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Wang RF, Ko D, Friedman BJ, Lim HW, Mohammad TF. Disorders of hyperpigmentation. Part I. Pathogenesis and clinical features of common pigmentary disorders. J Am Acad Dermatol 2023; 88:271-288. [PMID: 35151757 DOI: 10.1016/j.jaad.2022.01.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/22/2021] [Accepted: 01/10/2022] [Indexed: 01/17/2023]
Abstract
Disorders of hyperpigmentation are common and, depending on the extent and location of involvement, can affect the quality of life and pose a significant psychologic burden for patients. Given the similarities in presentation of the various causes of hyperpigmentation, it is often difficult to elucidate the etiology of these conditions, which is important to guide management. Furthermore, certain disorders, such as lichen planus pigmentosus and ashy dermatosis, have similar clinical and/or histologic presentations, and their classification as distinct entities has been debated upon, leading to additional confusion. In this review, the authors selected commonly encountered disorders of hyperpigmentation of the skin, subdivided into epidermal, dermal, or mixed epidermal-dermal disorders based on the location of pigment deposition, along with disorders of hyperpigmentation of the mucosa and nails. Melanocytic nevi, genetic disorders, and systemic causes of hyperpigmentation were largely excluded and considered to be outside the scope of this review. We discussed the pathogenesis of hyperpigmentation as well as the clinical and histologic features of these conditions, along with challenges encountered in their diagnosis and classification. The second article in this 2-part continuing medical education series focuses on the medical and procedural treatments of hyperpigmentation.
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Affiliation(s)
- Rebecca F Wang
- From the Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Dayoung Ko
- From the Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Ben J Friedman
- From the Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Henry W Lim
- From the Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Tasneem F Mohammad
- From the Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
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2
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Zhu Y, Xiang W. Reflectance confocal microscopy of multiple idiopathic eruptive macular pigmentation: A case report. Skin Res Technol 2021; 28:357-360. [PMID: 34751467 PMCID: PMC9907656 DOI: 10.1111/srt.13110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Yuan Zhu
- Department of Dermatology, Hangzhou Third People's Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Wenzhong Xiang
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital of Zhejiang University School of Medicine, Hangzhou, China
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4
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Vasani RJ. Idiopathic Eruptive Macular Pigmentation - Uncommon Presentation of an Uncommon Condition. Indian J Dermatol 2018; 63:409-411. [PMID: 30210163 PMCID: PMC6124230 DOI: 10.4103/ijd.ijd_12_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Idiopathic eruptive macular pigmentation (IEMP) is an asymptomatic condition with dark brown, nonconfluent lesions chiefly occurring in children and adolescents. The usual sites involved are face, trunk, extremities, and the lesions resolve over few months to years. We report an unusual presentation of this uncommon condition. A 22-year-old male presented with multiple dark-colored asymptomatic lesions on the scalp and forehead for the past 3 years. There was no history of preceding symptoms, drug, or applications, past or family history of such lesions. Examination revealed multiple hyperpigmented macules and barely elevated nonscaly plaques with a velvety feel akin to acanthosis nigricans (AN). Dermoscopy was similar to AN. Blood sugar, thyroid, and lipid profiles were normal. Histology showed "pigmented papillomatosis" concluding the final diagnosis of IEMP. Confluence of lesions is a rarely described phenomenon, with the scalp being a hitherto unreported site. The velvety feel of lesions, the dermoscopic, and histopathological findings further substantiate the hypothesis of this entity being an eruptive variant of AN.
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5
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Kumarasinghe SPW, Pandya A, Chandran V, Rodrigues M, Dlova NC, Kang HY, Ramam M, Dayrit JF, Goh BK, Parsad D. A global consensus statement on ashy dermatosis, erythema dyschromicum perstans, lichen planus pigmentosus, idiopathic eruptive macular pigmentation, and Riehl's melanosis. Int J Dermatol 2018; 58:263-272. [PMID: 30176055 DOI: 10.1111/ijd.14189] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 05/18/2018] [Accepted: 07/17/2018] [Indexed: 01/19/2023]
Abstract
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.
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Affiliation(s)
| | - Amit Pandya
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Michelle Rodrigues
- Department of Dermatology, St Vincent's Hospital, Fitzroy, Vic, Australia
| | - Ncoza C Dlova
- Department of Dermatology, College of Health Sciences, Durban, South Africa
| | - Hee Young Kang
- Department of Dermatology, Ajou University, Suwon, South Korea
| | - M Ramam
- Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India
| | - Johannes F Dayrit
- Department of Dermatology, Research Institute for Tropical Medicine, Metro Manila, Philippines
| | | | - Davinder Parsad
- Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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6
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Joshi R. Idiopathic Eruptive Macular Pigmentation in an Indian Male. Indian Dermatol Online J 2018; 9:64-65. [PMID: 29441306 PMCID: PMC5803950 DOI: 10.4103/idoj.idoj_298_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Rajiv Joshi
- Department of Dermatology, P. D. Hinduja Hospital, Veer Savarkar Marg, Mumbai, Maharashtra, India
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7
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Subhadarshani S, Singh A, Ramateke PP, Verma KK. Idiopathic Eruptive Macular Pigmentation in an Indian Male. Indian Dermatol Online J 2017; 8:367-370. [PMID: 28979876 PMCID: PMC5621203 DOI: 10.4103/idoj.idoj_274_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sweta Subhadarshani
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Aashim Singh
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant P Ramateke
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Kaushal K Verma
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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8
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Ghiasi M, Kamyab K. Idiopathic eruptive macular pigmentation with papillomatosis. Clin Exp Dermatol 2016; 42:94-95. [PMID: 27917516 DOI: 10.1111/ced.12964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2016] [Indexed: 11/29/2022]
Affiliation(s)
- M Ghiasi
- Department of Dermatology, Razi Hospital, Vahdat Eslami Square, Tehran, Iran
| | - K Kamyab
- Department of Pathology, Razi Hospital, Vahdat Eslami Square, Tehran, Iran
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9
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Misri RR, Khurana VK, Thole AV, Nagad MB. Idiopathic Eruptive Macular Pigmentation with Papillomatosis: An Unfamiliar Entity. Indian J Dermatol 2016; 61:581. [PMID: 27688467 PMCID: PMC5029264 DOI: 10.4103/0019-5154.190135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Rachita R Misri
- Department of Dermatology, Venereology and Leprosy, Hindu Rao Hospital, New Delhi, India. E-mail:
| | - Vinod K Khurana
- Department of Dermatology, Venereology and Leprosy, Hindu Rao Hospital, New Delhi, India. E-mail:
| | - Akhilesh V Thole
- Department of Dermatology, Venereology and Leprosy, Hindu Rao Hospital, New Delhi, India. E-mail:
| | - Monil B Nagad
- Department of Dermatology, Venereology and Leprosy, Hindu Rao Hospital, New Delhi, India. E-mail:
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10
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Fu CL, Hu YF, Song YZ. Idiopathic eruptive macular pigmentation in a child with citrin deficiency. Pediatr Int 2016; 58:902-5. [PMID: 27389718 DOI: 10.1111/ped.13007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/20/2016] [Accepted: 04/05/2016] [Indexed: 11/30/2022]
Abstract
Idiopathic eruptive macular pigmentation (IEMP) is a rare dermatological disorder with generally unclear etiology and pathogenesis. A 5½-year-old girl was referred to hospital with a 10 month history of brown skin rashes. In early infancy, citrin deficiency had been diagnosed with the SLC25A13 genotype c.851_854del4/c.998G > A, but all clinical and laboratory abnormalities recovered following the introduction of a lactose-free and medium-chain triglyceride-enriched formula. Physical examination at referral indicated symmetric, multiple and non-scaly brown macules on the neck, trunk, buttocks and proximal parts of the extremities. Histopathology indicated epidermal basal layer hyperpigmentation with an irregular distribution, along with a large number of melanophages in the upper dermis. The diagnosis of IEMP was thus made. Within 2 years of follow up, the rashes disappeared spontaneously and gradually. To our knowledge, this is the first description of IEMP in a patient with silent citrin deficiency.
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Affiliation(s)
- Chu-Li Fu
- Department of Pediatrics, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yun-Feng Hu
- Department of Dermatology, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yuan-Zong Song
- Department of Pediatrics, First Affiliated Hospital, Jinan University, Guangzhou, China.
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11
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Chandran V, Kumarasinghe SP. Macular pigmentation of uncertain aetiology revisited: two case reports and a proposed algorithm for clinical classification. Australas J Dermatol 2016; 58:45-49. [DOI: 10.1111/ajd.12428] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 10/18/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Veena Chandran
- Research Assistant; Western Dermatology; Perth Western Australia
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12
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Dedhia A, Someshwar S, Jerajani HR. Idiopathic eruptive macular pigmentation: What is it actually? Int J Dermatol 2015; 54:1462-5. [PMID: 26341362 DOI: 10.1111/ijd.13053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 03/19/2015] [Accepted: 04/01/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Ami Dedhia
- Department of Dermatology, MGM Medical College, Kamothe, Navi Mumbai, Maharashtra, India
| | - Shylaja Someshwar
- Department of Dermatology, MGM Medical College, Kamothe, Navi Mumbai, Maharashtra, India
| | - Hemangi R Jerajani
- Department of Dermatology, MGM Medical College, Kamothe, Navi Mumbai, Maharashtra, India
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13
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Affiliation(s)
- Ossama Abbas
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
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14
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Abstract
We present a case of a healthy 8-year-old boy who presented with disseminated asymptomatic brown macules on the face, neck, trunk, and proximal extremities for 3 months. Dermatologic examination revealed multiple, smooth, nonscaly, brown macules involving the face, neck, trunk, and proximal limbs. The Darier's sign was negative. Histopathologic study showed normal epidermis and basal membrane, and increasingly scattered melanophages in the papillary dermis. The final diagnosis was idiopathic eruptive macular pigmentation.
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Affiliation(s)
- Zha Wei-Feng
- Department of Dermatology, People's Hospital, Hangzhou, Zhejiang, China
| | - Xu Ai-E
- Department of Dermatology, People's Hospital, Hangzhou, Zhejiang, China
| | - Chen Jun-Fan
- Department of Dermatology, People's Hospital, Hangzhou, Zhejiang, China
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15
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Asymptomatic Hyperpigmented Macules and Patches on the Trunk. Am J Dermatopathol 2015; 37:546, 586. [PMID: 26091516 DOI: 10.1097/01.dad.0000469110.15512.4f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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[Greyish macular rash on the trunk of an adolescent patient]. An Pediatr (Barc) 2014; 82:e199-200. [PMID: 25103838 DOI: 10.1016/j.anpedi.2014.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 06/20/2014] [Accepted: 07/04/2014] [Indexed: 11/21/2022] Open
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17
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Herd TJ, Wright TS. Idiopathic eruptive macular pigmentation involving the distal extremities: a case report. Pediatr Dermatol 2014; 31:e52-4. [PMID: 24606211 DOI: 10.1111/pde.12295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Idiopathic eruptive macular pigmentation is a disorder of pigmentation found in children and adolescents. It typically manifests as nonconfluent tan to brown macules involving the neck, trunk, and proximal extremities. We report the case of a 6-year-old girl with an atypical presentation involving the distal extremities. Histopathology confirmed the subtle increase in pigmentation of the basal layer of the epidermis. Treatments are largely ineffective. The condition is generally self-limited over months to years, thus treatment is unnecessary.
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Affiliation(s)
- Tiffany J Herd
- Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
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18
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Oiso N, Kawada A. Idiopathic eruptive macular pigmentation following a Christmas tree pattern. J Dermatol 2013; 40:934-5. [PMID: 24127666 DOI: 10.1111/1346-8138.12270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Naoki Oiso
- Department of Dermatology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
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19
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Abstract
We present a case of an otherwise healthy 10-year-old girl who presented with asymptomatic brown macules over the trunk and proximal extremities, of three months’ duration. The cutaneous examination revealed multiple, dark brown, discrete, round to oval macules and a few mildly elevated lesions over the trunk and proximal limbs. The individual lesion was 1-3 cm in diameter and a few showed velvety appearance over the surface. Darier's sign was negative. The histopathological study from the velvety lesion showed acanthosis, papillomatosis and increased melanin in the basal layer. The upper dermis showed sparse perivascular infiltrate of lymphocytes without any dermal melanophages. It fulfilled the criteria for idiopathic eruptive macular pigmentation with additional histological finding of papillomatosis.
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Affiliation(s)
- Shikha Verma
- Department of Dermatology, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
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20
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Abstract
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.
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Affiliation(s)
- Naoki Oiso
- Department of Dermatology, Faculty of Medicine Kinki University, Osaka-Sayama, Japan.
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21
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Helbling I, Bamford WM, Taibjee SM. A girl with multiple asymptomatic pigmented macules and patches. Clin Exp Dermatol 2012; 38:215-6. [PMID: 22924709 DOI: 10.1111/j.1365-2230.2012.04394.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- I Helbling
- Department of Dermatology, University Hospitals Leicester, Leicester, UK
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Abstract
Idiopathic eruptive macular pigmentation (IEMP) is a rather under-reported condition of unknown etiology. Clinically consisting of benign hyperpigmented macules, the condition is characterized histopathologically by dermal melanization. It must be differentiated from lichen planus pigmentosus, erythema dyschromicum perstans, fixed drug eruption and mastocytosis.
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Affiliation(s)
- Sanjiv Grover
- Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India
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23
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de Souza DF, Cunha AC, Piñeiro-Maceira J, Gomes MK, Sodré CT, Ramos-e-Silva M. Idiopathic eruptive macular pigmentation associated with pregnancy. Int J Dermatol 2010; 49:810-2. [PMID: 20618504 DOI: 10.1111/j.1365-4632.2009.04356.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Dominique Fausto de Souza
- Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
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24
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Martín JM, Ramos V, Terradez L, Simó R, Ricart JM, Jordá E. Progressively fading asymptomatic brownish macules. Clin Exp Dermatol 2010; 35:e182-3. [PMID: 20518909 DOI: 10.1111/j.1365-2230.2009.03634.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J M Martín
- Dermatology Department, Hospital Clinico Universitario, Valencia, Spain.
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Affiliation(s)
- T Kawakami
- Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
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26
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Zaynoun S, Rubeiz N, Kibbi AG. Ashy dermatoses--a critical review of the literature and a proposed simplified clinical classification. Int J Dermatol 2008; 47:542-4. [PMID: 18477140 DOI: 10.1111/j.1365-4632.2008.03625.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Shukrallah Zaynoun
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
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27
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Kim EH, Lee ES, Kim YC, Kang HY. A Case of Idiopathic Eruptive Macular Pigmentation Limited to Flexural Areas. Ann Dermatol 2008; 20:98-101. [PMID: 27303170 DOI: 10.5021/ad.2008.20.2.98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 03/03/2008] [Indexed: 11/08/2022] Open
Abstract
Idiopathic eruptive macular pigmentation is a rare condition characterized by asymptomatic pigmented macules involving the neck, trunk, and proximal portions of the extremities. On histopathologic examination, there was increased pigmentation of the basal layer in otherwise normal epidermis and scattered melanophages in the papillary dermis. We report a case of a 26-year-old woman with idiopathic eruptive macular pigmentation involving only the flexural areas of the body. This condition should be considered in the differential diagnosis of flexural hyperpigmented skin lesions.
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Affiliation(s)
- En Hyung Kim
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
| | - Eun So Lee
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
| | - You Chan Kim
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
| | - Hee Young Kang
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
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28
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Affiliation(s)
- Viviane Marins de Arruda Câmara
- Department of Dermatology, Federal University of Rio de Janeiro, Instituto de Dermatologia Prof. Rubem Azulay, Santa Casa do Rio de Janeiro, Brazil
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29
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Stinco G, Favot F, Scott CA, Patrone P. Pigmentatio maculosa eruptiva idiopathica: a case report and review of the literature. Int J Dermatol 2008; 46:1267-70. [PMID: 18173521 DOI: 10.1111/j.1365-4632.2007.03422.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pigmentatio maculosa eruptiva idiopathica is a rare pediatric disease characterized by asymptomatic, brownish macules involving the neck and trunk with no preceding inflammatory process or history of drug exposure. METHODS A 9-year-old girl presented with brown-gray, nonconfluent, asymptomatic macules on the trunk, neck, and limbs, ranging from 5 to 30 mm in diameter. The macules appeared suddenly with no lesions preceding their occurrence. Histopathologic examination showed basal cell layer hyperpigmentation, and abundant melanophages with a mild perivascular lymphohistiocytic infiltrate in the papillary dermis. RESULTS The lesions disappeared spontaneously 1.5 years later with no therapy. No relapse occurred. CONCLUSION Pigmentatio maculosa eruptiva idiopathica must be differentiated from other skin disorders with hyperpigmentation in pediatric practice in order to avoid unnecessary treatment, as spontaneous resolution is expected. Following a literature review, we underline the importance of spontaneous regression as an additional clinical feature for this disease.
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Affiliation(s)
- Giuseppe Stinco
- Institute of Dermatology, Department of Clinical and Experimental Pathology and Medicine, University of Udine School of Medicine, Udine, Italy.
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30
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Abstract
The Mediterranean area represents the area of land that borders the Mediterranean basin. It is composed of several countries that share many geographic and racial characteristics. Although Mediterraneans seem to share common skin type and are subjected to similar enviromental factors, they still represent a genetic and socioeconomic diversity. True prevalence of pigmentary disorders in this area depends on large epidemiologic studies, including countries that are not available. This article, however, highlights and classifies the most important developmental (heritable-genetic) and acquired pigmentary disorders seen and reported in this important area of the world.
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Affiliation(s)
- Medhat A El-Mofty
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
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31
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Volz A, Metze D, Böhm M, Bruckner-Tuderman L, Nashan D. Idiopathic eruptive macular pigmentation in a 7-year-old girl: case report and discussion of differences from erythema dyschromicum perstans. Br J Dermatol 2007; 157:839-40. [PMID: 17714566 DOI: 10.1111/j.1365-2133.2007.08127.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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32
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Abstract
Pigmentary disorders with hypopigmentation/depigmentation or hyperpigmentation may have special manifestations in Latin America. Most pigmentary disorders are commonly observed in all areas of Latin America, but a few are particularly seen in tropical and subtropical regions. In most pigmentary disorder ailments described, multiple factors involved in their pathogenesis are known, but etiology remains elusive. Some pigmentary disorders have peculiar clinical expressions and, in spite of being restricted to certain geographical areas, they may be observed in other world areas because of frequent traveling of affected patients. Therapy of most of these ailments is difficult or remains unknown.
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Affiliation(s)
- Rafael Falabella
- Department of Dermatology, Universidad del Valle and Hospital Universitario del Valle, Calle 5 #36-08, Cali, Colombia.
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33
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Sebbag N, Lacour JP. [Erythema dyschromicum perstans]. Ann Dermatol Venereol 2006; 133:79-82. [PMID: 16495863 DOI: 10.1016/s0151-9638(06)70853-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- N Sebbag
- Service de Dermatologie, Hôpital Archet-2, CHU de Nice
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34
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Rallis E, Rigopoulos D, Anyfantakis V, Kalogirou O, Christophidou E, Papadakis P, Katsambas A. 'Dalmatian dog'-like skin eruption (two cases of multifocal fixed drug eruption induced by mefenamic acid). J Eur Acad Dermatol Venereol 2005; 19:753-5. [PMID: 16268887 DOI: 10.1111/j.1468-3083.2005.01302.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mefenamic acid is a common widely prescribed drug with analgesic activity. Authors report two cases of multifocal fixed drug eruption induced by mefenamic acid. Cases were diagnosed on basis of clinical examination and histopathology of skin lesion. Only a few cases have been reported in the literature and these are the first two described in Greece.
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Affiliation(s)
- E Rallis
- General Military Hospital of Athens, Department of Dermatology, 138 Mesogion Ave., Athens, Greece
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35
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Torrelo A, Zaballos P, Colmenero I, Mediero IG, de Prada I, Zambrano A. Erythema dyschromicum perstans in children: a report of 14 cases. J Eur Acad Dermatol Venereol 2005; 19:422-6. [PMID: 15987286 DOI: 10.1111/j.1468-3083.2005.01203.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Antonio Torrelo
- Department of Pediatric Dermatology, Hospital del Niño Jesús, Menéndez Pelayo 65, 28009 Madrid, Spain.
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36
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Milobratovic D, Djordjevic S, Vukicevic J, Bogdanovic Z. Idiopathic eruptive macular pigmentation associated with pregnancy and Hashimoto thyroiditis. J Am Acad Dermatol 2005; 52:919-21. [PMID: 15858495 DOI: 10.1016/j.jaad.2005.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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38
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Nuber UA, Tinschert S, Mundlos S, Hauber I. Dyschromatosis universalis hereditaria: Familial case and ultrastructural skin investigation. ACTA ACUST UNITED AC 2004; 125A:261-6. [PMID: 14994234 DOI: 10.1002/ajmg.a.20519] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We report a familial case of dyschromatosis universalis hereditaria (DUH) which is compatible with an autosomal dominant inheritance. The male proband from Bangladesh presented with randomly distributed hyper- and hypo-pigmented skin lesions of variable shape and size with a mottled appearance. Three additional members of the non-consangineous family are similarly affected. Light and electron microscopy show normal numbers of active melanocytes, but different amounts of fully melanized melanosomes in hyper-pigmented and hypo-pigmented macules. Our findings indicate that DUH is not a disorder of number. It appears to be a disorder of melanosome synthesis rate or in addition melanocyte activity.
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Affiliation(s)
- Ulrike A Nuber
- Max Planck Institute for Molecular Genetics, Berlin, Germany
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39
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Mehta S, Aasi S, Cole R, Chu P, Weinberg JM. Idiopathic eruptive macular pigmentation: a case of 21 years' duration. J Am Acad Dermatol 2003; 49:S280-2. [PMID: 14576654 DOI: 10.1016/s0190-9622(03)00745-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Idiopathic eruptive macular pigmentation is a rare condition characterized by asymptomatic pigmented macules involving the neck, trunk, and proximal portions of the extremities. Age at onset usually varies from 1 to 20 years. The lesions usually appear abruptly and remit spontaneously over months to years. An unusual case of a 24-year-old woman with idiopathic eruptive macular pigmentation lasting 21 years was characterized by several periods of spontaneous resolution followed by recurrences.
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Affiliation(s)
- Sheetal Mehta
- Department of Dermatology, St. Luke's-Roosevelt Hospital Center and Beth Israel Medical Center, New York, NY 10025, USA
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40
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Jang KA, Choi JH, Sung KS, Moon KC, Koh JK. Idiopathic eruptive macular pigmentation: report of 10 cases. J Am Acad Dermatol 2001; 44:351-3. [PMID: 11174413 DOI: 10.1067/mjd.2001.103642] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Idiopathic eruptive macular pigmentation (IEMP) is a rare disease. IEMP is characterized by asymptomatic, pigmented macules involving the neck, trunk, and proximal extremities. This study describes 10 cases of idiopathic eruptive macular pigmentation seen during a 9-year period at the Asan Medical Center, Seoul, Korea. We present these characteristic consecutive cases to provide more insight into the clinical picture and course of IEMP. Skin lesions of 8 patients were multiple brown macules involving the trunk, face, neck, and extremities. In 2 patients, multiple dark brown macules and patches were noted. The age of onset varied from 1 to 20 years. Tentative diagnoses were usually ashy dermatosis (erythema dyschromicum perstans), fixed drug eruption, or mastocytosis. The history of any erythema and drug medication was absent. Darier's sign was absent. Skin biopsy specimens showed increased pigmentation of the basal layer in an otherwise normal epidermis. Pigmentary incontinence, melanophages, and mild perivascular lymphohistiocytic infiltrate in the papillary dermis were also revealed. Mast cells could not be found. The lesions gradually disappeared during a period of several months to years. The alleged rarity of IEMP may be partially caused by medical unfamiliarity with this entity, despite its clinical and histopathologic characteristic picture. Treatment of IEMP is unnecessary because spontaneous resolution of the lesions can be expected within several months to a few years.
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Affiliation(s)
- K A Jang
- Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
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