Severe Pigmented Contact dermatitis( Riehl’s melanosis) in a 59 years old female: A case report

Riehl's melanosis(RM), is an acquired hyperpigmentary disorder characterized by ill-defined brown to graybrown macules and patches affecting the face and neck.We describe a case of a 59-year female with progressive facial hyperpigmentation beginning from the forehead and gradually spreading to involve the entire face and neck over a period of two months.The patient was prescribed a treatment regimen consisting of oral tranexamic acid, low-dose isotretinoin, topical azelaic acid 20%, and strict photoprotection with broadspectrum sunscreen which demonstrated significant improvement.This case highlights the importance of early diagnosis, careful evaluation for potential triggers, and a multimodal treatment approach combining systemic therapy, topical agents, and rigorous sun protection in achieving clinical improvement in Riehl's melanosis.