Nevus depigmentosus: review of a mark of distinction.

Nevus depigmentosus (ND), also known as nevus achromicus or achromic nevus, is an uncommon congenital hypomelanosis of the skin that is often characterized as being nonprogressive and having serrated borders. It needs to be distinguished from other hypopigmented skin conditions such as nevus anemicus, hypomelanosis of Ito, Fitzpatrick patches (ash leaf spots) of tuberous sclerosis, vitiligo, indeterminate leprosy, and pigment demarcation lines. Treatment may be desired for aesthetic and possible psychosocial considerations. We review and update knowledge about ND and its simulants.

Spectrum of periorbital dermatoses in South Indian population.

BACKGROUND: Periorbital dermatoses are very common dermatological disorders which pose a diagnostic and therapeutic challenge for the treating dermatologist due to the similarity of symptoms in this area. AIMS: To study the spectrum of periorbital dermatoses and to assess the association of systemic diseases with periorbital dermatoses. METHODS: This was a hospital based descriptive study done on 250 consecutive patients irrespective of their age and sex who attended the Dermatology out patient department (OPD), with dermatological conditions pertaining to the periorbital area over a period of 2 years from October 2010 to September 2012. RESULTS: The most common dermatological conditions seen in the periorbital region were benign and malignant skin tumors observed in 63 (25.2%) cases, followed by the disorders of pigmentation in 51 (20.4%) and eczema in 44 cases (17.6%), infections in 33 (13.2%) cases and nevoid conditions in 26 (10.4%) cases. Certain periorbital dermatoses were significantly more in females than in males in the present study like skin tags, connective tissue diseases, and periorbital melanosis (POM). Some periorbital dermatoses were significantly more common in older age group such as seborrheic keratoses, skin tags and airborne contact dermatitis whereas infections, syringomas, allergic contact dermatitis and atopic dermatitis were more prevalent in younger age group. Syringomas and POM were more common in middle-aged women. CONCLUSIONS: The most common dermatological condition seen in the periorbital region in this study are benign skin tumors (keratosis and skin tags), followed by the disorders of pigmentation and eczema, infections and nevoid conditions.

[Etiology of acquired hypochromic patches in dermatological area in Mali]. / Etiologies Des Hypochromies Acquises En Milieu Dermatologique.

INTRODUCTION: In dark skin patients, hypopigmentation is the most disfiguring condition. Very few studies on hypochromic disorders have been conducted in specialized health centers. The present study is aimed to describe the etiologies of hypochromic patches in dermatological area, in Bamako. METHODS: We carried out a cross sectional study in the Dermatology Clinic of the "Centre National d'Appui à la lutte contre la Maladie (CNAM, Ex Institut Marchoux)". All acquired hypochromic patches (HP) were selected. HP was defined as a "skin patch lighter in pigmentation than normal surrounding skin with a diameter of at least 1 cm". The diagnosis was mainly based on clinical findings. RESULTS: The prevalence of HP was 3.42% and the main causes were seborrheic dermatitis (23.3%), pytiriasis alba (20.15%), vitiligo (18.9%), pityriasis versicolore (18.5%) and leprosy (12.6%). CONCLUSION: There are many causes of HP including leprosy, a disease though rare to date, but still prevalent in dermatological area.

Clinicopathologic profile of hypopigmented mycosis fungoides in India.

BACKGROUND: Hypopigmented mycosis fungoides (HMF) is an under recognized disease in India, which is often mistaken for Hansen disease or vitiligo, resulting in delayed diagnosis and treatment. AIM: To describe the clinical, histopathologic and immunohistochemical features of HMF in Indian patients. MATERIALS AND METHODS: All cases presenting as hypopigmented lesions that were signed out as MF between 2001 and 2009 (15 cases) were included. Clinical data and histopathology slides were reviewed. Immunostains for CD4, CD8, and CD1a were done, where tissue was available. RESULTS: The age ranged from 14 to 38 years with a male preponderance. The commonest presentation was multiple hypopigmented patches on limbs and trunk with the duration of the lesions varying from 4 months to 14 years. All cases showed a psoriasiform/lichenoid epidermal pattern, disproportionate epidermotropism, basilar tagging of lymphocytes, monomorphous lymphocytes, haloed lymphocytes, and wiry dermal collagen. Other important findings were infiltration of hair follicles, larger epidermal lymphocytes, atypia of dermal lymphocytes, and stuffed dermal papillae. Dermal edema was absent in all cases. Immunohistochemistry done on 10 cases showed a CD8 phenotype in 6 cases and CD4 phenotype in the remaining 4 cases. CONCLUSIONS: Histopathology supplemented by immunohistochemistry is reliable in making a diagnosis of HMF. It is important to be aware of this uncommon, yet significant disease.

[Progressive macular confluent hypomelanosis in mixed ethnic melanodermic subjects: an epidemiologic study of 511 patients]. / Hypomélanose maculeuse confluente et progressive du métis mélanoderme: étude épidémiologique sur 511 sujets.

INTRODUCTION: The pathogenesis of the recently described (1985) entity macular confluent progressive hypomelanosis in black subjects of mixed ethnic origin, also called creole dyschromia is unknown. Patients are generally black adults of mixed ethnic origin and present with hypopigmented maculae located asymmetrically in unexposed areas. The mechanism appears to be a phenotypic modification of produced melanosomes. The cases published to date do not provide clear epidemiological data. MATERIALS AND METHODS: We took histories and examined 511 patients in the French West Indies (Martinique) during systematic screening for leprosy. Observations included presence or absence of creole dyschromia, the intensity of the depigmentation. History reports included chronology of the lesions and factors affecting disease course. RESULTS: One-hundred twenty-one cases of dyschromia were identified, often with few clinical signs. Creole dyschromia was found in one-third of the examined subjects between the age of 17 and 48 years and appeared to be more exception outside this age range. More men than women were found to have the disease and the duration of the clinical course was about 25 years. Clearer skin appeared to be more sensitive and only responded to intermittent exposure to sun. DISCUSSION: Due to the fact that the examination was mandatory, it was possible to identify a large number of cases unknown to dermatologists and sometimes to the subject himself. The clinical description corresponded to those given in the literature, but the higher frequency in males, the duration of the clinical course and the sensitivity of clearer skin appear to have been unreported to date.