- AKA Ashy dermatosis, dermatosis cenicienta
Epidemiology
- skin phototypes III-IV
- darkly pigmented latin-americans
- no sex prediection
- onset 1st-3rd decade of life
Pathogenesis
- Set of pollutants in the environment (contact, inhaled or ingested) in genetic predisposed individuals
- Ammonium nitrate
- Benzodiazepines
- Penicillin
- Pesticides
- Toxins
- Whipworm infestion
- HIV
- Contrast studies with barium sulfate
Clinical presentation
- Gray-brown to blue-gray macules and patches
- 0,5-2,5cm
- Oval shape with long axis following skin cleavage lines like pitiryasis rosea
- Distribution
- symetric
- Favors the neck, trunk and proximal extremities
Histology
- Histology: dermatite de interface vacuolar
- Pigment incontinence
- Melanophages
DDx
- Lichen planus pigmentosus
- Fixed drug eruption
- Lichenoid drug eruption
- Pityriasis rosea
- Small plaque parapsoriasis
- Macular urticaria pigmentosa
- Leprosy
Treatment
- A consistently effective treatment is not currently available
- Spontaneous remission may occur
- Sun protection
- Calcineurin inhibitors
- Retinoids
- Vitamin C
- Chemical peels
- Oral antibiotics
- Vitamin A
- Dapsone
- Antimalarials
- Griseofulvin
- Systemic corticosteroids
- Clofazimine
- nbUVB
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