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Alhameedy MM. Generalized reticulated hyperpigmented patches interspersed with hypopigmented macules. JAAD Case Rep 2021; 11:23-25. [PMID: 33898678 PMCID: PMC8058520 DOI: 10.1016/j.jdcr.2021.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Meshal Mohammad Alhameedy
- Department of Dermatology, King Fahad Specialist Hospital in Buraydah - Ministry of Health, Buraydah, Saudi Arabia
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2
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Rongioletti F. Commentary: New, Emerging, and Revisited Entities in Dermatology. Clin Dermatol 2021; 39:173-175. [PMID: 34272005 DOI: 10.1016/j.clindermatol.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Franco Rongioletti
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
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3
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Abstract
Acquired brachial cutaneous dyschromatosis (ABCD) is a relatively newly described, acquired disorder of pigmentation characterized by geographic-shaped, gray-brown, hyperpigmented patches and interspersed with hypopigmented macules, involving the dorsal aspects of the forearms in postmenopausal women. There is a suggested relationship with hypertension and antihypertensive medication intake, specifically angiotensin-converting enzyme inhibitors, or a cumulative effect of sun damage, as possible triggers. ABCD is benign, asymptomatic, and more of an esthetic concern. Topical depigmenting agents, chemical peels, and laser therapy may be helpful.
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Affiliation(s)
- Franco Rongioletti
- Section of Dermatology, Department of Medical Science and Public Health, University of Cagliari, Italy
| | - Laura Atzori
- Section of Dermatology, Department of Medical Science and Public Health, University of Cagliari, Italy.
| | - Caterina Ferreli
- Section of Dermatology, Department of Medical Science and Public Health, University of Cagliari, Italy
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4
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Choi MJ, Byun JY, Choi HY, Choi YW. Acquired Brachial Cutaneous Dyschromatosis in a Middle Aged Male. Ann Dermatol 2018; 30:342-344. [PMID: 29853750 PMCID: PMC5929953 DOI: 10.5021/ad.2018.30.3.342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 07/09/2017] [Accepted: 08/04/2017] [Indexed: 11/08/2022] Open
Abstract
Acquired brachial cutaneous dyschromatosis (ABCD) is an acquired disorder of pigmentary change that presents as chronic, asymptomatic, geographic-shaped, gray-brown patches, consisting of mixed hyper and hypopigmented macules on the dorsal aspect of the forearms. We report a case of a 40-year-old male who presented with asymptomatic, multiple brown-colored macules on the outer aspects of both arms. He had no history of hypertension and had never taken angiotensin converting enzyme inhibitors. He also denied chronic sun exposure history. Histologic examination demonstrated epidermal atrophy, increased basal layer pigmentation, and several telangiectatic vessels in the upper dermis. Solar elastosis was not remarkable. The patient's clinical and histopathologic features were consistent with a diagnosis of ABCD. Poikiloderma of Civatte, melasma, acquired bilateral telangiectatic macules and other pigmentary disorders should be considered in the differential diagnosis of ABCD. Herein, we report a case of ABCD in a middle-aged male without hypertension and medication.
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Affiliation(s)
- Min Jung Choi
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Ji Yeon Byun
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hae Young Choi
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, Korea
| | - You Won Choi
- Department of Dermatology, Ewha Womans University School of Medicine, Seoul, Korea
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5
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Kim GW, Shin K, Kim TW, You HS, Jin HJ, Shim WH, Kim HS, Ko HC, Kim BS, Kim MB. The importance of dermoscopy for the diagnosis of acquired bilateral telangiectatic macules: the angioid streak pattern reveals underlying chronic liver disease. J Eur Acad Dermatol Venereol 2017; 32:1597-1601. [PMID: 29114961 DOI: 10.1111/jdv.14669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/18/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acquired bilateral telangiectatic macules (ABTM) are a newly recognized disease entity, which manifest as multiple telangiectatic pigmented macules confined mostly to the upper arms. OBJECTIVES To evaluate clinical and dermoscopic features in a group of 50 patients with ABTM and to determine the diagnostic usefulness of dermoscopy in ABTM. METHODS Patients were selected from two tertiary teaching hospitals in Korea [Pusan National University Hospitals (Busan and Yangsan)]. Fifty patients (41 males and 9 females; mean age 48.1 years; range 26-78 years) with ABTM were included in the study. The dermoscopic findings were graded using a 4-point scale: none (0), mild (1), moderate (2) and severe (3). In addition, the results of 23 patients with and 27 patients without chronic liver disease (CLD) were compared to determine whether the presence of CLD affects dermoscopic findings. RESULTS Three distinct dermoscopic patterns were observed; brown pigmentations, telangiectasia (linear-irregular vessels) and an angioid streak pattern. Brown pigmentation in the group without CLD had higher severity score than those in CLD group (mean score: 2.00 vs. 1.48, P = 0.033). However, mean telangiectasia severity score was higher in the CLD group (2.14 vs. 1.39, P < 0.001). The angioid streak pattern was more severe and more common in patients with CLD than in those without [1.37 vs. 0.35 (P < 0.001) and 63.0% vs. 26.1%, respectively]. CONCLUSIONS Detailed observations with dermoscopy can provide first clues of the presence of ABTM and underlying chronic liver disease.
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Affiliation(s)
- G-W Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - K Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - T-W Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H-S You
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H-J Jin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - W-H Shim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H-S Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H-C Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - B-S Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - M-B Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Moon HR, Kim YJ, Jung JM, Won CH, Lee MW, Choi JH, Chang SE. Acquired bilateral telangiectasia macularis eruptiva perstans: A unique clinical feature of photodamaging rather than a subtype of cutaneous mastocytosis. J Dermatol 2017. [PMID: 28646532 DOI: 10.1111/1346-8138.13928] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Telangiectasia macularis eruptiva perstans (TMEP) is a rare subtype of cutaneous mastocytosis, characterized by telangiectatic tan to brown macules on the trunk and extremities. Although TMEP has been descried as an uncommon disease in the literature, we often encounter patients with TMEP lesions in the outpatient clinic. We aimed to assess the clinical and histopathological characteristics of acquired bilateral TMEP, and the pathophysiological mechanism of acquired bilateral TMEP among these patients. We retrospectively reviewed 30 patients (28 men and 2 women) with acquired bilateral TMEP; multiple telangiectatic dark red to brown macules that were symmetrically distributed. The clinical characteristics and general histopathological findings of lesional skin were investigated. The number of mast cells was evaluated using immunohistochemical analysis with an antibody directed against c-kit (CD117). Acquired bilateral TMEP was predominantly localized on the sun-exposed area: the upper arm in 30 patients (100%), forearm in 19 patients (63.3%) and anterior chest in 15 patients (50%). A total of 16 patients (53.3%) showed at least one aggravating factor, including UV irradiation, alcohol use and heat exposure. Compared with the mast cell numbers in 19 age- and biopsy site-matched healthy controls (91 ± 29.0/mm2 ), the number of mast cells in the papillary dermal skin of acquired bilateral TMEP patients was significantly increased (159 ± 37.2/mm2 , P < 0.01). In addition, a significant difference in vessel numbers in the papillary dermis was observed between acquired bilateral TMEP patients and healthy controls (10.5 ± 1.9 vs 5.4 ± 1.0/mm2 , P < 0.01). Acquired bilateral TMEP is a relatively common disorder in middle-aged Asian men. An increased number of mast cells and dilated vessels might be a photoaging-related reactive process of chronic sun-exposure, which consequently leads to the formation of characteristic telangiectatic hyperpigmentary macules through certain melanogenic mediators.
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Affiliation(s)
- Hye-Rim Moon
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Jae Kim
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Min Jung
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jee Ho Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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7
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Hyperpigmented Macules on a Young Man's Arms. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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8
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de Asís-Cuestas S, Martí-Ibor E, Mateu-Puchades A. Hyperpigmented Macules on a Young Man's Arms. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:683-4. [PMID: 27061512 DOI: 10.1016/j.ad.2015.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 06/16/2015] [Accepted: 06/24/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- S de Asís-Cuestas
- Servicio de Dermatología, Hospital Universitario Doctor Peset, Valencia, España.
| | - E Martí-Ibor
- Servicio de Anatomía Patológica, Hospital Universitario Doctor Peset, Valencia, España
| | - A Mateu-Puchades
- Servicio de Dermatología, Hospital Universitario Doctor Peset, Valencia, España
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9
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Acquired brachial cutaneous dyschromatosis in a 60-year-old male: a case report and review of the literature. Case Rep Dermatol Med 2015; 2014:452720. [PMID: 25610668 PMCID: PMC4294462 DOI: 10.1155/2014/452720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 12/17/2014] [Indexed: 11/30/2022] Open
Abstract
Acquired brachial cutaneous dyschromatosis is an acquired pigmentary disorder that has been
described in only 20 patients but likely affects many more. This case of a man with acquired
brachial cutaneous dyschromatosis is unique as most reports are in women. We report the case of
a 60-year-old male who presents with an asymptomatic eruption characterized by
hyperpigmented and telangiectatic macules coalescing into patches on the bilateral extensor
aspects of the forearms which is consistent clinically and histopathologically with acquired brachial
cutaneous dyschromatosis. Given its presence in patients with clinical evidence of chronic sun
exposure and its histopathological finding of solar elastosis, acquired brachial cutaneous
dyschromatosis is likely a disorder caused by cumulative UV damage. However, a possible
association between angiotensin-converting enzyme inhibitors and acquired brachial cutaneous
dyschromatosis exists. Further investigation is needed to elucidate both the pathogenesis of the
disorder and forms of effective management. Treatment of the disorder should begin with current
established treatments for disorders of dyspigmentation.
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10
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Katoulis A, Makris M, Gregoriou S, Rallis E, Kanelleas A, Stavrianeas N, Rigopoulos D. Poikilodermatous changes on the forearms of a woman practicing aroma-therapy: extracervical poikiloderma of Civatte? An Bras Dermatol 2014; 89:655-6. [PMID: 25054757 PMCID: PMC4148284 DOI: 10.1590/abd1806-4841.20142925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 09/11/2013] [Indexed: 11/22/2022] Open
Abstract
We report the case of a 48-year-old, Caucasian female who presented with slowly
progressing asymptomatic poikilodermatous changes of the extensor aspects of the
forearms. She also had typical Poikiloderma of Civatte on the V of the neck and
erythemato-telangiectatic rosacea of the central face. The patient had been
practicing aroma-therapy for many years. Histologic examination revealed
findings consistent with PC. Patch-testing revealed positive reactions to
Fragrance mix and Nickel sulphate. Based on clinical and histological findings,
a diagnosis of extracervical PC was suggested. PC with extra-cervical or
extra-facial involvement is rare. In addition, this case supports the theory
that contact sensitization to fragrances may contribute to the development of
PC.
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Affiliation(s)
- Alexandros Katoulis
- "Attikon" General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Michalis Makris
- "Attikon" General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stamatis Gregoriou
- "Attikon" General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eustathios Rallis
- "Attikon" General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonis Kanelleas
- "Attikon" General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nicolaos Stavrianeas
- "Attikon" General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Rigopoulos
- "Attikon" General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Ritter C, Fiss D, Borges da Costa J, de Carvalho R, Bauermann G, Cestari T. Extra-facial melasma: clinical, histopathological, and immunohistochemical case-control study. J Eur Acad Dermatol Venereol 2012; 27:1088-94. [DOI: 10.1111/j.1468-3083.2012.04655.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Affiliation(s)
- Wei-Hsuan Huang
- Department of Dermatology and Pathology, Tri-Service General Hospital, Taipei, Taiwan
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