Idiopathic Eruptive Macular Pigmentation: Report of Five Patients

Abstract: We report the occurrence of idiopathic eruptive macular pigmentation in four children and one adolescent. This condition appears to be a distinct clinicopathologic and histologic entity. It is characterized by asymptomatic, pigmented macules involving the neck, trunk, and proximal limbs. All patients or their families denied the patients' having taken any drug before the eruption. In all of the patients the first sign was a pigmented spot without preceding erythematous, papular, or hypopigmented lesions. Histologic study showed enhanced epidermal basal layer pigmentation with pigmentary incontinence, a mild perivascular lympho-histiocytic infiltrate, and many melanophages in the papillary dermis. Electron microscopy showed an increased number of melanosomes in basal and suprabasal keratinocytes as well as clustered melanosomes in dermal melanophages. Treatment of this asymptomatic condition is unnecessary because spontaneous resolution of the lesions is to be expected within several months to a few years.     

特发性多发性斑状色素沉着症1例

患者男,21岁。躯干、四肢近心端褐色斑2月。皮损首先发生在腹部,无自觉症状,病程中无红斑期。查体见躯干、四肢近心端泛发性褐色斑,上无明显鳞屑。背部皮损组织病理示:表皮下部色素轻度增多,真皮乳头层散在嗜色素细胞。诊断:特发性多发性斑状色素沉着症。     

A Case of Idiopathic Eruptive Macular Pigmentation Limited to Flexural Areas

Idiopathic eruptive macular pigmentation is a rare condition characterized by asymptomatic pigmented macules involving the neck, trunk, and proximal portions of the extremities. On histopathologic examination, there was increased pigmentation of the basal layer in otherwise normal epidermis and scattered melanophages in the papillary dermis. We report a case of a 26-year-old woman with idiopathic eruptive macular pigmentation involving only the flexural areas of the body. This condition should be considered in the differential diagnosis of flexural hyperpigmented skin lesions.     

Progression of Idiopathic Eruptive Macular Pigmentation in a Girl from Childhood to Adolescence: Case Report and Literature Review

A 14‐year‐old girl developed brownish round macules and patches over the face, trunk, and proximal limbs with extensive progression since she was 7 years old. Electron microscopy examination revealed an increase in the number and maturity of melanosomes in basal and suprabasal keratinocytes, although the number of melanocytes was within the normal range. A diagnosis of idiopathic eruptive macular pigmentation was made. We describe the unusual disease progression of this case of idiopathic eruptive macular pigmentation, which was thought to be self‐limited.     

Idiopathic Non-Familial Acro-Osteolysis: A Rare Case Report

A 25-year-old woman patient presented with shortening of fingers with racket nails and numerous yellowish papules over the hands and forearms for 21 years. X-ray of the hands revealed destructive osteolytic changes in all the terminal phalanges. Skin biopsy from the yellowish papules showed epidermal proliferation, perivascular mononuclear infiltrate, thickening of dermal collagen, septal fibrosis and loss of adipocytes mimicking sclerodermatous changes in the dermis and hypodermis. The patient did not have any history of similar illness in the family or occupational exposure to vinyl chloride. After excluding all other possibilities of acral-osteolysis, we diagnosed the case as idiopathic non-familial variety of acro-osteolysis. This is a rare entity characterized by terminal resorption of fingers, sometimes associated with Raynaud''s phenomena and yellowish cutaneous papules.     

Generalized Eruptive Histiocytoma: Report of a Pediatric Case

A one-year-old boy was seen with brownish, flat papules on his face, neck, and upper arms. The lesions were symmetric, discrete, slightly raised, firm to the touch, and asymptomatic papular eruptions. Histological and immunohistochemical investigation revealed monomorphous infiltration of S-100 negative, lysozyme negative, and α₁-antitrypsin negative, but α₁-antichymotrypsin positive and vimentin positive histiocytic cells with small numbers of lymphocytic cells. The histiocytic cells did not show any foamy changes in the cytoplasm. No giant cells were found. The lesions increased in number during the first few years and then spontaneously regressed by the sixth year of age, leaving partial brownish pigmentation.     

Imipramine-Induced Facial Pigmentation: Case Report and Literature Review

Background

Patients who present with facial pigmentation can be a diagnostic challenge. ObjectiveThe goal of this study was to discuss the diagnosis and management of imipramine-induced facial pigmentation.

Methods

We describe a patient with facial pigmentation of 26 years’ duration that was associated with imipramine treatment for depression. We discuss light and election microscopic findings and review 11 previously reported cases of imipramine-induced skin pigmentation.

Results

Examination showed blue–gray facial pigmentation. Light microscopy showed perivascular pigment granule deposits in the upper dermis that stained positively with Fontana–Masson stain and negatively with Prussian blue stain. Electron microscopy showed electron-dense bodies within histiocytes without clearly identifiable melanin granules, consistent with drug-induced pigmentation. Six weeks after switching to sertraline the patient reported a slight improvement of her cutaneous pigmentation.

Conclusion

Imipramine is a rare cause of gray–blue facial pigmentation. Light microscopy consistently shows granular dermal deposits that stain positively with Fontana–Masson stain but negatively with iron stain.     

Eruptive Vellus Hair Cysts: Case Report and Review of the Literature

A 6-year-old Caucasian girl had dozens of asymptomatic, flesh-colored, 2- to 5-mm eruptive vellus hair cysts. These papules on the buttocks, thighs, and groin increased in number for three months. Histologic examination revealed poorly defined, keratin-filled cysts in the upper middermis, containing numerous transversely or obliquely cut portions of vellus hair. The histopathologic differential diagnosis with other epithelial cysts containing hair shafts is debated, and new clinical differential diagnoses are proposed. Review of the literature suggests that eruptive vellus hair cyst is not a rare disorder, but its frequency is probably underestimated due to paucity of symptoms. Nevertheless, the clinical relevance of some of the differential diagnoses should convince clinicians to obtain histologic confirmation.     

Eruptive Collagenomas of the Skin: A Case History

Abstract: We present a case of eruptive collagenomas of the skin in a young girl. The typical clinical features and histology of this rare condition are described. The differential diagnosis and other types of cutaneous collagenomas are briefly discussed. A biopsy is required to confirm the excessive mature collagen which predominates in these lesions.     

发疹性黄瘤1例

患者男,41岁。面部、躯干下部及双下肢泛发橘黄色丘疹3个月。面部、躯干下部及双下肢散在分布橘黄色丘疹,米粒至绿豆大小,质硬,部分基周红晕,有压痛。抠挤后破溃,结痂,遗留色素性或肥厚性瘢痕。患糖尿病和脂肪肝2年。诊断:发疹性黄瘤。嘱低脂饮食,继续治疗高脂血症,面部皮损予激光治疗,现随访中。     

发疹性黄瘤1例

患者女,37岁。躯干部出现红色丘疹20余天。躯干、四肢可见泛发性密集分布的淡黄色丘疹或桔黄色丘疹,约针尖至绿豆大小,质坚。左背部皮损组织病理示:表皮未见异常,真皮中上部可见一肉芽肿性浸润,浸润由泡沫组织细胞和淋巴细胞组成。诊断:发疹性黄瘤。     

全身性发疹性组织细胞瘤1例

患儿男 ,2岁。颜面、躯干、四肢起暗褐色丘疹 1年余。皮肤组织病理 :真皮上中部组织细胞均匀一致的浸润 ,组织细胞核大 ,淡染 ,胞浆内无吞噬细胞 ,未见多核巨细胞。姬姆萨染色 (-)。免疫组化染色 :S10 0 (-) ,CD68(+ )。诊断为全身发疹性组织细胞瘤。本文重点讨论了本病的诊断和鉴别诊断。     

全身发疹性组织细胞瘤1例

患者女,60岁。颜面、躯干及四肢暗红色丘疹2年。皮损组织病理示:真皮上中部组织细胞均匀一致的浸润,胞浆内无吞噬细胞,未见多核巨细胞。免疫组化:CD68(KP1)阳性,S-100和CD1a均阴性。诊断:全身发疹性组织细胞瘤。     

伴斑点状色素沉着的单纯性大疱性表皮松解症1例国内首报

患儿男,15岁。躯干、四肢反复发生水疱和大疱,伴色素沉着和色素减退15年。皮损组织病理示:棘层下部棘细胞间裂隙和陈旧性表皮内水疱,部分基底细胞液化或空疱变性及基底层色素增加,真皮血管周围多数淋巴和嗜酸粒细胞浸润。直接免疫荧光检查阴性。透射电镜下超微结构示角质形成细胞间水肿,基底细胞内裂隙和空泡形成,并见大量张力微丝排列为均质化团块,部分呈漩涡状;基底细胞及细胞间可见黑素小体。诊断:单纯性大疱性表皮松解症,斑点状色素沉着。经云南省医学信息研究所查证证实该例为国内首例报道。     

发疹性毳毛囊肿1例

患者女,40岁。前胸部出现丘疹2年,无自觉症状。皮损为直径2～4mm的丘疹,呈肤色。皮损组织病理示:真皮内见囊肿样结构,囊壁为复层鳞状上皮,囊内见多个毳毛横断面或斜断面。诊断:发疹性毳毛囊肿。     

A Case of Eruptive Collagenoma on the Left Calf

Eruptive collagenoma is an acquired connective tissue nevus without family history. It is typically described as numerous small papules or nodules on the trunk and arms with histopathological features of decreased or degenerated elastic fibers. We report a case of a 16-year-old male who presented with multiple asymptomatic 2 to 5 mm sized yellowish grouped papules on the left calf. Histopathologically, the lesion showed thickened homogenized collagen fibers highlighted by Masson trichrome stain and decreased and fragmented elastic fibers stained by Verhoeff-van Gieson stain. The skin lesion was diagnosed as eruptive collagenoma and no treatment was provided.     

毛囊角化病样发疹性汗管瘤1例

患者男, 45岁。四肢皱褶部位多发性褐红色小丘疹 5年,依靠组织病理学的特异性表现确诊为发疹性汗管瘤。     

Eruptive Cutaneous Collagenoma: Report of Two Cases

Introduction:Eruptive cutaneous collagenoma is non familial connective tissue nevi of unknown etiology presented with an abrupt onset.To date,the literatures on...