Exogenous Pigmentation Mimicking Acral Melanoma

Stashak, A. Bianca; Laarman, Rachel; Fraga, Garth; Liu, Deede Y.

doi:10.1001/jamadermatol.2014.567

Cited by 6 publications

(13 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, this entity remains a diagnosis of exclusion and requires a history of exposure. 76 Similar cases of acral pigmentation clinically mimicking melanoma have been described with exposure to black rubber sandals and para-phenylenediamine, but again the histological examination fails to show any specific features in the stratum corneum. 77,78 Infectious elements in the stratum corneum The horn as the outer layer of the skin can be host to infectious agents that may or may not have histopathological clues towards their identification.…”

Section: Melanin In the Stratum Corneummentioning

confidence: 76%

“…In spite of the worrisome clinical presentation, the pigment is not apparent on H&E staining and fails to highlight with other histochemical stains such as Fontana‐Masson, Perls, periodic acid‐Schiff (PAS) and Giemsa. Thus, this entity remains a diagnosis of exclusion and requires a history of exposure . Similar cases of acral pigmentation clinically mimicking melanoma have been described with exposure to black rubber sandals and para‐phenylenediamine, but again the histological examination fails to show any specific features in the stratum corneum …”

Section: Pigment In the Stratum Corneummentioning

confidence: 92%

See 1 more Smart Citation

‘Hints’ in the horn: diagnostic clues in the stratum corneum

et al. 2017

View full text Add to dashboard Cite

Review'Hints' in the horn: diagnostic clues in the stratum corneumThe stratum corneum or horny layer is the uppermost layer of the epidermis, and is mainly responsible for the skin's barrier function. In spite of its complexity at the ultrastructural and molecular level, the features accessible to visualization on conventional histology are relatively limited. Nevertheless, knowledge of subtle clues that one may observe in the stratum corneum can prove useful in a wide range of situations in dermatopathology. We herein review a selection of common and rare entities in which the horny layer may reveal significantly important hints for the diagnosis. These clues include parakeratosis and its different patterns (focal, confluent, alternating, associated with spongiosis, epidermal hyperplasia or lichenoid changes), subcorneal acantholysis, infectious organisms in the stratum corneum (including fungal, bacterial and parasitic), thickening or thinning of the stratum corneum and the presence of different kinds of pigment. Even when normal, the horny layer may prove to be useful when seen in association with severe epidermal damage, a combination of features testifying to the acute nature of the underlying pathological process.Keywords: histopathology, hyperkeratosis, hypokeratosis, parakeratosis, stratum corneum Cardoso JC, Veraitch O, Gianotti R, Ferrara G, Tomasini CF, Singh M, Zalaudek I, Stefanato CM. 'Hints' in the horn: diagnostic clues in the stratum corneum.

show abstract

Section: Melanin In the Stratum Corneummentioning

confidence: 76%

Section: Pigment In the Stratum Corneummentioning

confidence: 92%

‘Hints’ in the horn: diagnostic clues in the stratum corneum

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Of note, dermoscopy may not be helpful because a parallel ridge pigment pattern can be seen in both exogenous acral hyperpigmentation and acral lentiginous melanoma. 1 This case demonstrates the importance of considering exogenous sources of acute-onset asymptomatic acral hyperpigmentation, especially in pediatric patients.…”

Section: Discussionmentioning

confidence: 85%

“…Vitiligo patients commonly use complementary and alternative treatments options. 1 No studies have systematically investigated the composition of over-the-counter products marketed to vitiligo patients. Given the utility of phototherapy in vitiligo management, manufacturers may include photosensitizing ingredients in such products.…”

Section: High Frequency Of Photosensitizers In Products Marketed Onli...mentioning

confidence: 99%

NUT an Uncommon Cause of Exogenous Acral Hyperpigmentation

et al. 2022

View full text Add to dashboard Cite

A cute-onset acral hyperpigmentation can be a concerning clinical finding presentation. Thorough consideration of both endogenous and exogenous etiologies is important for guiding evaluation and management. Endogenous causes include elevated adrenocorticotropic hormone, hemochromatosis, iatrogenic, melanocyte proliferation, subcorneal or intraepidermal hemorrhage, tinea nigra, and vasculitis. Exogenous etiologies include clothing, shoes, and plants. There is limited literature on the latter, especially on acral surfaces and in the pediatric population. We present a case of exogenous acral pigmentation in a young girl. CASEA healthy 11-year-old girl presented to her primary care physician in October in Northeastern America with multiple 0.5-to 3.0-cm well-demarcated brown macules and patches on her bilateral plantar feet, mainly at pressure points (Fig. 1). These asymptomatic lesions had been noticed 1 week prior and persisted through vigorous washing. The patient denied prolonged exposure to water or cold temperatures. She had no personal or family history of skin cancer. During consultation with a pediatric dermatologist, additional history was elicited that the patient had been barefoot in the woods days before noticing the lesions. A diagnosis of exogenous acral hyperpigmentation secondary to barefoot contact with fallen husks of walnut trees was favored. Watchful waiting was recommended. The lesions resolved spontaneously. Figure 1. Asymptomatic brown macules (0.5-3 cm) and patches on the bilateral plantar feet of an 11-year-old girl.

show abstract

“…consultant360.com mimicked acral lentiginous melanoma, a differential diagnosis that was ruled out following histopathologic examination. 18 The final diagnosis was made when the patient later reported exposure to black walnuts, leaving readers with a final reminder from the authors to consider exogenous tissue dyeing in the differential diagnosis of acral pigmented lesions. 18…”

Section: Consultantmentioning

confidence: 99%