Ochronosislike pigmentation from hydroquinone bleaching creams in American blacks.

Two patients had pitch-black pigmentation and colloid milium formation following the use of 2% hydroquinone-containing bleaching creams. These are among the first known cases in American blacks, although this phenomenon has been recognized previously in African blacks. Ultrastructural studies indicated that the pigment was due to the formation of elastotic fibers. These fibers attained an enormous size and disintegrated, leaving irregular fibers and fragments dispersed in the dermis. It is important that this clinical picture be recognized, since the use of these bleaching creams is widespread.