RESUMEN
BACKGROUND: Although well known in clinical practice, research in lichen planus pigmentosus and related dermal pigmentary diseases is restricted due to lack of consensus on nomenclature and disease definition. AIMS AND OBJECTIVES: Delphi exercise to define and categorise acquired dermal pigmentary diseases. METHODS: Core areas were identified including disease definition, etiopathogenesis, risk factors, clinical features, diagnostic methods, treatment modalities and outcome measures. The Delphi exercise was conducted in three rounds. RESULTS: Sixteen researchers representing 12 different universities across India and Australia agreed to be part of this Delphi exercise. At the end of three rounds, a consensus of >80% was reached on usage of the umbrella term 'acquired dermal macular hyperpigmentation'. It was agreed that there were minimal differences, if any, among the disorders previously defined as ashy dermatosis, erythema dyschromicum perstans, Riehl's melanosis and pigmented contact dermatitis. It was also agreed that lichen planus pigmentosus, erythema dyschromicum perstans and ashy dermatosis did not differ significantly apart from the sites of involvement, as historically described in the literature. Exposure to hair colours, sunlight and cosmetics was associated with these disorders in a significant proportion of patients. Participants agreed that both histopathology and dermatoscopy could diagnose dermal pigmentation characteristic of acquired dermal macular hyperpigmentation but could not differentiate the individual entities of ashy dermatosis, erythema dyschromicum perstans, Riehl's melanosis, lichen planus pigmentosus and pigmented contact dermatitis. LIMITATIONS: A wider consensus involving representatives from East Asian, European and Latin American countries is required. CONCLUSION: Acquired dermal macular hyperpigmentation could be an appropriate conglomerate terminology for acquired dermatoses characterised by idiopathic or multifactorial non-inflammatory macular dermal hyperpigmentation.
Asunto(s)
Dermatitis por Contacto , Hiperpigmentación , Liquen Plano , Melanosis , Humanos , Consenso , Técnica Delphi , Hiperpigmentación/etiología , Liquen Plano/diagnóstico , Liquen Plano/terapia , Liquen Plano/complicaciones , Eritema/etiología , Melanosis/complicaciones , Dermatitis por Contacto/complicacionesAsunto(s)
Enfermedades del Cabello/diagnóstico , Hemocromatosis/diagnóstico , Melanosis/diagnóstico , Diagnóstico Diferencial , Enfermedades del Cabello/complicaciones , Hemocromatosis/complicaciones , Humanos , Melanocitos/patología , Melanosis/complicaciones , Piebaldismo/complicaciones , Piebaldismo/diagnóstico , Trastornos de la Pigmentación/complicaciones , Trastornos de la Pigmentación/diagnósticoRESUMEN
Phacomatosis cesioflammea is a rare condition defined by the simultaneous presence of both vascular and pigmentary nevus in the same patient. We report a case of a 4-year-old Indian female child who presented with diffuse dermal melanosis on the upper shoulders, upper anterior chest and lower back and extending to involve both sides of the arms and forearms, generalized port-wine stain on the back, shoulders and both upper limbs with sparing of the right palm. At places, the two types of lesions were superimposed on each other and were also present discretely on the back, but in close proximity to each other. There was the presence of melanosis bulbi on the right side of the eye. She was otherwise normal. She was clinically diagnosed as a case of phacomatosis pigmentovascularis cesioflammea. The nonallelic twin spotting phenomenon has been proposed in the pathogenesis of this disorder.
Asunto(s)
Melanosis/diagnóstico , Síndromes Neurocutáneos/diagnóstico , Preescolar , Femenino , Humanos , India , Melanosis/complicaciones , Síndromes Neurocutáneos/complicacionesRESUMEN
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