Erythema Dyschromicum Perstans/Ashy Dermatosis

Abstract

Eight patients with erythema dyschromicum perstans (ashy dermatosis) are described. The characteristic ashy macules occurred mainly on the trunk and limbs. The condition did not appear to be associated with infection or drug ingestion. Seven patients had preceding erythema before onset of ashy macules; three had urticarial eruptions associated with the early erythema. Biopsy consistently showed mild, superficial, perivascular mononuclear cell infiltration and abundant melanophages in all the patients. In five, vascuolar degeneration of the basal epidermal cells was evident. There was no evidence to suggest that the condition was associated with lichen planus. The dermatosis appeared to run a prolonged course.

Erythema Dyschromicum Perstans in Prepubertal Children

“…Most adult patients with EDP have been of Hispanic descent, although Caucasian patients have been described from Europe (4,6–11), Scandinavia (2,12,13) and the United States (14–29). African American (15,19–21,23,26), Asian (3,9,27,28), and Indian (27,29) patients have also been described. Prepubertal children with EDP are more likely to be Caucasian than Hispanic.…”

“…Increased expression of intercellular adhesion molecule (ICAM)‐1 and HLA‐DR (28) has been demonstrated in the basal cell layer of lesional skin samples. Papillary dermal edema and pigmentary incontinence with numerous dermal melanophages are also characteristic histologic features (27,32,35,36). Immunofluorescent deposits are seen inconsistently, and may be absent (32), but may appear as colloid or cytoid bodies with IgM (3,4,18–20), IgG (14,19,28), IgA (22), C3 (4,22), fibrinogen (22), or C4 (18).…”

Erythema Dyschromicum Perstans: Report of a New Case and Critical Review of the Literature

“…The dermatosis is ubiquitous, affecting all ethnic groups and appearing mainly (40/50 evaluated cases) before the age of 30 years. The lesions are asymptomatic and rarely pruritic (34,38,51). The pigmented macules appear spontaneously; they typically have an ashy colour but show various hues from grey-brown or blue-grey to black-grey (59).…”

“…The pigmented macules appear spontaneously; they typically have an ashy colour but show various hues from grey-brown or blue-grey to black-grey (59). They measure 0.5-2 cm and have a sharply-limited, flat border; they may rarely be preceded by an erythematous macule (44) or temporarily surrounded by an ery thematous, flat (9,42,51,55,58,63) or slightly papular but non-extensive border (27-29, 61, 65). Fully-developed lesions con sist of a constellation of oval-shaped, occa sionally confluent, macules.…”

“…The palms, soles, scalp and mucous membranes are spared. Once developed, the dermatosis is stable but may disappear spontaneously (38,50) or subside within two to three years (27,51,58). Distinctly different clinical forms have been described on the basis of varying hues or particular location of skin lesion.…”