ABSTRACT
@#INTRODUCTION: Pigmented contact dermatitis (PCD) is characterized by non-eczematous pigmentation associated with contact sensitizers, usually without any active or preceding pruritus and erythema. PCD was first described by Riehl, who identified patients with brown to gray facial pigmentation concentrated on the face most commonly associated with sensitizing chemical such as cosmetics, fragrances, and textiles. CASE REPORT: This is a case of a 48-year-old female Filipino who presents with blue-grey to brown patches on the forehead of 1-year duration with no significant pathologic history. Clinical examination, dermoscopy and histology were consistent with a variant of pigmented contact dermatitis known as Riehl melanosis. Since anamnesis was unremarkable, patch testing was done to identify the contact allergen triggering the symptom. Results obtained a positive reaction to nickel, potassium dichromate, and textile dye. CONCLUSION:Treatment includes the elimination of trigger factors, hence the importance of patch testing in the investigation of its cause. Alongside adequate photoprotection, a combination treatment of 1,064 nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, 20% tricholoacetic acid (TCA) peel and oral retinoids, were found safe and effective in the management of facial melanosis. Three-dimensional imaging and dermoscopy were utilized to obtain a more standard and objective pre- and post-treatment comparison.
Subject(s)
Lasers, Solid-State , Patch Tests , Melanosis , Skin Abnormalities , Dermatitis, ContactABSTRACT
BACKGROUND: Henna is a natural dye derived from the leaves of the tree Lawsonia inermis known for its very low allergic properties. Recently, however, cases of pigmented contact dermatitis after henna dyeing have been increasing. OBJECTIVE: To analyze the clinical and histologic features of pigmented contact dermatitis caused by henna dyeing. METHODS: We retrospectively reviewed the clinical and histopathologic features of patients diagnosed with pigmented contact dermatitis after henna dyeing from June 2014 to August 2017. RESULTS: A total of 22 patients with a history of henna dyeing were included. All patients were female, and mean age was 58.9±8.2 years. They presented with rapidly spreading dark brownish patches located mostly adjacent to the hairline, such as at the forehead, temple, and lateral cheek. The mean duration between symptom onset and henna dyeing was 4.52 months (0~15). Standard patch test and as is test using henna showed no significant results. There were 18 patients with pruritus, which was only present at the early stage. Histopathologic examinations showed lichenoid inflammation with dermal melanin incontinence, vacuolar alteration, epidermal apoptotic cells, and perivascular inflammation. CONCLUSION: These results suggest that pigmented contact dermatitis observed after henna dyeing was caused by the toxicity of henna itself, not by other additives. The active ingredient of henna is lawsone (2-hydroxy-1,4-naphthoquinone), which may have induced pigmented contact dermatitis by its own cellular toxicity. Dermatologists should consider henna dyeing as a potential cause of pigmentation of the face and neck.
Subject(s)
Female , Humans , Cheek , Dermatitis, Contact , Forehead , Inflammation , Lawsonia Plant , Melanins , Neck , Patch Tests , Pigmentation , Pruritus , Retrospective Studies , TreesABSTRACT
Pigmented contact dermatitis is characterized by a dark brown pigmentation that results from repeated exposure to small amounts of contact allergen. Histopathologic findings are liquefactive degeneration of the basal layer cells and melanophages in the upper dermis. We report a case of a 73-year-old man with dark brownish mottled hyperpigmented patches on the both cheeks and forehead. Patch tests were positive to isoeugenol, benzyl salicylate and after shave lotion. After shave lotion that the patient used maybe contain these fragrances. Improvement was seen 3 months after ceasing the use of after shave lotion.
Subject(s)
Aged , Humans , Cheek , Dermatitis, Contact , Dermis , Forehead , Patch Tests , PigmentationABSTRACT
Pigmented contact dermatitis denotes a kind of secondary hyperpigmentation resulting from recurrent contact dermatitis of low degree. Cinnamic aldehyde is a component of cinnamon,which is widely used in foods and fragrances. A 21 year-old girl presented with a well-defined dark brownish patch on right side of chest for 4 years. Histopathologic examination revealed epidermal spongiosis, hypermelanosis of basal layer, scattered melanophages and mild perivascular inflammatory cell infiltration in the upper dermis Patch test findings were positive to fragrance mix, cinnamic aldehyde and body shampoo which was used by the patient. Peroral challenge with cinnamon tea resulted in flare-up of the positive patch-test sites and the skin lesion.
Subject(s)
Female , Humans , Young Adult , Aldehydes , Cinnamomum zeylanicum , Dermatitis, Contact , Dermis , Hyperpigmentation , Patch Tests , Skin , Tea , ThoraxABSTRACT
Pigmented contact dermiatitis is a disease resulting from recirrent contact dermatitis due to hypersensitivity to cosmetic components, which produces secondery bizarre dark brown hyperpigmentation. Histological examinaition of this condition reveals liquefaction degeneration of the basal cells of the epidermis and melanopbages in the upper dermis. We report a case of pigmented contact dermatitis from musk tibeten, which was diagnosed by the histological examination, the patch and photopatch tests. Residul hisperpigmentation was seen on the region of the patch testing.