Erythema dyschromicum perstans in prepubertal children

Annular lichenoid diseases

Annular lichenoid diseases encompass a diverse range of pathologies that present as circular, raised, or flat lesions that may vary in size and number. Examples include annular lichenoid dermatitis of youth, annular lichen planus, erythema dyschromicum perstans, erythema multiforme, fixed drug eruption, lichen sclerosus, neonatal lupus, porokeratosis, subacute cutaneous lupus erythematosus, and lichenoid syphilis. Clinical morphology and histopathology can differentiate these entities.

A global consensus statement on ashy dermatosis, erythema dyschromicum perstans, lichen planus pigmentosus, idiopathic eruptive macular pigmentation, and Riehl's melanosis

Ashy dermatosis (AD), lichen planus pigmentosus (LPP), erythema dyschromicum perstans (EDP), and idiopathic eruptive macular pigmentation are several acquired macular hyperpigmentation disorders of uncertain etiology described in literature. Most of the published studies on these disorders are not exactly comparable, as there are no clear definitions and different regions in the world describe similar conditions under different names. A consensus on the terminology of various morphologies of acquired macular pigmentation of uncertain etiology was a long-felt need. Several meetings of pigmentary disorders experts were held to address this problem. A consensus was reached after several meetings and collation of e-mailed questionnaire responses and e-mail communications among the authors of publications on the above conditions. This was achieved by a global consensus forum on AD, LPP, and EDP, established after the 22nd International Pigment Cell Conference held in Singapore in 2014. Thirty-nine experts representing 18 countries participated in the deliberations. The main focus of the deliberations was terminology of the conditions; as such, we present here the consensus statement of the forum and briefly review the available literature on the subject. We have not attempted to discuss treatment modalities in detail.

Erythema Dyschromicum Perstans in an 8-Year-Old Indian Child

We report an 8-year-old East Indian boy with erythema dyschromicum perstans. The condition has very rarely been reported in prepubertal Indian children. A perusal of the literature revealed but two cases, to which we add another one. Recognition of erythema dyschromicum perstans in prepubertal Indian children is important for proper diagnosis and to prevent unnecessary investigations.

Pigmented Deposits in the Skin

Pigmented deposits can occur in the skin due to many and varied causes. Some of them are systemic conditions accompanied by involvement of internal organs. Others have serious prognostic implications, and early diagnosis can help in the correct and adequate management of the diseases. In addition, some of them are quite innocuous and the correct diagnosis avoids unnecessary treatments. In this article, we review the morphologic features of some of the most common and some of the less usual pigmented deposits in skin other than tattoos.

Facial Hyperpigmentation in Skin of Color: Special Considerations and Treatment

Differences in cutaneous diseases in people of color call for nuanced evaluation and management. One of the most common dermatological complaints from patients with skin of color is dyspigmentation, particularly hyperpigmentation. The challenge for clinicians is to establish correct diagnoses along with consistently successful treatments to meet the needs of the increasingly diverse population served. This review focuses on facial hyperpigmentation and outlines the most common skin disorders and treatment options.

Lichenoid and interface dermatoses

The terms 'lichenoid' and 'interface' dermatitis are often used interchangeably to describe an inflammatory pattern characterized histologically by damage to the basal keratinocytes in the epidermis. The mechanism of cell damage of such cells is now best understood as apoptosis, or programmed cell death. This inflammatory pattern of dermatoses, is also accompanied frequently by a band of lymphocytes and histiocytes in the superficial dermis, that often obscures the dermal-epidermal junction, hence the term 'lichenoid'. A discussion of the more common lichenoid/interface dermatitides encountered in the routine clinical practice encompasses the following entities: lichen planus, lupus erythematosus, dermatomyositis, erythema multiforme, graft versus host disease, fixed drug reactions, and multiple others.

Clinical and histological aspect of erythema dyschromicum perstans in Korea: A review of 68 cases

Erythema dyschromicum perstans (EDP) is a hypermelanotic disorder of the idiopathic variety characterized by blue-gray macules in healthy individuals. It has been described mainly in patients from tropical areas of Central and South America. Our aim was to evaluate EDP in Korea through the analysis of retrospective case series with EDP and to describe the clinical and histopathological features. It was a retrospective study (2002-2012) of EDP confirmed by review of clinical photographs and biopsy specimens. The files of 68 patients with EDP from six tertiary medical centers in Korea were included in this study. Of the 68 patients, 29 were male and 39 female. The age of patients ranged 3-76 years (mean, 33.9). Clinically, the majority of patients had lesions on the trunk (n = 47, 69.1%); the neck was affected in 27 cases, the upper extremities in 26, the face in 22 and the lower extremities in 16. Peripheral erythematous borders were observed in 12 patients (17.6%) and 11 patients had itching sensation at the lesion. Histopathologically, dermal melanophages and pigment incontinence were the most common findings. A follow up of more than 1 year was obtained in 51 patients. Of these, only one patient experienced complete clearance without recurrence. Our study illustrates the clinical and histopathological findings of EDP in Koreans. Our multicenter data may contribute to the understanding of EDP.

Ashy dermatosis in an 8-year-old Indian child

Ashy dermatosis is a disorder of pigmentation, characterized by asymptomatic symmetric ashy gray-colored macules, in the first to third decade of life. It can, however, affect children sometime. But, there is a paucity of similar cases in Indian children. We present a case of ashy dermatosis in an 8-year-old Indian girl who presented to skin OPD with areas of ashy pigmentation, which were distributed symmetrically. Skin biopsy was consistent with lichenoid pattern histology. This case has been reported to highlight the rarity of ashy dermatosis in Indian children.

Case for diagnosis

Dyschromicum erythema perstans, or ashy dermatosis, is a rare chronic acquired skin disease characterized by gray hyperpigmented patches with erythematous borders. Its etiology is unknown and there is no specific treatment for the condition. We report a case of ashy dermatosis in a 41-year-old patient with extensive lesions on the trunk and limbs.

Erythema dyschromicum perstans in a Japanese child

Erythema dyschromicum perstans (EDP) is asymptomatic slate-gray to blue-brown macules. Idiopathic eruptive macular pigmentation is asymptomatic brown nonconfluent macules. We describe electron microscopic studies of a 9-year-old Japanese girl with EDP. The ultrastructural figures indicated that the production of immature, small, irregular-shaped melanosomes in melanocytes and peripheral localization of melanosomes in keratinocytes caused the clinical appearance of EDP. The ultrastructural evidence distinguishes EDP from idiopathic eruptive macular pigmentation and suggests a distinct pathogenesis of the disease.

Erythema dyschromicum perstans in children: a report of 14 cases

BACKGROUND

Erythema dyschromicum perstans (EDP) or ashy dermatosis is a peculiar, slowly progressive, macular hyperpigmentation, which leaves a permanent discoloration. It is an acquired dermatosis that occurs most frequently in Central and South America. EDP usually appears in adults, but some isolated cases and small series have been reported in prepubertal children.

METHODS

A retrospective review of cases of EDP in 10-year-old children or younger, attended in a pediatric hospital between 1990 and 2003.

RESULTS

We present 14 cases of EDC in children 10 years and younger. With an additional 25 cases reported so far in the English language literature, a total of 39 children have been described. Unlike adult patients, who are most commonly of Hispanic origin, children with EDP are usually Caucasian. Other important facts in children with EDP are the absence of consistent trigger factors and an eventual improvement or resolution of the lesions in 50% of prepubertal patients.

CONCLUSION

We suggest that EDP is a distinctive clinical entity, different from lichen planus and lichen planus pigmentosus, which may be identical to the so-called idiopathic eruptive macular pigmentation.