Ingestion of ammonium nitrate as a possible cause of erythema dyschromicum perstans (ashy dermatosis).

Clinically and histologically typical erythema dyschromicum perstans has been provoked by repeated ingestion of very small amounts of a fertilizer, ammonium nitrate. It has been used by a boy who has noticed accidentally that after licking the fertilizer he developed hyperpigmentations. His main purpose was to avoid school attendance, and he developed a very ingenious method of licking the fertilizer once in several weeks in such a way that it did not produce any digestive or other troubles. His brother, an uniovular twin who had no contact with ammonium nitrate, was healthy. The case supports Pinkus' hypothesis that this type of lesions may be related to some environmental contaminant. Attention is called to a possible food contamination by ammonium nitrate.     

Chlorothalonil,a possible cause of erythema dyschromicum perstans (ashy dermatitis)*

We studied 39 patients with erythema-dyschromicum-perstans-like dermatitis seen at Changuinola Hospital in Panama. They were compared with 41 controls. The 2 groups were native field workers of the banana plantations exposed to many pesticides. In 34 patients, there was a positive patch test reaction to 2,4,5,6-l, 3-tetrachloroisophlhalonilnitrile (chlorothalonil. TCPN) 0.001% in acetone. In 39 cases, biopsies showed a lichenoid tissue reaction compatible with a chronic pigmented dermatitis or erythema-dyschromicum-perstans-like dermatitis, Chlorothalonil is possibly the cause of the pigmented dermatitis observed in the 39 banana farm workers studied. Until additional studies are carried out. We consider this a possible rather than definite cause-and-effect relationship.     

持久性色素异常性红斑一例报告

患者男,40岁.颈、面、躯干和上肢相继出现灰紫斑,偶有阵发性搔痒1年多.一年前初夏,日晒数日后,觉颈部有阵发性痒,出现大小不等红斑,有细小鳞屑,诊断为神经性皮炎,治疗后仅痒感减轻.此后屡经日晒,灰紫斑渐渐扩大,累及上胧和躯干.     

持久性色素异常性红斑1例

临床资料患者,女,53岁。主因前腰部红斑伴瘙痒5个月,于2009年3月26日来我科就诊。患者5个月前腰部扎腰带处出现红斑伴轻度瘙痒,红斑逐渐扩大,     

A global consensus statement on ashy dermatosis,erythema dyschromicum perstans,lichen planus pigmentosus,idiopathic eruptive macular pigmentation,and Riehl's melanosis

Ashy dermatosis (AD), lichen planus pigmentosus (LPP), erythema dyschromicum perstans (EDP), and idiopathic eruptive macular pigmentation are several acquired macular hyperpigmentation disorders of uncertain etiology described in literature. Most of the published studies on these disorders are not exactly comparable, as there are no clear definitions and different regions in the world describe similar conditions under different names. A consensus on the terminology of various morphologies of acquired macular pigmentation of uncertain etiology was a long-felt need. Several meetings of pigmentary disorders experts were held to address this problem. A consensus was reached after several meetings and collation of e-mailed questionnaire responses and e-mail communications among the authors of publications on the above conditions. This was achieved by a global consensus forum on AD, LPP, and EDP, established after the 22nd International Pigment Cell Conference held in Singapore in 2014. Thirty-nine experts representing 18 countries participated in the deliberations. The main focus of the deliberations was terminology of the conditions; as such, we present here the consensus statement of the forum and briefly review the available literature on the subject. We have not attempted to discuss treatment modalities in detail.     

Erythema dyschromicum perstans/ashy dermatosis--a report of eight cases from Singapore

Eight patients with erythema dyschromicum perstans (ashy dermatosis) are described. The characteristic ashy macules occurred mainly on the trunk and limbs. The condition did not appear to be associated with infection or drug ingestion. Seven patients had preceding erythema before onset of ashy macules; three had urticarial eruptions associated with the early erythema. Biopsy consistently showed mild, superficial, perivascular mononuclear cell infiltration and abundant melanophages in all the patients. In five, vascuolar degeneration of the basal epidermal cells was evident. There was no evidence to suggest that the condition was associated with lichen planus. The dermatosis appeared to run a prolonged course.     

Simultaneously active lesions of vitiligo and erythema dyschromicum perstans

Recently, a patient presented to us with skin that had areas of normal pigmentation, hyperpigmentation, and depigmentation. Workup eventually showed him to have simultaneously active lesions of a depigmenting disorder, vitiligo, and a hyperpigmenting disorder, erythema dyschromicum perstans.     

持久性色素异常性红斑

患者女,41岁. 主诉：躯干部灰色斑片6月. 现病史：患者6月前无明显诱因下腹部出现散在分布的淡红色斑片,甲盖大小,无痒痛等不适,红斑消退后,留有灰色斑片,渐增多,扩展至腰部、背部,部分融合成片,形状不规则,曾于外院诊断为色素性玫瑰疹等,先后给予氯雷他定、扑尔敏抗过敏、外用糖皮质激素软膏、窄普中波紫外线等治疗,缓解不明显,遂于我中心就诊.     

Clinical and histological aspect of erythema dyschromicum perstans in Korea: A review of 68 cases

Erythema dyschromicum perstans (EDP) is a hypermelanotic disorder of the idiopathic variety characterized by blue‐gray macules in healthy individuals. It has been described mainly in patients from tropical areas of Central and South America. Our aim was to evaluate EDP in Korea through the analysis of retrospective case series with EDP and to describe the clinical and histopathological features. It was a retrospective study (2002–2012) of EDP confirmed by review of clinical photographs and biopsy specimens. The files of 68 patients with EDP from six tertiary medical centers in Korea were included in this study. Of the 68 patients, 29 were male and 39 female. The age of patients ranged 3–76 years (mean, 33.9). Clinically, the majority of patients had lesions on the trunk (n = 47, 69.1%); the neck was affected in 27 cases, the upper extremities in 26, the face in 22 and the lower extremities in 16. Peripheral erythematous borders were observed in 12 patients (17.6%) and 11 patients had itching sensation at the lesion. Histopathologically, dermal melanophages and pigment incontinence were the most common findings. A follow up of more than 1 year was obtained in 51 patients. Of these, only one patient experienced complete clearance without recurrence. Our study illustrates the clinical and histopathological findings of EDP in Koreans. Our multicenter data may contribute to the understanding of EDP.