A 27-year-old woman was seen with a new rash on her face. Over the preceding years, she had facial hyperpigmentations that she treated with different bleaching creams, finally using Pigmanorm (Louis Widmer GmbH, Rheinfelden, Germany), a hydroquinone-containing bleaching cream. On examination she was found to have circumscribed, erythematous, tumid, palpable plaques on her face (Figure 1) and on the right forearm, where she rested her face during sleep. Histologic analysis of punch biopsy specimens revealed dense lymphocytic aggregates in the middle and deep corium, partly perivascular and periadnexal in localization (Figure 2). Clinically and histologically, no alteration of the epidermis could be detected. Immunohistologic findings revealed infiltrates of CD3+ T cells dominated by CD4+ cells with only few CD8+ cells. Toluidine blue staining did not reveal any mucin. Findings of serum analysis for antinuclear antibodies remained negative. The clinical and histologic findings suggested lymphocytic infiltration of the skin Jessner-Kanof.
Caroli UM, Berner D, Schlegel C, Metzler G, Röcken M, Biedermann T. Lymphocytic Infiltration of the Skin Jessner-Kanof After Treatment With a Hydroquinone-Containing Bleaching Cream. Arch Dermatol. 2006;142(12):1650-1666. doi:10.1001/archderm.142.12.1655