Idiopathic eruptive macular pigmentation associated with pregnancy and Hashimoto thyroiditis

Milobratović, Danica; Djordjević, Sanja; Vukičević, Jelica; Bogdanovic, Zoran

doi:10.1016/j.jaad.2005.01.008

Cited by 18 publications

(26 citation statements)

References 5 publications

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“…While majority of the cases have been reported in children and adolescents, it has also been reported in a 31-year-old female. [2] Criteria have been established for diagnosis of IEMP,[3] namely: (a) eruption of brownish, non-confluent, asymptomatic macules involving the trunk, neck and proximal extremities in children and adolescents (b) absence of preceding inflammatory lesions (c) no previous drug exposure (d) basal layer hyperpigmentation of the epidermis and prominent dermal melanophages without visible basal layer damage or lichenoid inflammatory infiltrate (e) normal mast cell count. Our cases fulfilled all these criteria for diagnosis of the entity.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic eruptive macular pigmentation: Report on two cases

Grover

Basu

2010

Indian J Dermatol

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Section: Discussionmentioning

confidence: 99%

Idiopathic eruptive macular pigmentation: Report on two cases

Grover

Basu

2010

Indian J Dermatol

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“…[4,5] Though most cases have been reported in the young; it has also been reported in a 31-year-old female. [6] A study by Sanz de Galdeano et al [7] gave the criteria for diagnosis in 1996, namely: (a) Eruption of brownish, non-confluent, asymptomatic macules involving the trunk, neck and proximal extremities in children and adolescents (b) absence of preceding inflammatory lesions (c) no previous drug exposure (d) basal layer hyperpigmentation of the epidermis and prominent dermal melanophages without visible basal layer damage or lichenoid inflammatory infiltrate (e) normal mast cell count. The present case fulfilled all the above mentioned criteria and very few cases of similar nature have been reported [2,8] among Indians.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic eruptive macular pigmentation

Begum¹,

Ramachandra²,

Kumar³

2014

Indian J Paediatr Dermatol

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physical and systemic examination was unremarkable. Cutaneous examination revealed multiple brownish gray to dark, discrete, round to oval macules [ Figures 1 and 2]. The lesions on the lower abdomen had a velvety texture [ Figure 3 and 4]. Palms and soles were spared. The size varied from 0.5 cm to 3 cm. Darier's sign was negative. The mucosae, hair and nails were normal. Hematological investigations were normal. Biopsy showed moderate irregular acanthosis, slight papillomatosis [ Figure 5 and 6] and basal layer hyperpigmentation [ Figure 7 and 8]. The upper dermis showed sparse superficial lymphohistiocytic infiltrate. Few melanophages were seen in the papillary dermis. The mast cell number was normal. The final diagnosis was IEMP. No specific treatment was given.An unusual case of a 24-year-old woman lasting 21 years was characterized by several periods of spontaneous resolution followed by recurrences. [3] This case is reported for its rarity with an objective to increase its awareness among dermatologists, pathologists and pediatricians. A misdiagnosis can lead to unnecessary, sometimes dangerous management of a clinical entity which otherwise regresses spontaneously. ABSTRACTIdiopathic eruptive macular pigmentation (IEMP) is an uncommon, rather under-reported disease entity of the pediatric age characterized by asymptomatic, brownish hyperpigmented macules involving the neck and trunk with no preceding inflammation or exposure to drug. Here we report this case to increase awareness of this entity among dermatologists, dermatopathologists and pediatricians. A 11-year-old healthy boy presented with brownish-gray to dark, discrete, asymptomatic macules on the face, trunk, neck and limbs of insidious onset. Histopathologic examination showed melanophages, mild perivascular lymphohistiocytic infiltrate in the papillary dermis and papillomatosis. The natural course of the disease is spontaneous remission without treatment, which was so even in our patient. IEMP is a benign entity with an excellent prognosis as it exhibits spontaneous resolution. It falls into the differential diagnoses of asymptomatic hyperpigmentatory disorders in pediatric population. Awareness of the entity leads to avoidance of unnecessary aggressive damaging treatment.

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“…Recently, association with pregnancy and Hashimoto thyroiditis has been reported suggesting the role of hormonal factors and autoimmunity in the etiopathogenesis of IEMP 9 . In our patient, hormonal imbalance due to sudden weight loss could be considered as a possible cause.…”

Section: Case Reportmentioning

confidence: 99%

“…In our patient, hormonal imbalance due to sudden weight loss could be considered as a possible cause. This could be explained by the fact that hormonal changes had sensitized melanocytes and eventually caused hyperpigmentation 9,10 . However, the specific reason why the pigmentations were limited to the flexural areas is unknown.…”

Section: Case Reportmentioning

confidence: 99%