A Case of Idiopathic Eruptive Macular Pigmentation Limited to Flexural Areas

Idiopathic eruptive macular pigmentation in an Indian male

“…Recently, lesions occurring in a Christmas tree pattern[ 5 ] and limited to flexures[ 6 ] have been described. The differential diagnosis include lichen planus pigmentosus (LPP), erythema dyschromicum perstans (EDP), fixed drug eruption, and mastocytosis.…”

“…[ 7 ] Emphasis has been laid on the histological presence of pigmented papillomatosis to be a diagnostic criteria for IEMP [ Table 1 ]. [ 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 ]…”

Idiopathic Eruptive Macular Pigmentation: A Rare and an Under-reported Entity

“…Clinically, the characteristic eruption of IEMP is composed of round to oval, circumscribed, non-pruritic, homogeneous pigmented macules and plaques that appear without previous erythematous, papular, or hypochromic lesions, occurring mostly on the trunk, neck, and proximal portion of the extremities. However, lesions occurring in a Christmas tree pattern and limited to flexural areas of the body have also been documented in the literature [18,19]. IEMP needs to be differentiated clinically and histologically from friction melanosis, post-inflammatory hyperpigmentation, fixed drug eruption (FDE), urticaria pigmentosa, lichen planus pigmentosus (LPP), erythema dyschromicum perstans (EDP), pigmentary disorders that involve the flexural areas like Dowling-Degos disease and acanthosis nigricans as these conditions can cause diagnostic conundrum and unnecessary therapeutic interventions [13,19].…”