ABSTRACT
El eritema discrómico perstans o dermatitis cenicienta, es un trastorno pigmentario de la piel poco común, de etiología desconocida. Se describe el caso de un adulto de 35 años con antecedente de VIH, quien consulta por aparición de lesiones irregulares, bien definidas café-grises localizadas en cuello, área mandibular inferior, espalda y brazos, de borde levemente eritematoso. El diagnóstico de eritema discrómico perstans se realizó con base en los hallazgos clínicos e histopatológicos.
Erythema dyschromicum perstans also known as ashy dermatosis is a rare skin pigmentary disorder of unknown etiology. We describe the case of a 35-year-old man HIV positive who presented irregular, well defined brown-gray lesions with slightly erythematous border located in neck, lower jaw, back and arms. Diagnosis of erythema dyschromicum perstans in this patient was made based on clinical and histopathological criteria.
Subject(s)
Humans , Male , Adult , HIV Infections/complications , Hypopigmentation/diagnosis , Hypopigmentation/pathology , Erythema/diagnosis , Erythema/pathologyABSTRACT
BACKGROUND: Ashy dermatosis is a disorder of pigmentation, characterized by asymptomatic symmetric blue-gray-colored macules of unknown pathophysiology. OBJECTIVE: Our aim was to evaluate ashy dermatosis in Koreans and to describe its clinical and histopathological features. METHODS: Medical records, photographs, and biopsy specimens obtained from 74 patients were assessed. RESULTS: Of the 74 patients, 38 were men and 36 were women. Clinically, most patients showed lesions on the trunk (83.8%), followed by the extremities (44.6%). At the time of the mean age was 29.9 years, and disease duration was 18.4 months before the institution. We tentatively classified the lesions into the following 3 groups: generalized confluent, generalized macular, and localized type. Clinically, the most common lesion was the generalized macular type (67.6%). Peripheral erythematous borders or concomitant erythematous lesions were observed in 18 patients (24.3%). Histopathologically, the lesions showed perivascular inflammation, dermal melanophages, and pigmentary incontinence. CONCLUSION: Our study classified ashy dermatosis into 3 groups, and this categorization may contribute to a better understanding of ashy dermatosis.
Subject(s)
Female , Humans , Male , Biopsy , Extremities , Inflammation , Medical Records , Pigmentation , Skin DiseasesABSTRACT
La dermatosis cenicienta es un trastorno pigmentario infrecuente que se presenta en individuos de piel morena, especialmente en centroamericanos. Las lesiones consisten en manchas hiperpigmentadas de coloración gris-azulada, principalmente localizadas en la cara, tronco y brazos. Su principal diagnóstico diferencial debe ser planteado con tres dermatosis pigmentarias de origen idiopático: eritema discrómico perstans, pigmentación macular eruptiva idiopática y liquen plano pigmentoso. Hay consenso en considerar al eritema discrómico perstans como la misma enfermedad, pero con un borde eritematoso transitorio. La pigmentación macular eruptiva idiopática es clínicamente similar, pero sin una dermatitis de interfase al estudio histopatológico, y sólo muestra una pigmentación de la capa basal, incontinencia pigmentaria y melanófagos en la dermis. Finalmente, el liquen plano pigmentoso debe ser considerado como una variedad pigmentada de liquen plano.
Ashy dermatosis is an infrequent disorder of pigmentation, which predominantly occurs in darkly pigmented individuals, specially in central americans. The lesions consist of bluish-gray hyperpigmented patches mainly located on the face, trunk and arms. Its main differential diagnosis must be raised with three idiopathic pigmentary disorders: erythema dyschromicum perstans, idiopathic eruptive macular pigmentation and lichen planus pigmentosus. It has been widely accepted that erythema dischromicum perstans is the same disease, but with a transient erythematous border. Idiopathic eruptive macular pigmentation is clinically similar but without an interfase dermatitis at histopathologic studies, only showing increased pigmentation of the basal layer and pigmentary incontinence and many melanophages in the dermis. Finally, lichen planus pigmentosus must be considered as a pigmented variant of lichen planus.
Subject(s)
Humans , Pigmentation Disorders/diagnosis , Erythema/diagnosis , Pigmentation Disorders/pathology , Diagnosis, Differential , Erythema/pathology , Lichen Planus/diagnosisABSTRACT
El eritema discromicum perstans (EDP) o Dermatosis cenicienta es una entidad clínica poco común, de curso crónico e irreversible. Se presenta como máculas hiperpigmentadas color gris-ceniza, de tamaño y forma variable, distribuidas en cara, tronco, y extremidades. En Chile existen pocos casos reportados. La etiología es actualmente desconocida. Los hallazgos histopatológicos no son específicos de EDP, por lo que el diagnóstico es clínico e histopatológico. Aunque se han reportado múltiples opciones de tratamiento, ninguno ha demostrado ser efectivo de manera consistente. Presentamos dos casos de EDP y una revisión de los principales aspectos clínicos, epidemiológicos e histopatológicos de esta entidad.
Erythema dyschromicum perstans (EDP) or cinderella Dermatosis is an uncommon clinical entity, of chronic and irreversible course. Clinically it appears as hyper pigmented gray-ashy macules, of variable size and shape, distributed on face, trunk, and extremities. There are few cases reported on Chile. Etiology is currently unknown. The histopathological features are not characteristic of EDP, so the diagnosis is based upon clinical findings plus histopathology. Although there are several treatment options, none of them have been demonstrated to be consistently effective. We present two cases of EDP and a review of the clinical, epidemiological, and histopathological features of this entity.
Subject(s)
Female , Humans , Middle Aged , Erythema/diagnosis , Erythema/therapy , Pigmentation Disorders/diagnosis , Pigmentation Disorders/therapy , Erythema/pathology , Pigmentation Disorders/pathology , Diagnosis, DifferentialABSTRACT
Facial melanoses (FM) are a common presentation in Indian patients, causing cosmetic disfigurement with considerable psychological impact. Some of the well defined causes of FM include melasma, Riehl's melanosis, Lichen planus pigmentosus, erythema dyschromicum perstans (EDP), erythrosis, and poikiloderma of Civatte. But there is considerable overlap in features amongst the clinical entities. Etiology in most of the causes is unknown, but some factors such as UV radiation in melasma, exposure to chemicals in EDP, exposure to allergens in Riehl's melanosis are implicated. Diagnosis is generally based on clinical features. The treatment of FM includes removal of aggravating factors, vigorous photoprotection, and some form of active pigment reduction either with topical agents or physical modes of treatment. Topical agents include hydroquinone (HQ), which is the most commonly used agent, often in combination with retinoic acid, corticosteroids, azelaic acid, kojic acid, and glycolic acid. Chemical peels are important modalities of physical therapy, other forms include lasers and dermabrasion.
ABSTRACT
Ashy dermatosis, also known as erythema dyschromicum perstans, is a peculiar, slowly progressive, idiopathic dermal melanosis. In most cases, slate gray- to lead-colored patches are symmetrically distributed over the body. Ashy dermatosis with a unilateral distribution is rare. We report a case of unilateral ashy dermatosis in a 27-year-old Korean man.
Subject(s)
Adult , Humans , Erythema , Melanosis , Skin DiseasesABSTRACT
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.
Subject(s)
Adult , Female , Humans , Acanthosis Nigricans , Dermis , Diagnosis, Differential , Epidermis , Extremities , Hyperpigmentation , Neck , Pigmentation , Skin , Skin Diseases, Genetic , Skin Diseases, PapulosquamousABSTRACT
We studied 25 cases of clinically diagnosed erythema dyschrornicum perstans (EDP) who were seen in our clinic within 11-year period, from 1975 through 1985, and compared light and electron microscopic findings, and direct immunoflunrescence findings. The results are summarized as follows: 1. There were 16 males(64%) and 9 females(36%). The peak age incidence was in the second decade. 2. The mean age of onset was 18 years(M: 16. 6, F: 19. 4) and the rnean duration was 1.8 years(M: 2.6, F: 1.0). 3. The annual incidence increased from 1981 and was peaked in 1985. 4. The most commonly involvement site was the trunk(92%), the least common involvement(4%) was one of the face, neck, and shoulder combined. 5. The histopathologic findings in most patients shows focal vacuolization of the basal cell layer, pigment incontinence, dermal melanophages. 6. Electron microscopic findings of five patients consist of vauoles with abundant melanosomes in the basal cells, widened intercellular spaces and dermal melanophages.