Dyschromatosis Symmetrica Hereditaria of Late Onset?

Abstract

Dyschromatosis symmetrica hereditaria (DSH), also known as reticulated acropigmentation of Dohi, is an autosomal dominant disease with high penetrance, characterized by hypo- and hyperpigmented macules of varying sizes on the dorsal of the extremities with reticulated pattern. This paper presents a female patient with typical dermatological lesions, but only diagnosed in adulthood. It is necessary to perform differential diagnosis with other pigmentary disorders. This entity is not very common in South America, and the vast majority of cases were described in Japanese population. Since it is a benign disease, it is important to be aware of this diagnosis in order to establish the correct conduct for these patients.

Clinical Overlaps in Reticulate Pigmentary Disorders: A Study of Three Cases

“…Dyschromatosis symmetrica hereditaria (DSH), also referred to as the reticulated acropigmentation of Dohi, is an inherited condition that follows an autosomal dominant pattern, manifesting with small hypo-and hyperpigmented macules, with uneven size and shape, symmetrically scattered on the dorsum of the hands and feet. Lesions occur in childhood, typically before the age of six, and persist throughout life without any alterations in color or distribution after reaching stability in adolescence [4]. The histology of the lesions reveals either elevated or reduced basilar pigmentation in the hyperpigmented or hypopigmented lesions, respectively.…”

Dyschromatosis symmetrica hereditaria with cutaneous lupus erythematosus and hyperthyroidism

“… 6 Our patient started to have skin lesions at a later age (10 years) when compared with most of the reported cases; late onset of DSH, however, has been reported in a few cases. 10 …”