Characteristic Dermatoscopic Features of Hyperpigmented Macules on the Faces of Young Children

The aim was to describe the characteristic dermatoscopic features of hyperpigmented macules on the faces of young children. Sixteen patients with typical clinical presentations of hyperpigmented macules on the faces of young children were included in this study. The lesions were evaluated using a dermatoscope. The clinical and dermatoscopic features were analyzed and summarized. There were 12 boys and 4 girls enrolled in the study. The hyperpigmented macules had an age of onset ranging from 1 to 18 months (mean, 6.12 months). The hyperpigmentation was distributed on the forehead and/or temple, as follows: forehead (n = 8 [50%]); temple (n = 3 [18.8%]); and both sites (n = 5 [31.2%]). Fifteen patients (93.7%) had pseudoreticular pigmentation, 1 patient (6.3%) had reticular pigment with pseudoreticular pigment, and 100% had erythema and linear/branching vessels. Light brown pseudoreticular pigment and linear vessels were shown to be the 2 major dermatoscopic manifestations of hyperpigmented macules on the faces of young children.

Cutaneous findings in Fanconi anemia

BACKGROUND

Fanconi anemia (FA) is a genetic disorder that results in bone marrow failure, physical abnormalities, and solid organ malignancies. The diagnosis of FA is often delayed because the early disease characteristics have not been well established.

OBJECTIVE

To outline the spectrum of cutaneous findings seen in patients with FA.

METHODS

A cross-sectional study in which patients with FA received a full-body skin examination. Patient characteristics are summarized with mean (SD) for continuous and count (%) for categorical variables. Poisson regression and logistic regression models were used to examine the relationships between pigmentary changes and patient characteristics.

RESULTS

At least 1 cutaneous pigmentary alteration was present in 96.8% of patients, most arising before the teenage years. The most common finding was café-au-lait macules. Other findings included hypopigmented macules, skin-fold freckle-like macules, extensive sun-exposed freckling, and both hypopigmented and hyperpigmented pigment macules.

LIMITATIONS

Patients received a single assessment, so the number of pigmentary changes could not be assessed over time.

CONCLUSIONS

Characteristic morphology of FA includes faint and ill-defined café-au-lait macules, hypopigmented skin-fold freckle-like macules and the concurrence of hypopigmented and hyperpigmented macules. The recognition of these findings could aid clinicians in making earlier diagnoses.

Hyperpigmented macules on the face of young children: a series of 25 cases

BACKGROUND

Acquired hyperpigmented lesions in early childhood can be the presenting sign of serious diseases or benign conditions and often cause significant parental anxiety.

OBJECTIVE

We sought to report a series of 25 young children with hyperpigmented macules on the forehead and temples without preceding erythema, edema, or desquamation.

METHODS

We conducted a retrospective review of 25 children with similar clinical findings, seen from 2009 to 2013, from 5 medical centers in 3 countries.

RESULTS

There were 13 boys and 12 girls of many races. Their ages ranged from 2 to 24 months (mean 12.2 months, median 6 months). The hyperpigmentation presented abruptly in the summer (12 cases), spring (5 cases), winter (5), and fall (2), and was not clearly specified in 1 case. Histopathologic analysis in 3 cases was consistent with postinflammatory hyperpigmentation. After a follow-up period ranging from 3 months to 4.5 years, the lesions persist to a variable degree in 19 cases in which follow-up was possible.

LIMITATIONS

The age of our patients precluded patch testing and/or invasive diagnostic methods.

CONCLUSIONS

The clinical features and prolonged clinical course over years do not correspond with any known or previously described cause of acquired facial hyperpigmented macules in young children.