We report two cases of lichen planus pigmentosus (LPP) that developed in a unilateral linear pattern. The patients presented with unilateral linear brown macules on the extremities. Skin biopsy showed orthokeratosis, basal hydropic degeneration with scarce lymphohistiocytic infiltrates, and numerous melanophages in both patients. These patients, to the best of our knowledge, are the first cases of LPP presenting with a linear pattern. LPP should be considered in the differential diagnosis of linear hyperpigmented skin lesions.
Adolescent ; Adult ; Biopsy ; Female ; Human ; Hyperpigmentation/diagnosis/pathology ; Lichen Planus/*diagnosis/pathology ; Skin/pathology

Anti-Bacterial Agents ; adverse effects ; Humans ; Hyperpigmentation ; chemically induced ; pathology ; Male ; Middle Aged ; Minocycline ; adverse effects

Hereditary sclerosing poikiloderma (HSP) is a very rare disease. The clinical features are principally widespread poikiloderma and linear hyperkeratotic and sclerotic bands. We report an 18-yr-old male who presented reticular hyperpigmented lesions on the trunk and extremities since 2-yr-old. Also, linear sclerosing bands appeared on both antecubital and popliteal fossae after yr. Histopathologic finding showed dense sclerotic collagen fibers with telangiectasia in the upper dermis and fragmentations of damaged elastic fibers in the elastic stain, consistent with HSP. We report the first Korean case of HSP.
Abnormalities, Multiple ; Adolescent ; Elastic Tissue/pathology ; Fingers/abnormalities ; Humans ; Hyperpigmentation/pathology ; Male ; Micrognathism/pathology ; Rothmund-Thomson Syndrome/*diagnosis/pathology ; Sclerosis/pathology ; Skin Diseases/diagnosis/pathology

OBJECTIVETo identify keratin 5 (K5) and keratin 14 (K14) gene mutations in a family affected with epidermolysis bullosa simplex with mottled pigmentation.

METHODSGenomic DNA was extracted from peripheral blood samples obtained from eleven patients from the family and controls. All the exons of K5 and K14 genes were amplified using polymerase chain reaction (PCR) and directly sequenced.

RESULTSBy DNA sequence analysis, a missense mutation in K5 gene (c.237C>T) was detected. The same mutation was not found in non-affected members from the family and normal controls.

CONCLUSIONMutation in K5 gene (c.237C>T) may be responsible for the development of disease in this family.

Base Sequence ; DNA Mutational Analysis ; Epidermolysis Bullosa Simplex ; genetics ; pathology ; Exons ; Female ; Humans ; Hyperpigmentation ; genetics ; pathology ; Keratin-14 ; genetics ; Keratin-5 ; genetics ; Male ; Mutation ; Pedigree ; Sequence Analysis, DNA

Stasis dermatitis is an itchy, scaly, and hyperpigmented condition of the lower leg due to venous insufficiency. Hemosiderin and/or melanin have been considered responsible for the brown pigmentation. However, there are not sufficient histopathologic studies. In this retrospective study the hospital records and biopsy slides of 20 patients were reviewed to determine the pathogenetic mechanisms of brown pigmentation in stasis dermatitis. Fifteen were men (75%) and 5 were women (25%) with a mean age of 46.2+/-8.2 yr (18-76), mean age at onset of 43.4+/-18.0 yr (17-73), and a mean duration of the disease 2.8+/-2.5 yr (0.25-10). All patients had varicose vein and complained of pruritus. On histopathologic evaluation, two cases out of 20 (3 skin biopsy specimens from 25 samples) showed dermal melanocytes containing melanin, and incontinence of melanin pigment was observed in 5 cases, which indicates that melanin pigments from epidermis could contribute to cutaneous pigmentation in stasis dermatitis. However, the existence of dermal melanocytes in two cases cannot be explained because normally the dermis contains no melanocytes. Further studies concerning the role of iron or inflammatory cytokines on the development of dermal melanocytes should be conducted.
Adolescent ; Adult ; Aged ; Dermatitis/etiology/metabolism/*pathology ; Dermis/metabolism/pathology ; Female ; Humans ; Hyperpigmentation/etiology/metabolism/*pathology ; Leg Dermatoses/etiology/metabolism/pathology ; Male ; Melanins/metabolism ; Melanocytes/metabolism/*pathology ; Middle Aged ; Venous Insufficiency/complications

Both acquired bilateral nevus of Ota-like macules (ABNOM) and nevus of Ota are characterized by the presence of dermal melanocytes. There are no differences in the method of treatment, however, postinflammatory hyperpigmentation (PIH) develops more often in ABNOM than in nevus of Ota following treatment. We investigated the differences in the development of PIH after treatment between ABNOM and nevus of Ota, and the histopathologic differences in the PIH. A total of 82 patients with ABNOM (n=47) and nevus of Ota (n=35) were treated with Q-switched alexandrite laser and followed up 2 weeks and 3 months later. Biopsies were performed on lesional skin before treatment. The distribution and the amount of melanin pigments were visualized with Fontana-Masson stain, and the distribution and the depth of melanocytes were measured by GP-100 (NK1-beteb) stain. Clinically, there was more erythema and PIH in ABNOM than in nevus of Ota. Histopathologically, intradermal melanocytes were clustered in groups and dispersed perivascularly in ABNOM, while melanocytes were scattered evenly throughout the dermis in nevus of Ota. Both groups show that when there is a statistically significant number of melanocytes in the perivascular area, erythema and PIH occur after laser therapy. In conclusion, indirect vessel injury in addition to perivascular clustering melanocytes might be considered the cause of increased PIH after treatment in ABNOM.
Adolescent ; Adult ; Child ; Child, Preschool ; Comparative Study ; Humans ; Hyperpigmentation/*pathology ; Laser Therapy, Low-Level ; Melanocytes/*chemistry/cytology ; Middle Aged ; *Nevus of Ota/pathology/therapy ; *Nevus, Pigmented/pathology/therapy ; Silver Nitrate ; *Skin Neoplasms/pathology/therapy ; Treatment Outcome

Laugier-Hunziker syndrome (LHS) is an acquired pigmentary condition affecting lips, oral mucosa and acral area, frequently associated with longitudinal melanonychia. There is neither malignant predisposition nor underlying systemic abnormality associated with LHS. Herein, we present three uncommon cases of LHS with possibly new feature of nail pigmentation, which were diagnosed during the past 2 years. We also review the clinical and histological findings, differential diagnosis, and treatment of the syndrome in published literature.
Adult ; Female ; Gingival Diseases ; diagnosis ; Humans ; Hyperpigmentation ; diagnosis ; Lip Diseases ; diagnosis ; Male ; Melanins ; analysis ; Middle Aged ; Mouth Diseases ; diagnosis ; Mouth Mucosa ; pathology ; Nail Diseases ; diagnosis ; Syndrome ; Tongue Diseases ; diagnosis

We describe a 58-year-old woman who was incidentally found to have gastric and colonic polyposis, hypoalbuminemia, cutaneous hyperpigmentation and onychodystrophy (Cronkhite-Canada syndrome). Histology of polyps from the stomach showed features of juvenile or retention type (hamartomatous) polyps with Helicobacter pylori (H. pylori) infection. The large pedunculated colonic polyps showed hamartomatous polyps with adenomatous component and polypectomy was performed. After the treatment with H. pylori eradication and omeprazole, the gastric polyposis, hypoalbuminemia and anemia regressed, and endoscopic polypectomy of gastric polyps were performed. After the continuous use of omeprazole for 14 months, the patient showed complete resolution of clinical features of Cronkhite-Canada syndome. The experience of this case suggests that eradication of H. pylori and proton pump inhibitor treatment might be considered in patients with gastric polyposis combined with Cronkhite-Canada syndome.
Anti-Ulcer Agents/*therapeutic use ; Colonic Polyps/complications/microbiology/pathology ; Female ; Helicobacter Infections/complications/*drug therapy ; *Helicobacter pylori ; Humans ; Hyperpigmentation/pathology ; Middle Aged ; Nails, Malformed/pathology ; Omeprazole/*therapeutic use ; Polyps/*complications/microbiology/pathology ; Proton Pumps/antagonists & inhibitors ; Stomach Neoplasms/*complications/microbiology/pathology ; Syndrome

Toxic erythema of chemotherapy (TEC) refers to a group of chemotherapy-induced cutaneous toxicities. We present a case of TEC in an 11-year-old girl who received gemcitabine and docetaxel for osteosarcoma of the femur.
Antineoplastic Agents ; adverse effects ; Axilla ; Bone Neoplasms ; drug therapy ; Child ; Deoxycytidine ; adverse effects ; analogs & derivatives ; Erythema ; chemically induced ; Female ; Femur ; pathology ; Humans ; Hyperpigmentation ; Lung Neoplasms ; drug therapy ; secondary ; Mouth ; drug effects ; Orbit ; drug effects ; Osteosarcoma ; drug therapy ; Taxoids ; adverse effects ; Treatment Outcome