph nodes.
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