Dermoscopic Findings in Laugier-Hunziker Syndrome

Abstract

Background: Laugier-Hunziker syndrome (LHS) is a rare, acquired mucocutaneous hyperpigmentation often associated with longitudinal melanonychia. The clinical behavior of mucocutaneous pigmented lesions ranges from benign to highly malignant. Therefore, in most cases, the clinical diagnosis should be confirmed by further diagnostic methods. Dermoscopy is a noninvasive technique that has been used to make more accurate diagnoses of pigmented skin lesions. Nevertheless, to our knowledge, the dermoscopic features of the pigmented lesions in LHS have not been described previously. Herein, we report a case of LHS together with its dermoscopic features.

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“…1 This original concept of this acquired pigmentary disorder was later modified to idiopathic lenticular mucocutaneous pigmentation after the condition was detected in other areas where a similar histology was found. 2,3 The etiopathogenesis of this condition is unknown, although different theories have been proposed to explain the mechanism behind the melanocytic dysfunction.…”

“…1,[5][6][7] Diagnosis is clinical and was reached following the exclusion of all other causes of mucocutaneous hyperpigmentation commonly associated with longitudinal melanonychia. 1 The pathology of this condition consists of hyperpigmentation of the basal layer, an increase in melanophages and the presence of pigmentary incontinence in the papillary dermis, with no hyperproliferation or melanocytic atypia. 2,6,7 The disorder is more evident in the areas most affected.…”

“…2 Various conditions should be included in the differential diagnosis of mucocutaneous pigmentary disorders such as the following syndromes: McCune-Albright, LEOPARD, Addison, LAMB, Gardner, Cronkhite-Canada, neurofibromatosis and Peutz-Jeghers, as well as racial pigmentation, which is a benign disorder and the principal cause of longitudinal melanonychia. 1,6,7,8 Nail disorders may be caused by fungi such as Scytalidium dimidiatum, Fusarium spp, Wangiella dermatitidis, Exophiala dermatitidis, Scopulariopsis brevicaulis, Aspergillus niger, Alternaria sp, Penicillium sp and Acremonium sp; however, nail disorders have also been reported to have been caused by the Trichophyton rubrum dermatophyte and by yeasts (Candida spp). 8 Melanonychia may also be a consequence of the use of certain drugs, principally tetracycline, minocycline, antimalarials, phenothiazines and chemotherapeutic agents.…”

“…These conditions are easily excluded by associated clinical findings and supplementary tests. 1,2,5,7,9 Hutchinson's sign is always present in the case of subungual melanomas; however, it may be present in Peutz-Jeghers and Laugier-Hunziker syndromes, subungual hematoma, racial pigmentation and AIDS, in association with the use of certain drugs such as minocycline and zidovudine, and in Bowen's disease. 9,10 No treatment is required, since the condition is not associated with systemic diseases or complications.…”

“…9,10 No treatment is required, since the condition is not associated with systemic diseases or complications. 1,3,4,9 There have been no reports of malignant degeneration. 6 From a cosmetic point of view, laser therapy may be useful.…”