1
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Hossain OB, Labiak A, Mieczkowska K, Srikantha R, Ciocon DH, Williams RF. Postinflammatory Hyperpigmentation Following Mohs Micrographic Surgery: An Observational Study. J Drugs Dermatol 2024; 23:316-321. [PMID: 38709696 DOI: 10.36849/jdd.8146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
IMPORTANCE Functional and cosmetic outcomes following Mohs micrographic surgery (MMS) are poorly studied in individuals with skin of color (SOC). Postinflammatory hyperpigmentation (PIH) may be long-lasting and highly distressing. SOC individuals are particularly susceptible to PIH following procedures. Objective: To characterize factors that contribute to the development of PIH following MMS in SOC. DESIGN This retrospective study included 72 SOC individuals with 83 cases of keratinocyte carcinoma treated with MMS between August 2020 and August 2021 at a single medical center in the Bronx, New York. RESULTS Postinflammatory hyperpigmentation following Mohs micrographic surgery was more common in Fitzpatrick skin types (FST) IV to V (48.0%) compared to FST I to III (18.2%; P=0.006). Grafts and granulation resulted in higher rates of PIH compared to linear repairs and flaps (87.5% vs 30.7%; P=0.003). Cases with postoperative complications resulted in higher rates of PIH compared to cases without (81.8% vs 29.2%; P=0.001). In a subset analysis of linear repairs, polyglactin 910 as a subcutaneous suture produced a higher rate of PIH compared to poliglecaprone 25 (46.2% vs 7.1%; P=0.015). Conclusions and Relevance: Individuals with SOC (FST IV to V) are more likely to develop PIH following MMS. Grafts and granulation lead to PIH more often than linear repairs and flaps. Postoperative complications significantly increase the risk of PIH. Surgeons should consider these risk factors during surgical planning in an effort to mitigate PIH in SOC individuals. Studies with larger sample sizes are indicated. J Drugs Dermatol. 2024;23(5):316-321. doi:10.36849/JDD.8146.
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2
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Dhami RK, Handfield C, Johnson EF, Tollefson MM. Idiopathic eruptive macular pigmentation in a pediatric patient and a review of the literature. Pediatr Dermatol 2024; 41:504-507. [PMID: 38156740 DOI: 10.1111/pde.15496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/02/2023] [Indexed: 01/03/2024]
Abstract
Idiopathic eruptive macular pigmentation (IEMP) is a rare, benign, self-resolving melanosis consisting of hyperpigmented macules typically on the face, trunk, and extremities that can occur in children and adolescents and often presents a diagnostic conundrum. We report a case involving an 8-year-old female whose previous clinical presentation was concerning for an atypical presentation of cutaneous mastocytosis or neurofibromatosis. The clinical and histopathologic evaluation was consistent with the diagnosis of IEMP, and no active intervention was pursued. Our accompanying literature review serves to better characterize this condition, highlight key diagnostic features, and emphasize the tendency for spontaneous resolution to avoid unnecessary treatments with limited clinical efficacy.
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Affiliation(s)
- Ramneek K Dhami
- Reno School of Medicine, University of Nevada, Reno, Nevada, USA
| | | | - Emma F Johnson
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Megha M Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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3
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Gutovitz JM, Ben-Simon G, Egozi E, Bar A, Landau Prat D. Transient Postinflammatory Hyperpigmentation Following Eyelid Surgery. Ophthalmic Plast Reconstr Surg 2024; 40:286-290. [PMID: 37972970 DOI: 10.1097/iop.0000000000002565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
PURPOSE The authors' aim was to describe a rare mild complication of eyelid surgery presenting as transient hyperpigmentation along the suture lines. METHODS A retrospective case series of 6 patients experiencing transient hyperpigmentation following eyelid surgery. Each patient underwent either blepharoplasty alone or blepharoplasty with ptosis repair utilizing Müller muscle conjunctival resection. Data including surgery type, hyperpigmentation laterality and location, time to diagnosis, follow-up time, and outcome were assessed. RESULTS All 6 patients with hyperpigmentation were females. All patients underwent blepharoplasty, including 1 upper eyelid blepharoplasty and 4 with both upper and lower eyelid blepharoplasty. One patient underwent bilateral upper blepharoplasty with concurrent posterior approach ptosis surgery repair of the left upper eyelid. Hyperpigmentation was bilateral in all 5 blepharoplasty cases and unilateral in the ptosis repair case. Hyperpigmentation included the medial portion of the operated upper eyelid in all cases. Time to diagnosis ranged from 1 to 4 weeks postoperatively, and follow-up time ranged from 3 to 5 months. Management was conservative in all cases. Five patients experienced complete resolution, and 1 patient experienced near-complete resolution on a 3-month follow-up. CONCLUSIONS Transient hyperpigmentation is a rare posteyelid surgery complication, generally with an excellent outcome not requiring additional intervention.
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Affiliation(s)
- Joel M Gutovitz
- Department of Ophthalmology, Goldschleger Eye Institute, Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel
- Faculty of Medicine, Tel aviv University, Ramat Aviv, Israel
| | - Guy Ben-Simon
- Department of Ophthalmology, Goldschleger Eye Institute, Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel
- Faculty of Medicine, Tel aviv University, Ramat Aviv, Israel
| | - Ella Egozi
- Dermatology and Aestetics, Dr. Ella Egozi Medical Center, Faculty of Medicine, Tel aviv University, Ramat Aviv, Israel
| | - Ariel Bar
- Faculty of Medicine, Tel aviv University, Ramat Aviv, Israel
| | - Daphna Landau Prat
- Department of Ophthalmology, Goldschleger Eye Institute, Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel
- Faculty of Medicine, Tel aviv University, Ramat Aviv, Israel
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4
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Hammoud H, Mishlab S, Avitan-Hersh E. Pigmentary Changes in a Woman With Oral Lichen Planus. JAMA Dermatol 2024; 160:569-570. [PMID: 38506819 DOI: 10.1001/jamadermatol.2023.6043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
A woman in her 60s presented with oral lichen planus on hands and cheeks since childhood and also present in her parent and sibling. What is your diagnosis?
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Affiliation(s)
- Hani Hammoud
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
| | - Salih Mishlab
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Department of Pathology, Rambam Health Care Campus, Haifa, Israel
| | - Emily Avitan-Hersh
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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5
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Moon RJ, Rowland AC, Davies JH. Hyperpigmentation at diabetes technology sites may be indicative of evolving Addison's disease. Arch Dis Child 2024; 109:432. [PMID: 38336458 DOI: 10.1136/archdischild-2023-326750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2024] [Indexed: 02/12/2024]
Affiliation(s)
- Rebecca J Moon
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Amy C Rowland
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Justin H Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
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6
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Peng JP, Yang XY, Luo F, Yuan XM, Xiong H, Ma WK, Yao XM. Hydroxychloroquine-induced hyperpigmentation of the skin and bull's-eye maculopathy in rheumatic patients: a case report and literature review. Front Immunol 2024; 15:1383343. [PMID: 38660312 PMCID: PMC11039820 DOI: 10.3389/fimmu.2024.1383343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024] Open
Abstract
Hydroxychloroquine (HCQ) is used as a traditional disease-modifying antirheumatic drugs (DMARDs), for the treatment of autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). However, it can cause serious adverse reactions, including hyperpigmentation of the skin and bull's-eye macular lesions. Here, we present a case of HCQ-induced hyperpigmentation of the skin and bull's-eye macular lesions in a patient who received HCQ for RA. A 65-year-old female patient developed blurred vision and hyperpigmentation of multiple areas of skin over the body for one month after 3 years of HCQ treatment for RA. Based on clinical presentation, ophthalmological examination and dermatopathological biopsy, a diagnosis of drug-induced cutaneous hyperpigmentation and bullous maculopathy of the right eye was made. After discontinuation of HCQ and treatment with iguratimod tablets, the hyperpigmentation of the patient 's skin was gradually reduced, and the symptoms of blurred vision were not significantly improved. We also reviewed the available literature on HCQ-induced cutaneous hyperpigmentation and bull's-eye macular lesions and described the clinical features of HCQ-induced cutaneous hyperpigmentation and bull's-eye macular lesions. In conclusion, clinicians should be aware of early cutaneous symptoms and HCQ-associated ophthalmotoxicity in patients with rheumatic diseases on HCQ sulphate and should actively monitor patients, have them undergo regular ophthalmological examinations and give appropriate treatment to prevent exacerbation of symptoms.
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Affiliation(s)
- Ji-peng Peng
- Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Xiao-yu Yang
- Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Feng Luo
- Guizhou University of Traditional Chinese Medicine, Guiyang, China
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Xue-mei Yuan
- Guizhou University of Traditional Chinese Medicine, Guiyang, China
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Hong Xiong
- Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Wu-kai Ma
- Guizhou University of Traditional Chinese Medicine, Guiyang, China
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Xue-ming Yao
- Guizhou University of Traditional Chinese Medicine, Guiyang, China
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
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7
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Sadeghi NB, Ziemer CM, Wu SB, Miedema JR, Blasiak RC. Persistent Hyperpigmented Macules on the Scalp and Face: A Clinicopathologic Challenge: Challenge. Am J Dermatopathol 2024; 46:e27-e28. [PMID: 38488353 DOI: 10.1097/dad.0000000000002653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Affiliation(s)
- Nakisa B Sadeghi
- University of North Carolina, School of Medicine, Chapel Hill, NC; and
| | - Carolyn M Ziemer
- University of North Carolina, Department of Dermatology, Chapel Hill, NC
| | - Sam B Wu
- University of North Carolina, Department of Dermatology, Chapel Hill, NC
- Piedmont Plastic Surgery and Dermatology, Charlotte, NC
| | - Jayson R Miedema
- University of North Carolina, Department of Dermatology, Chapel Hill, NC
| | - Rachel C Blasiak
- University of North Carolina, Department of Dermatology, Chapel Hill, NC
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8
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Gosch ME, McMichael AJ, Niehaus AG, Sangüeza OP. Progressive Hyperpigmentation on the Face in a Skin of Color Woman: Challenge. Am J Dermatopathol 2024; 46:e25-e26. [PMID: 38488352 DOI: 10.1097/dad.0000000000002670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Affiliation(s)
- Marianne E Gosch
- Department of Dermatology, Hospital del Salvador, Providencia, Santiago, Chile
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; and
| | - Amy J McMichael
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; and
| | - Angela G Niehaus
- Department of Pathology, Wake Forest Baptist Health, Medical Center Boulevard, Winston-Salem, NC
| | - Omar P Sangüeza
- Department of Pathology, Wake Forest Baptist Health, Medical Center Boulevard, Winston-Salem, NC
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9
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Sadeghi NB, Ziemer CM, Wu SB, Miedema JR, Blasiak RC. Persistent Hyperpigmented Macules on the Scalp and Face: Answer. Am J Dermatopathol 2024; 46:257-258. [PMID: 38488350 DOI: 10.1097/dad.0000000000002655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Affiliation(s)
- Nakisa B Sadeghi
- School of Medicine, University of North Carolina, Chapel Hill, NC; and
| | - Carolyn M Ziemer
- Department of Dermatology, University of North Carolina, Chapel Hill, NC
| | - Sam B Wu
- Department of Dermatology, University of North Carolina, Chapel Hill, NC
| | - Jayson R Miedema
- Department of Dermatology, University of North Carolina, Chapel Hill, NC
| | - Rachel C Blasiak
- Department of Dermatology, University of North Carolina, Chapel Hill, NC
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10
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Gosch ME, McMichael AJ, Niehaus AG, Sangüeza OP. Progressive Hyperpigmentation on the Face in a Skin of Color Woman: Answer. Am J Dermatopathol 2024; 46:255-256. [PMID: 38488349 DOI: 10.1097/dad.0000000000002671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Affiliation(s)
- Marianne E Gosch
- Department of Dermatology, Hospital del Salvador, Providencia, Santiago, Chile
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; and
| | - Amy J McMichael
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; and
| | - Angela G Niehaus
- Department of Pathology, Wake Forest Baptist Health, Winston-Salem, NC
| | - Omar P Sangüeza
- Department of Pathology, Wake Forest Baptist Health, Winston-Salem, NC
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11
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Mitev S, Zheleva N, Ivanova A. Sunlight's Dark Side: A Case of Subtle Skin Lesions and Hyperpigmentation. Gastroenterology 2024; 166:376-378. [PMID: 37926131 DOI: 10.1053/j.gastro.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Stefan Mitev
- Gastroenterology Clinic, University Hospital Sveti Ivan Rilski, Sofia, Bulgaria.
| | - Nadezhda Zheleva
- Gastroenterology Clinic, University Hospital Sveti Ivan Rilski, Sofia, Bulgaria
| | - Aneta Ivanova
- Bulgarian Porphyria Center, University Hospital Sveti Ivan Rilski, Sofia, Bulgaria
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12
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Nakajima M, Watanabe K, Ohara Y, Otsuki M, Wakasa T, Tsuruta D, Oiso N. Hyperpigmentation with droplets of melanocytes into the dermis in primary localized cutaneous amyloidosis. J Dermatol 2024; 51:e72-e73. [PMID: 37789690 DOI: 10.1111/1346-8138.16986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/27/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Maki Nakajima
- Department of Dermatology, Kindai University Nara Hospital, Ikoma, Japan
| | - Keiko Watanabe
- Department of Dermatology, Kindai University Nara Hospital, Ikoma, Japan
| | - Yushiro Ohara
- Department of Dermatology, Kindai University Nara Hospital, Ikoma, Japan
| | - Mai Otsuki
- Department of Dermatology, Kindai University Nara Hospital, Ikoma, Japan
| | - Tomoko Wakasa
- Department of Diagnostic Pathology, Kindai University Nara Hospital, Ikoma, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Osaka Metropolitan University School of Medicine, Osaka, Japan
| | - Naoki Oiso
- Department of Dermatology, Kindai University Nara Hospital, Ikoma, Japan
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13
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Lemarcq L, De Vis M, Deweer S, Gutermuth J, Velkeniers B. Coexistence of Vitiligo and Hyperpigmentation: A Quiz. Acta Derm Venereol 2024; 104:adv35429. [PMID: 38380976 PMCID: PMC10910515 DOI: 10.2340/actadv.v104.35429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/22/2024] [Indexed: 02/22/2024] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- Laure Lemarcq
- SKIN Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Department of Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
| | - Maarten De Vis
- Department of Endocrinology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Sophie Deweer
- Department of Endocrinology and Diabetology, Algemeen Ziekenhuis Sint-Elisabeth Zottegem, Belgium
| | - Jan Gutermuth
- SKIN Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Department of Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Brigitte Velkeniers
- Department of Internal Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
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14
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Hashemi DA, Wang JV, Geronemus RG. Potential Role of Tranexamic Acid and Nonablative Fractional Resurfacing in Managing Facial Hyperpigmentation. JAMA Dermatol 2024; 160:239-240. [PMID: 38231520 DOI: 10.1001/jamadermatol.2023.5470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Affiliation(s)
| | - Jordan V Wang
- Laser & Skin Surgery Center of New York, New York
- Laser & Skin Surgery Center of Pennsylvania, Devon
| | - Roy G Geronemus
- Laser & Skin Surgery Center of New York, New York
- The Ronald O. Perelman Department of Dermatology, New York University Langone Health, New York
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15
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Lai S, Lu Y, Huang X, Ji Q. Characteristic Dermatoscopic Features of Hyperpigmented Macules on the Faces of Young Children. Clin Pediatr (Phila) 2024; 63:244-248. [PMID: 37070525 DOI: 10.1177/00099228231167842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
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.
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Affiliation(s)
- Sha Lai
- Department of Dermatology, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Yao Lu
- Department of Dermatology, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Xulei Huang
- Department of Dermatology, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Qiuqin Ji
- Department of Dermatology, Chengdu Women's and Children's Central Hospital, Chengdu, China
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16
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Sun L, Sousa D, de Vasconcelos P, Antunes J, Soares-de-Almeida L, Filipe P. Generalized hyperpigmented and hypopigmented macules and papules. Clin Exp Dermatol 2024; 49:192-194. [PMID: 37878587 DOI: 10.1093/ced/llad356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/05/2023] [Indexed: 10/27/2023]
Abstract
A 49-year-old White woman with an unremarkable medical history presented with mildly pruritic hyperpigmented and hypopigmented macules and papules scattered across her face, trunk and limbs since her twenties.
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Affiliation(s)
- Lanyu Sun
- Serviço de Dermatologia, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Diogo Sousa
- Serviço de Dermatologia, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Pedro de Vasconcelos
- Serviço de Dermatologia, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Joana Antunes
- Serviço de Dermatologia, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Luís Soares-de-Almeida
- Serviço de Dermatologia, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Paulo Filipe
- Serviço de Dermatologia, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
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Emamverdi M, Habibi A, Ashrafkhorasani M, Nittala MG, Kadomoto S, Sadda SR. Optical Coherence Tomography Features of Macular Hyperpigmented Lesions without Intraretinal Hyperreflective Foci in Age-Related Macular Degeneration. Curr Eye Res 2024; 49:73-79. [PMID: 37937806 DOI: 10.1080/02713683.2023.2267801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/02/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE To evaluate the optical coherence tomography (OCT) features of hyperpigmented lesions in the absence of intraretinal hyperreflective foci (IHRF) on OCT in eyes with age-related macular degeneration (AMD). METHODS We retrospectively analyzed OCT images of eyes with intermediate AMD (iAMD) and macular hyperpigmentation (HP) on color fundus photograph (CFP) but without IHRF on OCT in the corresponding location. The most prominent or definite HP was selected for analysis. The infrared reflectance (IR) image registered with the CFP, and the location corresponding to the HP lesion were defined on the IR image. The location of the HP on the corresponding OCT B-scan was assessed for retinal pigment epithelium (RPE) elevation, acquired vitelliform lesion (AVL), abnormal retinal pigment epithelium + basal lamina (RPE + BL) band reflectivity, RPE + BL band thickening, as well as interdigitation zone (IZ), ellipsoid zone (EZ) and external limiting membrane (ELM) disruption. RESULTS 49 eyes (39 patients) were included in this study. Forty-six (94%) of the hyperpigmented lesions showed a thickened RPE + BL band. RPE + BL band reflectivity was increased in 37 (76%) of the lesions. RPE + BL band thickening, however, was not correlated with RPE + BL band reflectivity (p-value = 0.31). Either thickening or hyperreflectivity of the RPE + BL band was present in all cases. Twenty (41%) lesions had evidence of ELM disruption, 42 (86%) demonstrated EZ disruption and 48 (98%) had IZ disruption. Five (10%) HPs demonstrated AVL. Among cases with RPE elevation (15 cases, 31%), 10 were classified as drusen, 2 as drusenoid PEDs, and 3 as fibrovascular PEDs. CONCLUSIONS Thickening and/or hyperreflectivity of the RPE + BL band commonly correspond to regions of macular hyperpigmentation without IHRF in eyes with iAMD.
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Affiliation(s)
- Mehdi Emamverdi
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
| | - Abbas Habibi
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
| | - Maryam Ashrafkhorasani
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
| | - Muneeswar G Nittala
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
| | - Shin Kadomoto
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
| | - SriniVas R Sadda
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
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18
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Callender VD, Orlinsky D, Simmons-O'Brien E, Nwade NC, Rhodes T, Byrd AS. Comparing the Efficacy and Tolerability of Moderate to Severe Hyperpigmentation and Skin Unevenness. J Drugs Dermatol 2024; 23:1260-1265. [PMID: 38206158 DOI: 10.36849/jdd.7584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Dyschromia is the result of irregular facial pigmentation. These cutaneous manifestations can have a significant impact on the quality of life of those affected, especially among females and skin of color. In this randomized, double-blinded, two-cell, single-center, 16-week clinical study, all subjects had moderate to severe (scores 4-9 on the modified Griffiths Scale) hyperpigmentation and skin unevenness of the face such that approximately 20% of subjects had post-inflammatory hyperpigmentation (PIH), 40% had overall mottled hyperpigmentation, and 40% had superficial melasma (Superficial Melasma was determined by Wood's Lamp Assessment). Study participants received either Product A (proprietary new formulation - Cysteamine HSA) or Product B (current marketed product - Cyspera®) and used the test product either in the morning or at night, beginning with every other day application, and then advanced to every day, or as tolerated. The results revealed that both Product A (Cysteamine HSA) and Product B (Cyspera®) had statistically significant improvement in facial hyperpigmentation and skin unevenness, however, Product A (Cysteamine HSA) had better tolerability results for scaling, peeling, burning, stinging, erythema, and dryness, indicating that Product A (Cysteamine HSA) outperformed Product B (Cyspera®). J Drugs Dermatol. 2024;23(1):1260-1265. doi:10.36849/JDD.7584.
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Hamsho S, Alaswad M, Sleiay M, Alhusseini A. Hyperglycemia with hypogonadism and growth hormone deficiency in a 17-year-old male with H syndrome: the first case report from Syria. BMC Endocr Disord 2023; 23:274. [PMID: 38093297 PMCID: PMC10720192 DOI: 10.1186/s12902-023-01525-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The nucleoside transport capabilities of the human equilibrative nucleoside transporter-3 (hENT3) are disrupted by mutations in SLC29A3 (10q22.2), which are genes for the nucleoside transporter and are the cause of the unusual autosomal recessive disease known as H syndrome. As a result, histiocytic cells invade a number of organs. CASE PRESENTATION A 17-year-old Syrian male was admitted to the internal medicine department with a one-month history of polyuria, polydipsia, general weakness, and pallor. He had a history of progressive bilateral sensorineural hearing loss and failure to gain weight for three years. Physical examination revealed various abnormalities, including scrotal mass, small penis and testicles, absence of pubic and axillary hair, joint abnormalities, short stature, hallux valgus, fibrous protrusion near the navel, and hyperpigmented non-itchy painful skin plaques. Clinical signs along with laboratory test results confirmed hyperglycemia, primary hypogonadism, osteopenia, and growth hormone deficiency. After a review of the relevant medical literature, this patient's presentation of hyperglycemia with hypogonadism, hyperpigmentation, hallux valgus, hearing loss, hematological abnormalities, and short stature suggested the diagnosis of H syndrome. The patient received treatment with insulin and testosterone, leading to a significant improvement in his presenting symptoms. CONCLUSIONS H syndrome is a very rare condition, and the fact that the first case has only recently been reported in Syria serves to emphasize how rare it is. H Syndrome should be suspected if a patient has short stature with signs of hyperglycemia and other endocrine and cutaneous abnormalities. We are reporting this case to increase physicians' awareness of this exceedingly rare and unique syndrome.
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Affiliation(s)
- Suaad Hamsho
- Rheumatology department, Faculty of Medicine, Damascus University, Damascus, Syria
| | | | | | - Ayham Alhusseini
- Neurology Department, Faculty of Medicine, Damascus University, Damascus, Syria
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20
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Kakurai M, Honda R, Miyahara H, Ito S. Minocycline-induced Hyperpigmentation Confined to Lupus Miliaris Disseminatus Faciei. Acta Derm Venereol 2023; 103:adv18462. [PMID: 38059580 PMCID: PMC10719862 DOI: 10.2340/actadv.v103.18462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/30/2023] [Indexed: 12/08/2023] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Masakazu Kakurai
- Division of Dermatology, Hitachi General Hospital, Ibaraki, Japan
| | - Rie Honda
- Division of Dermatology, Hitachi General Hospital, Ibaraki, Japan.
| | - Hanako Miyahara
- Division of Dermatology, Hitachi General Hospital, Ibaraki, Japan
| | - Shusaku Ito
- Division of Dermatology, Hitachi General Hospital, Ibaraki, Japan
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21
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Obeng-Nyarko CN, Dazé R, Dorton D. Lichen planus pigmentosus inversus: a rare clinical variant. J Osteopath Med 2023; 123:593-594. [PMID: 37691631 DOI: 10.1515/jom-2023-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023]
Affiliation(s)
| | | | - David Dorton
- Bay Dermatology & Cosmetic Surgery, Spring Hill, FL, USA
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22
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Shah S, Baskaran N, Vinay K, Bishnoi A, Parsad D, Kumaran MS. Acquired dermal macular hyperpigmentation: an overview of the recent updates. Int J Dermatol 2023; 62:1447-1457. [PMID: 37767951 DOI: 10.1111/ijd.16859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Acquired dermal macular hyperpigmentation (ADMH), previously known as macular pigmentation of uncertain etiology (MPUE), is an umbrella concept that unifies the distinct but overlapping acquired dermal pigmentary disorders like lichen planus pigmentosus, ashy dermatosis, erythema dyschromicum perstans, Riehl's melanosis and pigmented contact dermatitis. All of these disorders usually lack a clinically apparent inflammatory phase, are characterised by dermal pigmentation clinically and histologically, and have a variable protracted disease course. Recently, a proposal has been made to classify these disorders into those with and without contact sensitisation. Dermoscopy is essentially similar across the spectrum of these disorders, and is useful for diagnosis and therapeutic response monitoring. Scoring system has been validated for the same. The treatment of ADMH remains challenging, with multiple topicals, oral therapies including mycophenolate mofetil, and lasers tried. Need of the hour is randomised controlled trials to enhance the therapeutic armamentarium.
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Affiliation(s)
- Shikha Shah
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Narayanan Baskaran
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu S Kumaran
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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23
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Li XY, Ma DL. X-Linked Reticulate Pigmentary Disorder. JAMA Dermatol 2023; 159:1383-1384. [PMID: 37851432 DOI: 10.1001/jamadermatol.2023.2980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
This case report describes a child with generalized reticulate hyperpigmentation and recurrent pneumonia, hypohidrosis, photophobia, and diarrhea.
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Affiliation(s)
- Xing-Yu Li
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Dong-Lai Ma
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
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Heidemeyer K, Cazzaniga S, Feldmeyer L, Imstepf V, Adatto M, Lehmann M, Rammlmair A, Pelloni L, Seyed Jafari SM, Bossart S. Skin hyperpigmentation index in melasma: A complementary method to classic scoring systems. J Cosmet Dermatol 2023; 22:3405-3412. [PMID: 37349912 DOI: 10.1111/jocd.15866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/08/2023] [Accepted: 06/01/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Due to relapsing nature of melasma with significant impact on quality of life, an objective measurement score is warranted, especially to follow-up the patients with melasma and their therapy response in a quantitative and precise manner. AIMS To prove concordance of skin hyperpigmentation index (SHI) with well-established scores in melasma and demonstrate its superiority regarding inter-rater reliability. Development of SHI mapping for its integration in common scores. METHODS Calculation of SHI and common melasma scores by five dermatologists. Inter-rater reliability was assessed by intraclass correlation coefficient (ICC) and concordance by Kendall correlation coefficient. RESULTS Strong concordance of SHI with melasma area and severity index (MASI)-Darkness (0.48; 95% CI: 0.32, 0.63), melasma severity index (MSI)-Pigmentation (0.45; 95% CI: 0.26, 0.61), and melasma severity scale (MSS) (0.6; 95% CI: 0.42, 0.74). Using step function for mapping SHI into pigmentation scores showed an improvement of inter-rater reliability with a difference in (ICC of 0.22 for MASI-Darkness and 0.19 for MSI-Pigmentation), leading to an excellent agreement. CONCLUSION Skin hyperpigmentation index could be an important additional cost-and time-conserving assessment method, to follow-up the patients with melasma undergoing brightening therapies in clinical studies, as well as in routine clinical practice. It is in strong concordance with well-established scores but superior regarding inter-rater reliability.
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Affiliation(s)
- Kristine Heidemeyer
- Department of Dermatology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Simone Cazzaniga
- Department of Dermatology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland
- Centro Studi GISED, Bergamo, Italy
| | - Laurence Feldmeyer
- Department of Dermatology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Valentina Imstepf
- Department of Dermatology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Maurice Adatto
- Department of Dermatology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland
- Skinpulse Dermatology & Laser Centre, Geneva, Switzerland
- Department of Dermatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Matthias Lehmann
- Department of Dermatology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Anna Rammlmair
- Department of Dermatology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Lorenzo Pelloni
- Department of Dermatology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland
| | - S Morteza Seyed Jafari
- Department of Dermatology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Simon Bossart
- Department of Dermatology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland
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25
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Singh A, Chandan Y, Pazare AR. Phakomatosis Pigmentovascularis: A Rare Disease. J Assoc Physicians India 2023; 71:91-92. [PMID: 38736059 DOI: 10.59556/japi.71.0419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
A 19-year-old female, Mrs. XYZ, resident of Mumbai came with complaints of fever and cough with whitish expectorate of 12 days duration. The patient had a bright red erythematous patches on bilateral cheeks and chin (Fig. 1). Hyperpigmented patches seen over the body at multiple sites since birth.
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Affiliation(s)
- Ashish Singh
- Juniour Resident, Department of Medicine, KJ Somaiya Medical Institute and Hospital, Mumbai, Maharashtra, India
| | - Yash Chandan
- Juniour Resident, Department of Medicine, KJ Somaiya Medical Institute and Hospital, Mumbai, Maharashtra, India
| | - Amar R Pazare
- Professor and HOU, Department of Medicine, KJ Somaiya Medical Institute and Hospital, Mumbai, Maharashtra, India, Corresponding Author
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26
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Young K, Pagan AD, Yoon J, Getachew E, Leung B, Nguyen N, Semenov YR, Mostaghimi A, Theodosakis N. Seasonal Patterns in Tetracycline-Associated Hyperpigmentation Among Patients With Acne Vulgaris. J Drugs Dermatol 2023; 22:e9-e11. [PMID: 37943268 DOI: 10.36849/jdd.7409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND Oral tetracyclines (TCNs) are commonly prescribed for acne, but they have been shown to increase the risk of hyperpigmentation, particularly in the setting of sun exposure. OBJECTIVE We evaluated seasonal trends in TCN-associated hyperpigmentation incidence in addition to Google search trends for hyperpigmentation-related terms. METHODS We performed a retrospective review of acne patients seen at Massachusetts General Brigham and Women’s Hospital between 1992 and 2022. We calculated the incidence of new hyperpigmentation diagnoses for each drug cohort. We also analyzed search volume of hyperpigmentation-related terms extracted from Google Trends. RESULTS Seasonal differences in new hyperpigmentation diagnoses were identified among acne patients prescribed doxycycline (P=0.016), with peak incidence in April. In the control group of patients who had never received a TCN, diagnoses peaked in May. There were no significant seasonal differences among patients prescribed minocycline (P=0.885). There was greater search volume for hyperpigmentation-related terms in spring and summer compared to fall and winter (P<0.001). Limitations of this study include its retrospective nature and reliance on prescription and diagnosis coding data. CONCLUSIONS Our findings support the seasonal periodicity of acne-related hyperpigmentation, underscoring the importance of photoprotection counseling for patients with acne. Additionally, doxycycline may be associated with an earlier onset of hyperpigmentation, suggesting a potential benefit of considering minocycline or other alternatives to doxycycline. J Drugs Dermatol. 2023;22(11):e9-e11 doi:10.36849/JDD.7409e.
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27
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Loyd IA, Weissman AS, Levin J. Hyperpigmented Flexural Plaques, Hypohidrosis, and Hypotrichosis. Cutis 2023; 112:E29-E31. [PMID: 38091441 DOI: 10.12788/cutis.0908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- India A Loyd
- Dr. Loyd is from the University of Oklahoma College of Medicine, Oklahoma City. Drs. Weissman and Levin are from the Department of Dermatology, University of Oklahoma Health, Oklahoma City
| | - Amanda S Weissman
- Dr. Loyd is from the University of Oklahoma College of Medicine, Oklahoma City. Drs. Weissman and Levin are from the Department of Dermatology, University of Oklahoma Health, Oklahoma City
| | - Jarad Levin
- Dr. Loyd is from the University of Oklahoma College of Medicine, Oklahoma City. Drs. Weissman and Levin are from the Department of Dermatology, University of Oklahoma Health, Oklahoma City
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28
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Murthy AB, Palaniappan V, Karthikeyan K, Anbarasan V. Dyschromatosis universalis hereditaria. Int J Dermatol 2023; 62:1218-1227. [PMID: 37634201 DOI: 10.1111/ijd.16817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/12/2023] [Accepted: 08/12/2023] [Indexed: 08/29/2023]
Abstract
Reticulate pigmentary dyschromatoses primarily include dyschromatosis universalis hereditaria (DUH), dyschromatosis symmetrica hereditaria (DSH) (Reticulate acropigmentation of Dohi), and unilateral dermatomal pigmentary dermatosis, which differ in their patterns of distribution. The disease was initially described by Ichikawa and Hiraga in Germany in 1933. The prevalence of DUH is 0.3 per 100,000 with a female preponderance. The skin lesions usually appear in infancy or early childhood and cease to progress beyond adolescence. The subtypes DUH 1 and DUH 3 are found to have autosomal dominant inheritance, which is the most common inheritance pattern, while DUH 2 has an autosomal recessive pattern. The most common gene involved in DUH is ABCB6, while the other genes include SASH 1, PER 3, and KITLG (DUH type 2). DUH is characterized by multiple irregular hyperpigmented macules interspersed with hypopigmented macules in a mottled pattern over the trunk and extremities. The face is involved in 50% of individuals. Rarely, it can also involve hairs, nails, mucous membranes, palms, and soles. Other varied presentations include localized forms, localization of lesions to sun-exposed areas, large macules, uniform palmar hypopigmentation, diffuse hyperpigmentation with spotty depigmented macules, and unilateral involvement. DUH has been reported to be associated with various cutaneous and systemic diseases. The authors have observed cases of DUH associated with hepatocellular carcinoma, solitary keratoacanthoma, and dermoid cyst. The various diagnostic modalities include dermoscopy, histopathology, electron microscopy, and targeted gene sequencing. Though various treatment modalities like NBUVB and lasers have been tried, no treatment is promising.
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Affiliation(s)
- Aravind B Murthy
- Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India
| | - Vijayasankar Palaniappan
- Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India
| | - Kaliaperumal Karthikeyan
- Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India
| | - Varshini Anbarasan
- Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India
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Tripathi S, Kumar M. Neonatal Chikangunya Presenting as Characteristic Cutaneous Hyperpigmentation. Indian J Pediatr 2023; 90:1041-1042. [PMID: 37195352 DOI: 10.1007/s12098-023-04599-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 04/03/2023] [Indexed: 05/18/2023]
Affiliation(s)
- Shalini Tripathi
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India.
| | - Mala Kumar
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India
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30
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Baklouti M, Sellami K, Rekik M, Charfi S, Sellami T, Turki H. Lichen planus pigmentosus: a clinico-pathological study in a Caucasian population from North Africa. Int J Dermatol 2023; 62:e535-e538. [PMID: 37326442 DOI: 10.1111/ijd.16737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 03/12/2023] [Accepted: 05/19/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Massara Baklouti
- Dermatology Department, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Khadija Sellami
- Dermatology Department, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Mariem Rekik
- Dermatology Department, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Slim Charfi
- Pathology Department, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Tahya Sellami
- Pathology Department, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Hamida Turki
- Dermatology Department, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
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Waters J, Desrosiers AS, Flint ND, Ferringer T. Reticular Hyperpigmentation With Keratotic Papules in the Axillae and Groin. Cutis 2023; 112:175-199. [PMID: 37988306 DOI: 10.12788/cutis.0870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Affiliation(s)
- Jefferson Waters
- Jefferson Waters is from Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania. Drs. Desrosiers, Flint, and Ferringer are from the Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania. Dr. Ferringer also is from the Department of Laboratory Medicine
| | - Andrew S Desrosiers
- Jefferson Waters is from Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania. Drs. Desrosiers, Flint, and Ferringer are from the Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania. Dr. Ferringer also is from the Department of Laboratory Medicine
| | - Nicholas D Flint
- Jefferson Waters is from Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania. Drs. Desrosiers, Flint, and Ferringer are from the Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania. Dr. Ferringer also is from the Department of Laboratory Medicine
| | - Tammie Ferringer
- Jefferson Waters is from Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania. Drs. Desrosiers, Flint, and Ferringer are from the Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania. Dr. Ferringer also is from the Department of Laboratory Medicine
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32
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González-Ramírez RA, Welsh-Hernández E, Guerrero-Putz MD. Reticular melanonychia: a dermoscopic clue for terra firma-forme dermatosis on the nails. Clin Exp Dermatol 2023; 48:1182-1183. [PMID: 37403647 DOI: 10.1093/ced/llad226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 07/06/2023]
Abstract
Terra firma-forme dermatosis of the nail plate can mimic other causes of melanonychia such as nail infection and melanoma. We present the cases of two patients and describe the dermoscopic features of this entity, which is characterized by a band-like reticular pigmentation that we describe as ‘reticular melanonychia’.
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Affiliation(s)
- Roger A González-Ramírez
- Departamento de Introduccion a la Clinica. Facultad de Medicina, Universidad Autónoma de Nuevo León, México
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
| | | | - María D Guerrero-Putz
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
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33
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Zhou D, Yang P, Chen H. Retyping and molecular pathology diagnosis of dyschromatosis universalis hereditaria. Exp Dermatol 2023; 32:1334-1343. [PMID: 37353900 DOI: 10.1111/exd.14860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/25/2023]
Abstract
Dyschromatosis universalis hereditaria (DUH) is characterized by diffuse symmetrically distributed hypopigmented macules mixed with hyperpigmentation. DUH is divided into three types by Online Mendelian inheritance in man (OMIM) that is, DUH1 (OMIM 127500), DUH2 (OMIM 612715) and DUH3 (OMIM 615402) according to the different linkage regions. Although each condition possesses corresponding phenotypic characteristics and the prognosis for each is somewhat different, these disorders are highly overlapped and difficult to differentiate in the clinical setting. Our latest study reveals a novel DUH subtype that presents a mild phenotype of pigmentation anomalies and is named PER3rs772027021 SNP related DUH or DUH4 by us, which make the DUH subtype can be further retyped. Heterozygous distribution or mosaic-like distribution of melanin is a newly discovered pathological features that is uniquely demonstrated in the affected layers of DUH1 and DUH4 patients. In this review, DUH is further divided into four subtypes according the causative genes and their mutational sites, and the mutation regions described in the previous reports. To make an accurate diagnosis, we suggest that Sanger sequencing or the target region sequencing (TRS) to the candidate causative genes related melanogenesis may be the most effective and convenient method of clinical diagnosis or/and prenatal diagnosis for DUH and DUH-like patients. More importantly, heterozygous distribution or mosaic-like distribution of melanin can be utilized for differential diagnosis of DUH. We also investigate the underlying molecular mechanism to form mosaic-like melanin in the affected layers of hyper- and/or hypo-pigmented macules from DUH1 and DUH4 patients. This review provides a molecular and pathological delineation of four types of DUH and aims to establish a concise diagnostic strategy to allow clinical dermatologists to make an accurate diagnosis.
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Affiliation(s)
- Ding'an Zhou
- Clinical Research Center, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China
| | - Pingping Yang
- School of Clinical Laboratory Science, Guizhou Medical University, Guiyang, People's Republic of China
| | - Hongyu Chen
- School of Clinical Laboratory Science, Guizhou Medical University, Guiyang, People's Republic of China
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34
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Frangos JE, Amini AE, Schmidt B, Ganske IM. Brief report: Areolar melanosis in a girl with precocious puberty. Pediatr Dermatol 2023; 40:877-878. [PMID: 36693395 DOI: 10.1111/pde.15242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/20/2022] [Indexed: 01/26/2023]
Abstract
We report a case of melanosis of the areola in a 7-year-old girl with early thelarche. Areolar melanosis is a rare condition previously only described in women over 25 years of age, often in the setting of pregnancy. This case supports a theory that hyperpigmentation may be associated with increased sensitivity to hormonal stimulation in areas with greater populations of melanocytes.
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Affiliation(s)
- Jason E Frangos
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Andrew E Amini
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Birgitta Schmidt
- Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Ingrid M Ganske
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
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35
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García-López BE, Mondragón-García D, Velázquez-Samano G, Velázquez-Samano G. [Eritema pigmentado fijo secundario a AINE: Reporte de caso]. Rev Alerg Mex 2023; 70:203. [PMID: 37933944 DOI: 10.29262/ram.v70i3.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Abstract
Background Fixed erythema pigmento (FPE) is an allergic drug reaction, the pathophysiology of which is not exactly known. It is more common in women with location on the face. Clinical presentation: round or oval red-purple macule, well defined, with swelling, pain, itching, and burning. Diagnosis is clinical, oral chal- lenge is contraindicated due to possible severe reaction. On withdrawal of the drug, residual violaceous hyperpigmentation remains. Case report 34-year-old female diagnosed with allergic rhinitis and asthma. She received treatment with ibuprofen and cephalexin 1 month ago due to dental infection. For the past 2 weeks, she has presented dermatological lesions characterized by hyperpigmentation under the lower eyelids, accompanied by pain, burning, and itching. On physical examination, well-defined red-purple pigmentation was observed in both periocular regions. The challenge test is not justified, the clinical history is the diagnostic pillar. The indication is to stop the medication immediately and continue monitoring. Conclusions EPF is a drug reaction related to drug use. It creates a challenge for diagnosis due to poor knowledge of the characteristics of the dermatosis and poor clinical and pharmacological questioning. The EPF approach requires knowing the clinical characteristics of this dermatosis, making a differential diagnosis with other lesions and indicating the suspension of the responsible medication.
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36
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Zhou Y, Zhang J, Zheng L, Yang F. Penile terra firma-forme dermatosis in children. Pediatr Dermatol 2023; 40:894-896. [PMID: 36805664 DOI: 10.1111/pde.15277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/21/2023] [Indexed: 02/22/2023]
Abstract
Terra firma-forme dermatosis (TFFD) is a rare, acquired keratinization disorder that predominantly affects children and young adults. Herein, we report three unusual cases of penile TFFD in children and the histopathologic and ultrastructural observations.
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Affiliation(s)
- Youyou Zhou
- Department of Dermatology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, China
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Jianglin Zhang
- Department of Dermatology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Lixiong Zheng
- Department of Dermatology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, China
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Fang Yang
- Department of Dermatology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, China
- The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
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37
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Johnson KM, Lause M, Chung C, Massick S. Kratom ingestion associated with photodistributed hyperpigmentation. Int J Dermatol 2023; 62:e494-e496. [PMID: 36942835 DOI: 10.1111/ijd.16650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023]
Affiliation(s)
- Kirsten M Johnson
- Department of Dermatology, The Ohio State University, Columbus, OH, USA
| | - Michael Lause
- Department of Dermatology, The Ohio State University, Columbus, OH, USA
| | - Catherine Chung
- Department of Dermatology, The Ohio State University, Columbus, OH, USA
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Susan Massick
- Department of Dermatology, The Ohio State University, Columbus, OH, USA
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38
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Thaware A, Rathi R. Case of hyperpigmentation due to excessive androgen in a child. Pan Afr Med J 2023; 45:118. [PMID: 37745924 PMCID: PMC10516753 DOI: 10.11604/pamj.2023.45.118.34986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/16/2023] [Indexed: 09/26/2023] Open
Affiliation(s)
- Archana Thaware
- Department of Kaumarbhritya, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India
| | - Renu Rathi
- Department of Kaumarbhritya, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India
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39
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Lin LY, Stagner AM, Freitag SK. Minocycline-induced Conjunctival Hyperpigmentation. Ophthalmic Plast Reconstr Surg 2023; 39:e133. [PMID: 36700850 DOI: 10.1097/iop.0000000000002278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Lisa Y Lin
- Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School
| | - Anna M Stagner
- David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Suzanne K Freitag
- Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School
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40
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Kayumova LN, Spuzovskaya AI. Terra Firma-Forme Dermatosis. J Cutan Med Surg 2023; 27:418. [PMID: 37073975 DOI: 10.1177/12034754231169263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Affiliation(s)
- L N Kayumova
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A I Spuzovskaya
- Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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41
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Alhassan E, Al-Hassan L. Hydroxychloroquine-Induced Oral Mucosal Hyperpigmentation. J Clin Rheumatol 2023; 29:e54. [PMID: 37068286 DOI: 10.1097/rhu.0000000000001970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Affiliation(s)
- Eaman Alhassan
- From the Division of Rheumatology, Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Lamees Al-Hassan
- College of Health Solutions, Arizona State University, Tempe, AZ
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42
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Herron ED, Weir SA, Herron MD, Kole LCS. Annular Plaques Overlying Hyperpigmented Telangiectatic Patches on the Neck. Cutis 2023; 111:65-79. [PMID: 37075176 DOI: 10.12788/cutis.0707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Affiliation(s)
- Elliott D Herron
- Ms. Herron, Ms. Weir, and Dr. Kole are from the University of Alabama at Birmingham. Ms. Herron and Ms. Weir are from the Heersink School of Medicine, and Dr. Kole is from the Department of Dermatology. Dr. Herron is from Herron Dermatology and Laser, Montgomery, Alabama
| | - Sydney A Weir
- Ms. Herron, Ms. Weir, and Dr. Kole are from the University of Alabama at Birmingham. Ms. Herron and Ms. Weir are from the Heersink School of Medicine, and Dr. Kole is from the Department of Dermatology. Dr. Herron is from Herron Dermatology and Laser, Montgomery, Alabama
| | - Mark D Herron
- Ms. Herron, Ms. Weir, and Dr. Kole are from the University of Alabama at Birmingham. Ms. Herron and Ms. Weir are from the Heersink School of Medicine, and Dr. Kole is from the Department of Dermatology. Dr. Herron is from Herron Dermatology and Laser, Montgomery, Alabama
| | - Lauren C S Kole
- Ms. Herron, Ms. Weir, and Dr. Kole are from the University of Alabama at Birmingham. Ms. Herron and Ms. Weir are from the Heersink School of Medicine, and Dr. Kole is from the Department of Dermatology. Dr. Herron is from Herron Dermatology and Laser, Montgomery, Alabama
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Rodriguez E, Hutson S, Akintilo L, Meehan S, Rieder E, Adotama P. Acute Onset Linear Lichen Planus Pigmentosus of the Forehead: A Case Series. J Drugs Dermatol 2023; 22:94-97. [PMID: 36607749 DOI: 10.36849/jdd.7200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Linear lichen planus pigmentosus (LPP) of the face is a rare variant of lichen planus, with only a few cases published in the literature.1 It is an inflammatory condition with unknown etiology, characterized by blue-gray hyperpigmented macules, and tends to affect sun-exposed areas of the head and neck.1-4 The pathophysiology of linear lichen pigmentosus is poorly understood, though it is postulated to be caused by T-lymphocyte autoimmunity against keratinocytes.5-7 LPP more frequently affects middle age woman and skin phototypes III-VI.1,3 Treatment for linear LPP is difficult and there is no established first-line therapy; however, tacrolimus ointment, topical corticosteroids, and various systemic agents have shown to be effective in improving the appearance.3,8,9 Prior reports have characterized linear LPP that follows the lines of Blashko as more commonly affecting the trunk.1 We present three cases of linear lichen planus pigmentosus (LPP) of the forehead, a unique novel presentation of linear LPP of the face. One of our cases also provides supporting evidence for tacrolimus to be used as a preferred therapy to treat linear LPP of the face; however, more research is needed to support this claim. To our knowledge, this case series is the largest case series of linear lichen planus pigmentosus (LPP) of the forehead to be reported. J Drugs Dermatol. 2023;22(1):94-97. doi:10.36849/JDD.7200.
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45
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Ali NS, Jin MF, Wetter DA. Blue-black hyperpigmentation on the extremities. J Fam Pract 2022; 71:445-447. [PMID: 36735946 DOI: 10.12788/jfp.0520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
In some cases, diagnosis entails less "what is it?" and more "what caused it?"
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Affiliation(s)
- Nora S Ali
- Dermatology Consultants, PA, Saint Paul, MN (Dr. Ali); Department of Dermatology, Mayo Clinic, Rochester, MN (Dr. Wetter); Mayo Clinic Alix School of Medicine, Rochester, MN (Mr. Jin)
| | - Mauricio F Jin
- Dermatology Consultants, PA, Saint Paul, MN (Dr. Ali); Department of Dermatology, Mayo Clinic, Rochester, MN (Dr. Wetter); Mayo Clinic Alix School of Medicine, Rochester, MN (Mr. Jin)
| | - David A Wetter
- Dermatology Consultants, PA, Saint Paul, MN (Dr. Ali); Department of Dermatology, Mayo Clinic, Rochester, MN (Dr. Wetter); Mayo Clinic Alix School of Medicine, Rochester, MN (Mr. Jin)
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46
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Danielsen E, Hansen JF, Klose M, Worm D. [Hyperpigmentation reveals Addison's disease in a pregnant woman]. Ugeskr Laeger 2022; 184:V07220434. [PMID: 36458598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
A 31-year-old woman was admitted to the local department of endocrinology for control of known anti-TPO positive hypothyroidism during pregnancy. The clinician noticed a remarkable hyperpigmentation. Primary adrenal insufficiency was diagnosed and treatment with cortico- and mineralosteroids commenced. Diagnosis of primary adrenal insufficiency during pregnancy is challenging as many symptoms overlap with normal symptoms of pregnancy. The usual diagnostic criteria cannot be used due to the altered hormone concentrations during pregnancy.
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Affiliation(s)
- Elisabeth Danielsen
- Endokrinologisk Ambulatorium, Medicinsk Afdeling, Københavns Universitetshospital - Amager Hospital
| | - Juliana Frohnert Hansen
- Endokrinologisk Ambulatorium, Medicinsk Afdeling, Københavns Universitetshospital - Amager Hospital
| | - Marianne Klose
- Afdeling for Hormon- og Stofskiftesygdomme, Københavns Universitetshospital - Rigshospitalet
| | - Dorte Worm
- Endokrinologisk Ambulatorium, Medicinsk Afdeling, Københavns Universitetshospital - Amager Hospital
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47
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Rodríguez-Gutiérrez JS, Ramírez-Gómez KM, Omaña-Domínguez M, Ruelas-Villavicencio AL. [Cutaneous hyperpigmentation as a manifestation in acute on chronic liver failure]. Rev Med Inst Mex Seguro Soc 2022; 60:698-702. [PMID: 36283065 PMCID: PMC10396061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The acquired cutaneous pigmentation represents a little recognized clinical manifestation in liver disorders, both acute and chronic, and can occur in the exacerbation processes of preexisting hepatopathies, as in the context of acute-on-chronic liver failure. Several hypotheses about the increase in pigment at skin and mucous membranes have been developed; some try to explain it as a defect in the degradation of melanin with secondary accumulation at tissues; others, on the other hand, describe it as a consequence of the release of fibroblast growth factors like endothelial growth factor and hepatocyte growth factor, which are produced under the stimulation of liver regeneration and cause a melanogenesis stimulation. The aim of this article is to study pigmentary skin changes in the background of liver diseases. CLINICAL CASES We described two clinical cases of patients with acuteon chronic liver failure secondary to different clinical scenarios are presented, who have in common the development of acquired pigmentary skin changes. CONCLUSION In hepatopathies, the cutaneous hyperpigmentation is a sign with unknown etiology, so further studies are required to know the accurate pathophysiology. Reporting this finding is useful for physicians, since timely identification can help in the early diagnosis of underlying liver diseases.
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Affiliation(s)
- Jesús Sebastián Rodríguez-Gutiérrez
- Universidad Autónoma de Sinaloa, Centro de Investigación y Docencia en Ciencias de la Salud, Departamento de Dermatología. Culiacán, Sinaloa, México
| | - Karen Montserrat Ramírez-Gómez
- Secretaría de Salud, Centro Dermatológico "Dr. Ladislao de la Pascua", Departamento de Dermatología. Ciudad de México, México
| | - Maricela Omaña-Domínguez
- Universidad Autónoma de Sinaloa, Centro de Investigación y Docencia en Ciencias de la Salud, Departamento de Dermatología. Culiacán, Sinaloa, México
| | - Ana Lilia Ruelas-Villavicencio
- Secretaría de Salud, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Dermatología. Ciudad de México, México
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Hirota Y, Matsushita T. Hyperpigmentation as a clue to Addison disease. Cleve Clin J Med 2022; 89:498-499. [PMID: 37907439 DOI: 10.3949/ccjm.89a.21082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Yusuke Hirota
- Department of Diabetology, Endocrinology and Metabolism, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Takaya Matsushita
- Department of Diabetology, Endocrinology and Metabolism, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
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49
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Poetzscher IK, Klebanov N, Das S. Widespread skin-thickening and hyperpigmentation. Cleve Clin J Med 2022; 89:485-487. [PMID: 37907438 DOI: 10.3949/ccjm.89a.21099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- India K Poetzscher
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Nikolai Klebanov
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Shinjita Das
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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50
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Yadav P, Sanke S, Mendiratta V, Chander R. Generalized Linear Porokeratosis in a Bilateral Distribution: An Unusual Presentation. Skinmed 2022; 20:220-223. [PMID: 35779030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
An 8-year-old girl was seen for asymptomatic flat to raised hyperpigmented plaques distributed in a linear pattern over multiple segments of her body present 1 year of age. The eruption initially started as an itchy papule over the left lateral malleolus, which developed into hyperpigmented plaque and gradually extended linearly over a period of 2-3 months to involve the leg. Over the next year, similar lesions appeared on the hands and left side of the body. Most of the lesions progressed in size; however, a few lesions on the extremities resolved partially, becoming hyperpigmentation. There was no further progression of the eruption in the following 6 months. There was no history of erosions, blisters, or comedone-like lesions. There was no history of developmental delay or mental retardation. There was no relevant family history. (SKINmed. 2022;20:220-223).
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Affiliation(s)
- Pravesh Yadav
- Department of Dermatology and Sexually Transmitted Diseases, Lady Hardinge Medical College and Suchita Kriplani Hospital, Shaheed Bhagat Singh Marg, Delhi, India;
| | - Sarita Sanke
- Department of Dermatology and Sexually Transmitted Diseases, Lady Hardinge Medical College and Suchita Kriplani Hospital, Shaheed Bhagat Singh Marg, Delhi, India
| | - Vibhu Mendiratta
- Department of Dermatology and Sexually Transmitted Diseases, Lady Hardinge Medical College and Suchita Kriplani Hospital, Shaheed Bhagat Singh Marg, Delhi, India
| | - Ram Chander
- Department of Dermatology and Sexually Transmitted Diseases, Lady Hardinge Medical College and Suchita Kriplani Hospital, Shaheed Bhagat Singh Marg, Delhi, India
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