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Exogenous ochronosis is a rare condition of paradoxical skin darkening seen with use of the skin lightening agent hydroquinone. Incidence has been highest in patients with darker skin types, prolonged use, and higher concentration treatment, but has been reported with low dose (2%) as well. Here we present a rare case of exogenous ochronosis, with resultant skin and nail hyperpigmentation, occurring in a Caucasian female using 3% hydroquinone cream over an eighteen-month period.

Exogenous Ochronosis with Use of Low Potency Hydroquinone in A Caucasian Patient