sQuiz your knowledge: a case of poikiloderma
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A 45-year-old woman presented with a 40-year history of asymptomatic, generalized reticular hyperpigmentation and hypopigmented spots over her body (figure 1A, B). The rashes were first noticed on her arm and abdomen, which progressed slowly to involve almost the entire body. Except for a history of hypertension for two years, she had no other specific diseases or familial medical history. Laboratory investigations, including full blood count, liver function test, renal profile, thyroid function tests, and tests for adrenocorticotropic hormone and cortisol, were normal. Histopathological results showed hyperkeratosis, an uneven distribution of melanin in the epidermis and amorphous eosinophilic material in the superficial dermis (figure 1C). The material stained positive with Congo red (figure 1D).
What is your diagnosis?
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References A 1. Song Z, Chen W, Zhong H, Ye Q, Hao F. Erythema papulosa semicircularis recidivans: a new reactive dermatitis? Dermatitis 2012; 23: 44-7. 2. Ohmori R, Kikuchi K, Yamasaki K, Aiba S. A new type of annular erythema with perieccrine inflammation: erythema papulatum centrifugum. Dermatology 2013; 226: 298-301. 3. Zhang LW, Wang WJ, Jiang CH, et al. Erythema papulatum centrifugum and new diagnostic criteria. Australas J Dermatol 2020; 61: e87-90.
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doi:10.1684/ejd.2020.3826
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sQuiz your knowledge: a case of poikiloderma Li-wen ZHANG1,a , Lin LI1,a , Dong-xian LIU2,a 1
Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China 2 Department of Dermatovenereology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China a These authors contributed equally. [email protected] [email protected]
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Figure 1. A) Generalized reticular hyperpigmentation and hypopigmented spots on the trunk and arm. B) The lesions on the lower limbs. C) Amorphous eosinophilic material in the superficial dermis (haematoxylin and eosin staining; ×400 magnification). D) Congo red stain shows amorphous eosinophilic masses in the papillary dermis (×200 magnification).
EJD, vol. 30, n◦ 4, July-August 2020
Amyloidosis cutis dyschromica Amyloidosis cutis dyschromica (ACD) is a rare variant of primary cutaneous amyloidosis which is considered to exhibit semi-dominant inheritance and is characterized by prepubertal onset of reticular hyperpigmentation and hypopigmented spots with no or little itchy sensation. Recently, bi-allelic mutations in glycoprotein non-metastatic melanoma protein b have been described in ACD [1, 2]. Histopathology indicates focal subepidermal amyloid deposition. The differential diagnosis includes hypopigmented macular diseases, dyschromatosis universalis hereditaria, dyschromatosis symmetric hereditaria, idiopathic guttate hypomelanosis, Addison’s disease, xeroderma pigmentosum and macular amyloidosis. Several therapeutic options for ACD are reported, such as topical corticosteroids, keratolytics, dimethyl sulfoxide, ultraviolet phototherapy, dermab
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