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Sarkar R, Vinay K, Bishnoi A, Poojary S, Gupta M, Kumaran MS, Jain A, Gurumurthy C, Arora P, Kandhari R, Rathi S, Zawar V, Gupta V, Ravivarma VN, Rodrigues M, Parsad D. A Delphi consensus on the nomenclature and diagnosis of lichen planus pigmentosus and related entities. Indian J Dermatol Venereol Leprol 2023; 89:41-46. [PMID: 35593293 DOI: 10.25259/ijdvl_804_2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/01/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Although well known in clinical practice, research in lichen planus pigmentosus and related dermal pigmentary diseases is restricted due to lack of consensus on nomenclature and disease definition. AIMS AND OBJECTIVES Delphi exercise to define and categorise acquired dermal pigmentary diseases. METHODS Core areas were identified including disease definition, etiopathogenesis, risk factors, clinical features, diagnostic methods, treatment modalities and outcome measures. The Delphi exercise was conducted in three rounds. RESULTS Sixteen researchers representing 12 different universities across India and Australia agreed to be part of this Delphi exercise. At the end of three rounds, a consensus of >80% was reached on usage of the umbrella term 'acquired dermal macular hyperpigmentation'. It was agreed that there were minimal differences, if any, among the disorders previously defined as ashy dermatosis, erythema dyschromicum perstans, Riehl's melanosis and pigmented contact dermatitis. It was also agreed that lichen planus pigmentosus, erythema dyschromicum perstans and ashy dermatosis did not differ significantly apart from the sites of involvement, as historically described in the literature. Exposure to hair colours, sunlight and cosmetics was associated with these disorders in a significant proportion of patients. Participants agreed that both histopathology and dermatoscopy could diagnose dermal pigmentation characteristic of acquired dermal macular hyperpigmentation but could not differentiate the individual entities of ashy dermatosis, erythema dyschromicum perstans, Riehl's melanosis, lichen planus pigmentosus and pigmented contact dermatitis. LIMITATIONS A wider consensus involving representatives from East Asian, European and Latin American countries is required. CONCLUSION Acquired dermal macular hyperpigmentation could be an appropriate conglomerate terminology for acquired dermatoses characterised by idiopathic or multifactorial non-inflammatory macular dermal hyperpigmentation.
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Affiliation(s)
- Rashmi Sarkar
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shital Poojary
- Department of Dermatology, K. J. Somaiya Medical College, Mumbai, Maharashtra, India
| | - Monisha Gupta
- Department of Dermatology, Liverpool Hospital, The Skin Hospital, NSW, Conjoint University of NSW, Western Sydney University, Sydney, Australia
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay Jain
- Department of Dermatology, Venereology and Leprology, Government Medical College, Kota, Rajasthan, India
| | - Chethana Gurumurthy
- Department of Dermatology, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Pooja Arora
- Department of Dermatology, Dr RML Hospital and ABVIMS, New Delhi, India
| | | | - Sanjay Rathi
- Dr. Rathi's Skin Clinic, Siliguri, West Bengal, India
| | - Vijay Zawar
- Department of Dermatology Dr. Vasantrao Pawar Medical College, Nashik, Maharashtra, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vignesh Narayan Ravivarma
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Michelle Rodrigues
- Chroma Dermatology, Pigment and Skin of Colour Centre, Melbourne, Australia
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Vinay K, Bishnoi A, Kamat D, Chatterjee D, Kumaran MS, Parsad D. Acquired Dermal Macular Hyperpigmentation: An Update. Indian Dermatol Online J 2021; 12:663-673. [PMID: 34667751 PMCID: PMC8456249 DOI: 10.4103/idoj.idoj_881_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/10/2021] [Accepted: 04/15/2021] [Indexed: 12/16/2022] Open
Abstract
Acquired dermal macular hyperpigmentation (ADMH) is an umbrella term that includes disorders clinically characterized by small and large pigmented macules/patches and histopathologically showing an evidence of current or resolved interface dermatitis with pigment incontinence, without clinically significant prior inflammatory phase. The term intends to include diseases previously described in the literature as lichen planus pigmentosus, Riehl's melanosis/pigmented cosmetic dermatitis and ashy dermatosis/erythema dyschromicum perstans. The nomenclature and origin of these disorders have always been a matter of discussion. These disorders share many clinicopathological similarities, are difficult to treat and adversely affect the quality of life. Recent consensus points towards the need for a unifying term to facilitate research and therapeutic trials. This article aims to provide a comprehensive review of the recent advances in ADMH.
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Affiliation(s)
- Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Divya Kamat
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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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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Vinay K, Kumar S, Bishnoi A, Aggarwal D, Radotra BD, Parsad D, Sendhil Kumaran M. A clinico‐demographic study of 344 patients with lichen planus pigmentosus seen in a tertiary care center in India over an 8‐year period. Int J Dermatol 2019; 59:245-252. [DOI: 10.1111/ijd.14540] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Sheetanshu Kumar
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Divya Aggarwal
- Department of Histopathology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Bishan Dass Radotra
- Department of Histopathology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
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Kumaran M, Dabas G, Vinay K, Parsad D. Reliability assessment and validation of the dermal pigmentation area and severity index: a new scoring method for acquired dermal macular hyperpigmentation. J Eur Acad Dermatol Venereol 2019; 33:1386-1392. [DOI: 10.1111/jdv.15516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 02/04/2019] [Indexed: 11/29/2022]
Affiliation(s)
- M.S. Kumaran
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - G. Dabas
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - K. Vinay
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India
| | - D. Parsad
- Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India
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Korekawa A, Nakajima K, Nakano H, Sawamura D. Ashy dermatosis with a positive patch test to gold sodium thiosulfate. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2019. [DOI: 10.1002/cia2.12054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Ayumi Korekawa
- Department of DermatologyHirosaki University Graduate School of Medicine Hirosaki Japan
| | - Koji Nakajima
- Department of DermatologyHirosaki University Graduate School of Medicine Hirosaki Japan
| | - Hajime Nakano
- Department of DermatologyHirosaki University Graduate School of Medicine Hirosaki Japan
| | - Daisuke Sawamura
- Department of DermatologyHirosaki University Graduate School of Medicine Hirosaki Japan
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