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Journal of the American Academy of... Nov 1988Two patients with spontaneously resolving hyperpigmented patches of the oral mucosa are reported. Histologically, lesions in both cases showed large pigment-laden... (Review)
Review
Two patients with spontaneously resolving hyperpigmented patches of the oral mucosa are reported. Histologically, lesions in both cases showed large pigment-laden dendritic cells singly dispersed at all levels of the epidermis, which simulated in situ melanoma. The absence of such cells in the basal layer of the epidermis served to histologically distinguish these lesions from a biologically malignant melanocytic tumor. Spontaneous resolution in both patients suggests that the condition is reactive. We propose the term mucosal melanotic macule, reactive type, for this lesion, which has been described previously under the misnomer oral melanoacanthoma.
Topics: Adolescent; Adult; Diagnosis, Differential; Epidermis; Female; Humans; Male; Melanocytes; Melanoma; Mouth Mucosa; Pigmentation Disorders
PubMed: 3056992
DOI: 10.1016/s0190-9622(88)70235-2 -
Acta Dermatovenerologica Croatica : ADC Dec 2023A 38-year-old Hispanic man without comorbidities presented to our dermatology clinic for the evaluation of an asymptomatic dark macule on his left hand, which had...
A 38-year-old Hispanic man without comorbidities presented to our dermatology clinic for the evaluation of an asymptomatic dark macule on his left hand, which had gradually grown since he was a child. The hyperpigmentation involved the dorsum and palm (Figure 1). The patient was right-handed and denied previous trauma, inflammation, occupational exposure to chemicals, or using any medications. During physical examination, no other similar pigmentation was found on the rest of his body. An incisional biopsy of the left palm was performed (Figure 2). The histopathology revealed the presence of spindle-shaped cells with melanin granules in the superficial and middle dermis, surrounding the blood vessels, and between collagen bundles, which are findings compatible with acquired dermal melanocytosis (1,2). On dermoscopy, we found a pattern of regular pigment with a gray-brown tone and whitish spots within. We discussed the benignity of this rare entity with the patient, and he decided not to pursue treatment. Acquired dermal melanocytosis (ADM) is a rare condition, with isolated presentation on the hand and with less than 10 cases reported (1). Dermal melanocytosis includes several benign pigmented lesions histologically characterized by the presence of melanocytes in the dermis, which are spindle-shaped dendritic cells containing brown melanin pigment. Melanocytes can also be identified with immunoperoxidase staining for S100 and Fontana-Masson melanin stain (2). The physiopathology of ADM remains unclear, but it has been proposed that it involves reactivation of latent dermal melanocytes due to external factors such as trauma, inflammation, chemical exposure, sunlight, drugs, and hormonal treatment with estrogen and/or progesterone (3). ADM with hand involvement usually appears in the Asian population without sex predilection. The lesions develop in adolescence or young adulthood and tend to affect both hands and other body areas such as the face or the legs; there have also been two reported cases in the Hispanic population (both by Fitzpatrick III) (3,4). ADM must be differentiated from ectopic Mongolian spots, plaque-type blue nevi, tinea nigra, or other pigmented neoplasms. A biopsy is mandatory to establish a proper diagnosis. Ectopic Mongolian spots and plaque-type blue nevi are both congenital dermal melanocytoses that may present as bluish macules on the hand. However, these lesions show deep and more widely scattered distribution of melanocytes (1). There have also been some reports of malignant melanoma and acquired dermal melanocytosis that appeared on congenital nevus spilus (5). ADM is a benign condition, and reassurance should be offered to these patients.
Topics: Adult; Humans; Male; Hispanic or Latino; Inflammation; Melanins; Nevus, Blue; Skin Neoplasms
PubMed: 38439726
DOI: No ID Found -
International Journal of Dermatology Oct 2023Reticulate pigmentary dyschromatoses primarily include dyschromatosis universalis hereditaria (DUH), dyschromatosis symmetrica hereditaria (DSH) (Reticulate... (Review)
Review
Reticulate pigmentary dyschromatoses primarily include dyschromatosis universalis hereditaria (DUH), dyschromatosis symmetrica hereditaria (DSH) (Reticulate acropigmentation of Dohi), and unilateral dermatomal pigmentary dermatosis, which differ in their patterns of distribution. The disease was initially described by Ichikawa and Hiraga in Germany in 1933. The prevalence of DUH is 0.3 per 100,000 with a female preponderance. The skin lesions usually appear in infancy or early childhood and cease to progress beyond adolescence. The subtypes DUH 1 and DUH 3 are found to have autosomal dominant inheritance, which is the most common inheritance pattern, while DUH 2 has an autosomal recessive pattern. The most common gene involved in DUH is ABCB6, while the other genes include SASH 1, PER 3, and KITLG (DUH type 2). DUH is characterized by multiple irregular hyperpigmented macules interspersed with hypopigmented macules in a mottled pattern over the trunk and extremities. The face is involved in 50% of individuals. Rarely, it can also involve hairs, nails, mucous membranes, palms, and soles. Other varied presentations include localized forms, localization of lesions to sun-exposed areas, large macules, uniform palmar hypopigmentation, diffuse hyperpigmentation with spotty depigmented macules, and unilateral involvement. DUH has been reported to be associated with various cutaneous and systemic diseases. The authors have observed cases of DUH associated with hepatocellular carcinoma, solitary keratoacanthoma, and dermoid cyst. The various diagnostic modalities include dermoscopy, histopathology, electron microscopy, and targeted gene sequencing. Though various treatment modalities like NBUVB and lasers have been tried, no treatment is promising.
Topics: Child, Preschool; Adolescent; Female; Humans; Skin Diseases, Genetic; Hyperpigmentation; Liver Neoplasms
PubMed: 37634201
DOI: 10.1111/ijd.16817 -
Archives of Dermatology Aug 1987A series of 41 cases of melanotic lesions of the lip from 1980 to 1984 are reported. These lesions occur preponderantly in young white women on the lower lip. The term...
A series of 41 cases of melanotic lesions of the lip from 1980 to 1984 are reported. These lesions occur preponderantly in young white women on the lower lip. The term labial melanotic macule is suggested for these lesions.
Topics: Biopsy; Humans; Lip; Lip Diseases; Melanosis; Terminology as Topic
PubMed: 3631980
DOI: No ID Found -
Oral Surgery, Oral Medicine, and Oral... Aug 1976Fifty-five cases of a melanotic lesion of the lips which is well known, but not well described, are reported. The lesions characteristically occur on the lower lips of...
Fifty-five cases of a melanotic lesion of the lips which is well known, but not well described, are reported. The lesions characteristically occur on the lower lips of young adults. Males and females are equally affected. These lesions may be ephelides, postinflammatory melanoses, or unique lesions for which there is no exact cutaneous counterpart. We suggest the term labial melanotic macule as a descriptive one which would encompass the three different constituent entities. On the basis of follow-up information obtained and the histopathologic character of the lesions, this entity is benign and does not, in our opinion, have any malignant potential.
Topics: Adolescent; Adult; Aged; Diagnosis, Differential; Epithelium; Female; Follow-Up Studies; Humans; Lentigo; Lip Diseases; Male; Melanins; Melanosis; Middle Aged
PubMed: 1066601
DOI: 10.1016/0030-4220(76)90124-9 -
Mayo Clinic Proceedings Jan 2020
Topics: Biopsy; Dermatitis, Toxicodendron; Diagnosis, Differential; Female; Humans; Melanoma; Skin; Young Adult
PubMed: 31902415
DOI: 10.1016/j.mayocp.2019.11.001 -
Dermatitis : Contact, Atopic,... 2016Chemical leukoderma, often clinically mimicking idiopathic vitiligo and other congenital and acquired hypopigmentation, is an acquired form of cutaneous pigment loss... (Review)
Review
Chemical leukoderma, often clinically mimicking idiopathic vitiligo and other congenital and acquired hypopigmentation, is an acquired form of cutaneous pigment loss caused by exposure to a variety of chemicals that act through selective melanocytotoxicity. Most of these chemicals are phenols and aromatic or aliphatic catechols derivatives. These chemicals, however, are harmful for melanocytes in individuals with an individual susceptibility. Nowadays, chemical leukoderma is fairly common, caused by common domestic products. The presence of numerous acquired confetti- or pea-sized macules is clinically characteristic of chemical leukoderma, albeit not diagnostic. Other relevant diagnostic elements are a history of repeated exposure to a known or suspected depigmenting agent at the sites of onset and a macules distribution corresponding to sites of chemical exposure. Spontaneous repigmentation has been reported when the causative agent is avoided; the repigmentation process is perifollicular and gradual, taking place for a variable period of weeks to months.
Topics: Dermatitis, Contact; Dermatitis, Occupational; Hand Dermatoses; Humans; Hypopigmentation
PubMed: 27172302
DOI: 10.1097/DER.0000000000000167 -
Actas Dermo-sifiliograficas Jun 2020
Topics: Arteriovenous Anastomosis; Glomus Tumor; Humans; Skin Abnormalities; Skin Neoplasms; Telangiectasis
PubMed: 32416937
DOI: 10.1016/j.ad.2018.11.010 -
Cureus Dec 2023A 63-year-old woman with light skin and a history of chronic sun damage presented with a painless, pale macule on her nasal tip. A punch biopsy was performed due to...
A 63-year-old woman with light skin and a history of chronic sun damage presented with a painless, pale macule on her nasal tip. A punch biopsy was performed due to concerns about skin conditions like vitiligo or morpheaform basal cell carcinoma (BCC). The biopsy confirmed a micronodular BCC, an unusual presentation, as these typically manifest as an erythematous macule or thin papule/plaque. This report highlights the importance of considering various factors and differential diagnoses to ensure the best patient care and the need for vigilance in diagnosing rare presentations of BCC.
PubMed: 38161568
DOI: 10.7759/cureus.49806 -
Journal of the American Academy of... Nov 2006
Topics: Diagnosis, Differential; Humans; Melanoma; Melanosis; Nail Diseases; Skin Neoplasms
PubMed: 17052513
DOI: 10.1016/j.jaad.2006.04.074