Dermoscopy in one case showed hypopigmented macules having feathery margins. 4 Histopathology revealed a reduced number of melanocytes and melanin pigment in most cases, but one report showed a normal number of melanocytes with macromelanosomes. 5 ASH has been compared with other reticular pigmentary disorders such as Dowling-Degos disease, acropigmentation of Kitamura, acropigmentation of Dohi. Unlike those, macules of ASH are more prominent on margins between dorsal and ventral surfaces of hands and feet, with normal intervening skin.Acral vitiligo can be a differential diagnosis of this condition, but non-progressive lesions in unilateral distribution, unresponsive to treatment in our case, does not favor the diagnosis.Confetti vitiligo presents as speckled depigmented macules of size 1-5 mm. They are usually seen around pre-existing vitiligo patches and are hallmark of rapidly progressing vitiligo. 7 Clinical, dermoscopic, and histological comparison of all differentials are described in Table 1.Previous reports have included ASH in reticular pigmentary disorders. Familial nature of this condition cannot be ascertained as only two reports had a family history. Our case stands apart as the girl has unilateral involvement with family history of vitiligo vulgaris.The etiology of this condition remains elusive. Further reports and genetic workup of speckled hypopigmentation cases may help to unravel the mystery of cause and course of this condition.
Penile annular secondary syphilis mimicking annular lichen planusDear Editor, Annular secondary syphilis is caused by Treponema Pallidum, which rarely occurs in the genital region. 1 We herein describe a case of annular secondary syphilis mimicking annular lichen planus with nonspecific location and histologic hallmarks.A 32-year-old Vietnamese male visited our hospital with annular lesions on the penile shaft. He had a history of oralgenital contact with an anonymous male 3 months prior to presentation. He denied any personal history of sexually transmitted diseases. Physical examination revealed annular erythematous plaques with well-defined, scaly borders on the
Sir, Annular lichen planus is an uncommonly reported variant of lichen planus, especially on the penis [1]. Herein, we report a case of penile annular lichen planus induced by artificial pearls. A 42-year-old, circumcised male presented to our hospital with asymptomatic, annular lesions of the glans penis. Around one month prior to presentation, he reported a history of inserting artificial pearls inside his penis by stainless steel. He denied a history of drug intake or a personal history of hepatitis C. A physical examination revealed multiple, reddish-purple, annular plaques with central atrophy on the glans penis (Fig. 1a). Inguinal lymph nodes and other mucocutaneous lesions were absent.
reaction and release of fibroblast growth factors. Rarely, particles from dental implants may cause a similar reaction. 4 To the best of our knowledge, only one similar case of cutaneous metallosis was published, until now, describing multiple cutaneous nodules with lymphedema, subsequently attributed to metal debris reaction after orthopedic surgery. 2 Herein, we describe, for the first time in the literature, an intriguing case of the darkly pigmented subcutaneous nodule due to metallosis which was histopathologically misdiagnosed as a melanoma metastasis. However, a detailed history from the patient warranted revision of histopathological analysis which surprisingly revealed a completely benign condition called metallosis.
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