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Erythema Dyschromicum Perstans: Response to Topical Tacrolimus.

Mahajan VK, Chauhan PS, Mehta KS, Sharma AL - Indian J Dermatol (2015 Sep-Oct)

Bottom Line: Both were treated successfully with topical tacrolimus 0.1% ointment.Overall, response to several therapeutic modalities including clofazimine and dapsone therapy is said to vary from complete failure to variable or inconsistent.Topical tarolimus provides an effective and safe alternative therapeutic option in erythema dyschromicum perstans.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India.

ABSTRACT

Background: Erythema dyschromicum perstans, a rare dermatosis of obscure etiopathogenesis and significant cosmetic morbidity, have no satisfactory treatment.

Observations: Two patients with having characteristic asymptomatic and slowly progressive, slate-grey macular lesions with distinct red borders involving the face, neck, upper trunk and limbs were diagnosed clinicopathologically as erythema dyschromicum perstans. Both were treated successfully with topical tacrolimus 0.1% ointment.

Conclusions: Overall, response to several therapeutic modalities including clofazimine and dapsone therapy is said to vary from complete failure to variable or inconsistent. Topical tarolimus provides an effective and safe alternative therapeutic option in erythema dyschromicum perstans.

No MeSH data available.


Related in: MedlinePlus

Case-1 (a and b) Multiple, variable sized, round to oval, bluish-grey macules with distinct minimally elevated red borders over neck and upper chest. (c and d) Moderate compact focal hyperkeratosis, epidermal thinning, basal cell degeneration, intense melanin incontinence and lymphohistiocytic infiltrate in the upper dermis (stain, H and E; C ×10, D ×40)
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Figure 1: Case-1 (a and b) Multiple, variable sized, round to oval, bluish-grey macules with distinct minimally elevated red borders over neck and upper chest. (c and d) Moderate compact focal hyperkeratosis, epidermal thinning, basal cell degeneration, intense melanin incontinence and lymphohistiocytic infiltrate in the upper dermis (stain, H and E; C ×10, D ×40)

Mentions: A 29-year-old man presented with numerous asymptomatic slate-grey macules over face, neck, upper trunk and extremities of 6 months duration. The lesions had started over right side of neck and new lesions appeared gradually to involve other body areas. He was an agriculturist and had no history of handling of chemicals or drug intake before or after noticing the skin lesions. His family and medical history was unremarkable. Physical examination showed multiple, round to oval, 0.5–5 cm sized bluish-grey-colored macules over cheeks, chin, neck, upper chest and back, abdomen, and both upper limbs. The lesions around neck showed distinct minimally elevated erythematous borders [Figure 1a and b]. Hair, nails, teeth, palms, soles, mucous surfaces and systemic examination were essentially normal. Laboratory work up including complete hemogram, blood biochemistry, urinalysis, and stool examination for intestinal parasites showed no abnormality. A biopsy specimen showed focal changes of moderate compact hyperkeratosis, epidermal thinning, basal cell degeneration, melanin incontinence, lymphohistiocytic infiltrate in the upper dermis and no colloid bodies [Figure 1c and d]. With the diagnosis of EDP he was prescribed topical tacrolimus ointment (0.1%) to be applied twice daily. No concurrent treatment was prescribed. All the skin lesions disappeared during next 3 months and no recurrence has been observed during follow up of more than a year.


Erythema Dyschromicum Perstans: Response to Topical Tacrolimus.

Mahajan VK, Chauhan PS, Mehta KS, Sharma AL - Indian J Dermatol (2015 Sep-Oct)

Case-1 (a and b) Multiple, variable sized, round to oval, bluish-grey macules with distinct minimally elevated red borders over neck and upper chest. (c and d) Moderate compact focal hyperkeratosis, epidermal thinning, basal cell degeneration, intense melanin incontinence and lymphohistiocytic infiltrate in the upper dermis (stain, H and E; C ×10, D ×40)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4601471&req=5

Figure 1: Case-1 (a and b) Multiple, variable sized, round to oval, bluish-grey macules with distinct minimally elevated red borders over neck and upper chest. (c and d) Moderate compact focal hyperkeratosis, epidermal thinning, basal cell degeneration, intense melanin incontinence and lymphohistiocytic infiltrate in the upper dermis (stain, H and E; C ×10, D ×40)
Mentions: A 29-year-old man presented with numerous asymptomatic slate-grey macules over face, neck, upper trunk and extremities of 6 months duration. The lesions had started over right side of neck and new lesions appeared gradually to involve other body areas. He was an agriculturist and had no history of handling of chemicals or drug intake before or after noticing the skin lesions. His family and medical history was unremarkable. Physical examination showed multiple, round to oval, 0.5–5 cm sized bluish-grey-colored macules over cheeks, chin, neck, upper chest and back, abdomen, and both upper limbs. The lesions around neck showed distinct minimally elevated erythematous borders [Figure 1a and b]. Hair, nails, teeth, palms, soles, mucous surfaces and systemic examination were essentially normal. Laboratory work up including complete hemogram, blood biochemistry, urinalysis, and stool examination for intestinal parasites showed no abnormality. A biopsy specimen showed focal changes of moderate compact hyperkeratosis, epidermal thinning, basal cell degeneration, melanin incontinence, lymphohistiocytic infiltrate in the upper dermis and no colloid bodies [Figure 1c and d]. With the diagnosis of EDP he was prescribed topical tacrolimus ointment (0.1%) to be applied twice daily. No concurrent treatment was prescribed. All the skin lesions disappeared during next 3 months and no recurrence has been observed during follow up of more than a year.

Bottom Line: Both were treated successfully with topical tacrolimus 0.1% ointment.Overall, response to several therapeutic modalities including clofazimine and dapsone therapy is said to vary from complete failure to variable or inconsistent.Topical tarolimus provides an effective and safe alternative therapeutic option in erythema dyschromicum perstans.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra, Tanda, Himachal Pradesh, India.

ABSTRACT

Background: Erythema dyschromicum perstans, a rare dermatosis of obscure etiopathogenesis and significant cosmetic morbidity, have no satisfactory treatment.

Observations: Two patients with having characteristic asymptomatic and slowly progressive, slate-grey macular lesions with distinct red borders involving the face, neck, upper trunk and limbs were diagnosed clinicopathologically as erythema dyschromicum perstans. Both were treated successfully with topical tacrolimus 0.1% ointment.

Conclusions: Overall, response to several therapeutic modalities including clofazimine and dapsone therapy is said to vary from complete failure to variable or inconsistent. Topical tarolimus provides an effective and safe alternative therapeutic option in erythema dyschromicum perstans.

No MeSH data available.


Related in: MedlinePlus