Introduction: Hyperpigmentary skin disorders may be defined as increased pigmentation of the skin and/or mucous membranes to the extent that the patient concerned seeks medical advice. They have varied etiological factors and overlapping clinical features, thus necessitating the use of histopathology to aid the diagnosis. Aims/Objectives: To study the series of hyperpigmented skin lesions at our institute and to assess age, gender, site wise distribution of hyperpigmented skin lesions. Materials and Method: Study was conducted in the Department of Pathology, SDM College of Medical Sciences and Hospital, Dharwad, over a period of 5 years. Cases with hyperpigmented skin lesions seeking consultation in Dermatology and Surgery department were subjected to punch/ excisional biopsy after patient’s consent. Tissue bits were subjected for processing and stained with H&E stain. Special stains were used whenever required. Results: 102 cases of hyperpigmented skin lesions were studied, out of which, 35 cases were non-neoplastic hyperpigmented lesions and 67 cases were neoplastic hyerpigmented lesions. In non-neoplastic lesions, 31 cases (88.57%) were inflammatory lesions with classical lichen planus being common (25.71%); others were 3 cases of metabolic lesions (8.57%) with 1 case each of macular amyloidosis, lichen amyloidosis, acanthosis nigricans and 1 case of infective lesion – Pityriasis versicolor (2.85%). In neoplastic lesions 89.55% cases were benign with Intradermal nevus (41.79%) being common and 10.44% were malignant with Malignant melanoma (7.46%) being common. Conclusion: Hyperpimentary skin lesions are not uncommon and have overlapping clinical features. Histopathology plays a crucial role in diagnosing the lesions as well as differentiating melanocytic lesions from non-melanocytic lesions as both present with skin hyperpigmentation.

Keywords: Skin; Hyperpigmentation; Special stains; Lichen planus; Malignant melanoma; Histopathology.