Idiopathic eruptive macular pigmentation: Report of 10 cases

Jang, Kyoung‐Ae; Choi, Jee‐Ho; Sung, Kyung Jeh; Moon, Kee‐Chan; Koh, Jai‐Kyoung

doi:10.1067/mjd.2001.103642

Cited by 61 publications

(63 citation statements)

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“…The youngest and oldest case reported in the literature is that of a 1-year-old and a 50-year-old. [4,5] Though most cases have been reported in the young; it has also been reported in a 31-year-old female. [6] A study by Sanz de Galdeano et al [7] gave the criteria for diagnosis in 1996, namely: (a) Eruption of brownish, non-confluent, asymptomatic macules involving the trunk, neck and proximal extremities in children and adolescents (b) absence of preceding inflammatory lesions (c) no previous drug exposure (d) basal layer hyperpigmentation of the epidermis and prominent dermal melanophages without visible basal layer damage or lichenoid inflammatory infiltrate (e) normal mast cell count.…”

Section: Discussionmentioning

confidence: 95%

Idiopathic eruptive macular pigmentation

Begum¹,

Ramachandra²,

Kumar³

2014

Indian J Paediatr Dermatol

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physical and systemic examination was unremarkable. Cutaneous examination revealed multiple brownish gray to dark, discrete, round to oval macules [ Figures 1 and 2]. The lesions on the lower abdomen had a velvety texture [ Figure 3 and 4]. Palms and soles were spared. The size varied from 0.5 cm to 3 cm. Darier's sign was negative. The mucosae, hair and nails were normal. Hematological investigations were normal. Biopsy showed moderate irregular acanthosis, slight papillomatosis [ Figure 5 and 6] and basal layer hyperpigmentation [ Figure 7 and 8]. The upper dermis showed sparse superficial lymphohistiocytic infiltrate. Few melanophages were seen in the papillary dermis. The mast cell number was normal. The final diagnosis was IEMP. No specific treatment was given.An unusual case of a 24-year-old woman lasting 21 years was characterized by several periods of spontaneous resolution followed by recurrences. [3] This case is reported for its rarity with an objective to increase its awareness among dermatologists, pathologists and pediatricians. A misdiagnosis can lead to unnecessary, sometimes dangerous management of a clinical entity which otherwise regresses spontaneously. ABSTRACTIdiopathic eruptive macular pigmentation (IEMP) is an uncommon, rather under-reported disease entity of the pediatric age characterized by asymptomatic, brownish hyperpigmented macules involving the neck and trunk with no preceding inflammation or exposure to drug. Here we report this case to increase awareness of this entity among dermatologists, dermatopathologists and pediatricians. A 11-year-old healthy boy presented with brownish-gray to dark, discrete, asymptomatic macules on the face, trunk, neck and limbs of insidious onset. Histopathologic examination showed melanophages, mild perivascular lymphohistiocytic infiltrate in the papillary dermis and papillomatosis. The natural course of the disease is spontaneous remission without treatment, which was so even in our patient. IEMP is a benign entity with an excellent prognosis as it exhibits spontaneous resolution. It falls into the differential diagnoses of asymptomatic hyperpigmentatory disorders in pediatric population. Awareness of the entity leads to avoidance of unnecessary aggressive damaging treatment.

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Section: Discussionmentioning

confidence: 95%

Idiopathic eruptive macular pigmentation

Begum¹,

Ramachandra²,

Kumar³

2014

Indian J Paediatr Dermatol

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“…Se presenta como una pigmentación, clínicamente indistinguible de la dermatosis cenicienta, con máculas generalmente asintomáticas, de color pardo a azul-pizarra, ovaladas o circulares, de alrededor de un cm de diámetro, localizadas preferentemente en el tronco, cuello y raíces de los miembros, la mayoría de las veces respetando cara y mucosas. Predomina en la infancia y adolescencia sin distinción por sexos 35,36,37,38,39,40,41 . No existe el antecedente de una lesión inflamatoria asociada o precedente -salvo dos casos relacionados con una pitiriasis rosada previa 42 -ni de ingesta de medicamentos que puedan atribuirse como causa de la hiperpigmentación.…”

Section: Figuraunclassified

Dermatosis cenicienta: revisión y diagnóstico diferencial con otros trastornos pigmentarios idiopáticos

Urbina

Sudy

González

2018

Rev. chil. dermatol

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ResumenLa 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. Palabras clave: Dermatosis cenicienta; eritema discrómico perstans; liquen plano pigmentoso; pigmentación macular eruptiva idiopática summaRy 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. Key words: ashy dermatosis, erythema dyschromicum perstans, lichen planus pigmentosus, idiopathic eruptive macular pigmentation. aRtículo de RevisiónDermatosis cenicienta: revisión y diagnóstico diferencial con otros trastornos pigmentarios idiopáticos intRoducciónDescrita por Ramírez en el Salvador en 1957, la dermatosis cenicienta es una enfermedad relativamente infrecuente, de etiología desconocida, caracterizada por manchas de coloración grisácea, de tonalidad variable, localizadas especialmente en cara, tronco y brazos 1 . El tamaño de las lesiones varía entre máculas de 1 centíme-tro hasta manchas extensas, a las que en forma ocasional se les describe transitoriamente en su fase activa un borde eritematoso, o más raramente palpable 2 , por lo que es también conocida como eritema discrómico perstans, nombre ampliamente aceptado como sinónimo, aunque discutido y objetado por algunos autores 3 . La evolución del cuadro es hacia la cronicidad, con crecimiento de las lesiones y aparición de otras nuevas, formando a veces po...

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“…IEMP is known to appear on various parts of the body. In previous cases of IEMP in young children and adolescents, the lesions were usually distributed on the face, trunk and extremities [1][2][3][4]9 . However, there has been no report of IEMP limited to flexural areas.…”

Section: Case Reportmentioning

confidence: 99%

“…in 1978 and there have been approximately 30 cases reported since 3 . For the diagnosis of IEMP, Sanz de Galdeano, et al 1 listed the following identifying characteristics; [1] eruption of brownish, nonconfluent, asymptomatic macules involving the trunk, neck, and proximal portions of the extremities in children and adolescents, [2] absence of preceding inflammatory lesions, [3] no previous drug exposure, [4] basal cell layer hyperpigmentation of the epidermis, [5] prominent dermal melanophages without visible basal layer damage or lichenoid inflammatory infiltrate, and [6] normal mast cell count on the histopathologic finding. Although IEMP is known to involve the neck, trunk, and proximal extremities, this report describes an unusual case of a 26-year-old Korean woman with IEMP involving only the flexural areas of the body.…”

Section: Introductionmentioning

confidence: 99%