Progressive cribriform and zosteriform hyperpigmentation

Five cases of progressive cribriform and zosteriform hyperpigmentation are described. The following criteria were fulfilled: (1) uniformly tan cribriform macular pigmentation in a zosteriform distribution; (2) a histologic pattern that consisted of a mild increase in melanin pigment in the basal cell layer and complete absence of nevus cells; (3) no history of rash, injury, or inflammation to suggest postinflammatory hyperpigmentation; (4) onset well after birth with gradual extension; and (5) lack of other associated cutaneous or internal abnormalities. This appears to be a newly described entity, although it resembles a Becker's nevus without hypertrichosis or an typical café au lait spot. We believe that such progressive cribriform and zosteriform pigmentation is not uncommon.     

单侧分布线状和漩涡状痣样过度黑素沉着病

报告1例单侧分布线状和漩涡状痣样过度黑素沉着病.患儿男,10岁.右侧躯干、四肢出现线状及旋涡状色素沉着斑8年,而部、掌跖、指(趾)甲、口腔黏膜、外阴未见类似皮损,患儿出现弱视5年.     

Linear and whorled nevoid hypermelanosis

Linear and whorled nevoid hypermelanosis (LWNHM) is a reticulate pigmentary disorder with a sporadic occurrence, representing genetic mosaicism. It is characterised by hyperpigmented macules in a reticulate pattern along Blaschko's lines, sparing the mucous membranes and stabilising after one to two years. It may be associated with various neurological abnormalities. The disorder may resemble incontinentia pigmenti, epidermal nevus, or zebra-like hyperpigmentation clinically. We report LWMNHM in a 15-year-old girl with progressively increasing streaks of reticulate hyperpigmented macules arranged in a whorled pattern over the trunk and extremities, which appeared soon after birth. There was no history of any preceding eruption or any associated systemic abnormality. Histopathological examination revealed basal cell hyperpigmentation without any pigmentary incontinence. CT scan of the brain was normal.     

Linear and whorled nevoid hypermelanosis

Linear and whorled nevoid hypermelanosis (LWNH) is a rare skin condition characterized by swirls and whorls of hyperpigmented macules in a reticulate pattern along Blaschko's lines; approximately 40 cases have been reported in the English language literature. We report a case of LWNH occurring in a 20-year-old man with widespread involvement over the trunk, face, upper limbs, and genitalia in association with scoliosis. A small hyperpigmented area on the abdomen was treated with a medium-depth chemical peel regimen using 70 percent glycolic acid and 35 percent trichloroacetic acid with no benefit. This is the first report of LWNH treated with medium-depth chemical peel.     

线状和漩涡状痣样过度黑素沉着病一例

患者男,29岁.因全身皮肤色素沉着斑29年,于2008年3月来本院就诊.患者出生2周后,背部,四肢和面部出现褐色斑点,色斑发生前皮肤无红斑、水疱和瘙痒,色斑随年龄增大而逐渐增多扩大,并排列成条纹状或漩涡状,无自觉症状.发育以及智力均正常,各系统检查未见异常,父母健康,非近亲结婚,家族中无类似疾病患者.     

线状和漩涡状痣样过度黑素沉着病

报告1例线状和漩涡状痣样过度黑素沉着病。患者女,17岁。出生2周后周身即出现色素斑,并排列成条纹状或漩涡状,皮损面积广泛,无黏膜、眼睛、掌跖受累,损害至成年仍未消退。组织病理学检查示基底层色素增加和黑素细胞增多,无色素失禁。本病易与色素失禁症和早期线状表皮痣相混淆。     

Progressive cribriform and zosteriform hyperpigmentation: a clinicopathologic study

Background  Progressive cribriform and zosteriform hyperpigmentation (PCZH) is a disorder of pigmentation. Although several cases of PCZH have been reported, no clinicopathologic studies of the condition have been published in the English‐language literature. Objectives  The purpose of this study was to determine the clinical characteristics and histologic findings of PCZH. Methods  Between 1999 and 2009, 30 patients were diagnosed with PCZH in our Department of Dermatology. Medical records, clinical photographs, and pathologic findings for each patient were retrospectively reviewed. Results  The patients included 16 men and 14 women. The mean age at onset was 14.27 years. The trunk was the most common site of involvement. Microscopic examination showed an increased level of melanin pigment in the basal cell layer compared with adjacent normal skin, although no significant difference existed in the number of melanocytes. Pigmentary incontinence was observed in 13 of 30 cases. Conclusions  There was no significant difference in prevalence, age at onset, and duration of lesions between male and female patients with PCZH. The lesions corresponded to the lines of Blaschko and were localized rather than exhibiting diffuse patterns. A common feature of the histopathologic findings was higher melanin content in the lesions than in normal skin but with no significant difference in the number of melanocytes.     

线状和漩涡状痣样过度黑素沉着病

患者女,15岁. 主诉:因躯干、四肢出现色素沉着斑15年,于2006年4月就诊. 现病史:患者出生1个月后胸部、腹部出现黑褐色斑.色素斑随着年龄增长逐渐增多、扩大,呈线状、条索状或漩涡状.色素斑发生前皮肤无红斑、水疱和瘙痒.患者曾多次在当地医院就诊,被诊断为色素失禁症,未接受任何治疗.     

Linear and whorled nevoid hypermelanosis

Two cases are presented of congenital linear and whorled hypermelanosis. Hyperpigmented macules in streaky configurations along Blaschko's lines appeared gradually after birth. Histologic examination revealed prominent epidermal melanocytes and irregular basal layer hyperpigmentation with normal melanosomes. This condition must be differentiated from incontinentia pigmenti, early systematized epidermal nevus, extensive hypomelanosis of Ito, and chimerism. Other similar case reports from the literature suggest that incidence is sporadic and may be associated with more serious congenital anomalies. The patterning is the inverse to that found in hypomelanosis of Ito. Developmental somatic mosaicism may be responsible for this patterned hypermelanosis.     

单侧线状和漩涡状痣样过度黑素沉着病一例

患者,男,3岁。因生后色素皮损缓慢扩大来我院皮肤科就诊。患儿自出生后即发现右侧躯干、肢体线带状色素沉着斑,缓慢进展至右侧颈部。色素沉着前未发现红斑水疱等损害。既往身体健康,父母健康,家族中无类似疾病。体格检查：发育正常,智力正常,各系统检查未见异常。     

线状和漩涡状痣样过度黑素沉着病一例

患者男,20岁.出生后全身开始出现色素斑,逐渐增多并排列成条纹状或漩涡状.无黏膜、眼睛、掌跖受累,损害至成年仍未消退.皮肤科检查:皮损分布广泛,躯干、四肢皆为淡褐色或深棕色条状或漩涡状排列的色素沉着斑纹,沿Blaschko线分布,斑纹较宽,在躯干部略呈漩涡状,弧形,四肢呈条状.组织病理检查:基底层色素增加,无色素失禁.诊断为线状和漩涡状痣样过度黑素沉着病.给予Q开关532 nm激光治疗1次,尚无明显效果,仍在随访中.本病需与色素失禁症和早期线状表皮痣相鉴别.     

婴儿线状和漩涡状痣样过度黑素沉着病一例

报告1 例婴儿线状和漩涡状痣样过度黑素沉着病。患者女, 5月。出生4 周后周身即出现色素斑, 并排列成条纹状或漩涡状, 皮损面积广泛, 无黏膜、眼睛、掌跖受累, 生长发育无异常。组织病理学检查示基底层色素增加和黑素细胞增多, 无色素失禁。本病常被误诊为色素失禁症。     

进行性筛状及带状色素沉着症一例

患者女,36岁。因右侧胸部、右上臂内侧和右大腿外侧带状分布淡褐色斑3年就诊。3年前,无意中发现右侧胸部出现小片状淡褐色斑,此后皮损逐渐累及右上臂内侧和右大腿外侧,呈带状分布,无瘙痒及疼痛。否认发病前局部有外伤、感染等病史。多次就诊于当地医院,诊断为炎症后色素沉着、扁平苔藓等疾病,外用和口服药物治疗（具体药物不详）,效果不佳。为明确诊断于2017年11月2日就诊于我科。患者既往体健,否认有长期服药史。家族中无类似疾病患者……     

Linear and whorled nevoid hypermelanosis complicated with inflammatory linear verrucous epidermal nevus and ichthyosis vulgaris

We report a 17-year-old girl who presented with linear and whorled melanosis following Blaschko lines mainly on her trunk. Ichthyosiform lesions and linear scaling erythemas were observed respectively on her lower limbs and the dorsa of her hands, left knee, ankle and foot. No abnormality was found in systemic examination and blood tests. A biopsy specimen of pigmentation of her back showed there was increased pigmentation within the basal keratinocytes, with focal incontinentia pigmenti. Notable lymphangiectasis could also be seen in the mid part of dermis, which had never previously been described. The biopsy of scaling erythemas of her hand showed dominant hyperkeratosis with focal parakeratosis, acanthosis and papillomatous hyperplasia in the epidermis. The diagnosis of linear and whorled nevoid hypermelanosis (LWNH) complicated with inflammatory linear verrucous epidermal nevus and ichthyosis vulgaris was made in accordance with clinical and pathological manifestations. LWNH ought to be differentiated from incontinentia pigmenti and hypomelanosis of Ito.     

线状和回旋状色素沉着症并发炎性线状表皮痣及寻常性鱼鳞病

报告1例线状和回旋状色素沉着症并发炎性线状表皮痣、寻常性鱼鳞病。患者女,17岁。2岁起胸背部出现线状和回旋状色素沉着,双下肢皮损覆鱼鳞状鳞屑,双手背关节和左侧膝部、踝部、足背关节处可见线状鳞屑性红斑。系统及实验室检查均正常。结合组织病理改变诊断为线状和回旋状色素沉着症并发炎性线状表皮痣、寻常性鱼鳞病。