Pigmentary Demarcation Lines

Matzumoto SH (1913)

Pigmentary demarcation lines are physiological, abrupt transitions between hyperpigmented and pale skin, a common and sometimes disconcerting feature of normal skin. They correspond to the innervation within a dermatome.

Eight types have been described depending on location (A-H); type B is located on the posteromedial side of the lower extremities; it is more common in women and is most often associated with pregnancy.

The pathogenesis of pigmentary demarcation lines remains unknown; however, neurogenic inflammation and/or mosaicism are thought to play a role in their development.

PDLs occur in the majority of dark-skinned women and in a smaller percentage of light-skinned women. They are also frequently observed in Japanese women (Zieleniewski Ł et al. 2019).

The changes only occur in adulthood. During pregnancy, this demarcation line can become particularly prominent. The demarcation lines in pregnancy have an unknown etiology; they occur mainly in the last trimester and disappear spontaneously months after delivery. A case of pregnancy-associated PDL with erythema without melanocytic pigmentation was reported (Navea OV et al. 2023)

This boundary between a laterally darker skin and a medially lighter skin is often clearly marked.

1. Malakar S et al. (2000) Pigmentary demarcation lines over the face. Dermatology 200:85-86.
2. Malakar S et al. (2007) Periorbital melanosis is an extension of pigmentary demarcation line-F on face. Indian J Dermatol Venereol Leprol 73:323-325
3. Navea OV et al (2023) Pigmentary Demarcation Lines During Pregnancy With Erythema. Cureus 15:e46023
4. Matzumoto SH (1913) On a proper pigment distribution at the Voiget's lines. Arch Dermatol Syphil 118:157-64.
5. Sarma N et al. (2014) Acquired, Idiopathic, Patterned Facial Pigmentation (AIPFP) Including Periorbital Pigmentation and Pigmentary Demarcation Lines on Face Follows the Lines of Blaschko on Face. Indian J Dermatol 59:41-48.
6. Zieleniewski Ł et al. (2019) Voigt-Futcher pigmentary demarcation lines. J Cosmet Dermatol 18:700-702.