Dermatosis Papulosa Nigra (also known as DPN) is characterized by small brown or black spots that are on the skin around the cheekbones and eyes. The dark spots may also be found on other areas of the face, neck, chest, and back. Some people with dermatosis papulosa nigra have a few, isolated spots while others have hundreds of spots. The spots may be flat or hang off the skin like a skin tag. The spots are neither cancerous nor medically concerning, but they may be itchy, irritating, or cosmetically undesired. They are often referred to as ‘moles’ but they are not true moles by definition. This condition occurs most frequently in blacks and dark-skinned Asians, and less frequently in other races. Fair-skinned blacks are less likely to develop dermatosis papulosa nigra than dark- skinned blacks. Women are more likely to develop this condition than men. The spots generally appear after puberty and grow in size and number with age.
What is the cause of dermatosis papulosa nigra?

The cause of dermatosis papulosa nigra is unknown.

How do I know if I have dermatosis papulosa nigra?

The appearance and distribution of dermatosis papulosa nigra allow a dermatologist to easily recognize the condition by clinical examination. Rarely, a dermatologist may perform a biopsy, a procedure in which a small skin sample is taken from the affected area and looked at under a microscope to confirm the diagnosis.

How is Dermatosis Papulosa Nigra treated?

Although dermatosis papulosa nigra is not a dangerous condition, some patients choose to have the spots removed for cosmetic reasons. The condition generally worsens with age, and the size and number of spots do not decrease without treatment. People who are considering treatment for dermatosis papulosa nigra should carefully consider their expectations and goals of treatment. Because treatment may not be able to completely remove spots, the goal of treatment should be to minimize the appearance of spots rather than to remove them completely. Treatment for dermatosis papulosa nigra is complicated by the fact that the condition occurs mostly in skin of color patients, who are at a higher risk of developing pigmentation defects (lightening or darkening of the skin) and scarring following treatment. The resultant blotchy or scarred appearance of the skin may be as cosmetically undesired as the original dermatosis papulosa nigra spots. Treatment options for dermatosis papulosa nigra include scissor excision, shave excision, cryosurgery, electrodessication, curettage, dermabrasion, and laser removal. The cost of treatment depends on the type of treatment and on the size of the area to be treated. Since treatment is usually performed for cosmetic reasons, removal of these benign lesions is not covered by insurance and is an out-of-pocket expense. The type of treatment that is best for dermatosis papulosa nigra depends on the individual patient. For example, a physician may prefer different treatments for patients with a small number of spots versus patients with many spots. Special care must be taken when treating skin of color patients with dermatosis papulosa nigra because of the increased likelihood of developing scarring and coloration problems. In conclusion, there are many treatment options for dermatosa papulosa nigra, but some carry a higher risk of causing scar formation and pigmentation changes in skin of color patients. Because of this, skin of color patients who are considering treatment for dermatosa papulosa nigra should consult a dermatologist who understands the unique properties and treatment outcomes of ethnic skin.

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