Patch testing and Histopathology in Thai patients with hyperpigmentation due to Erythema dyschromicum perstans, Lichen planus pigmentosus, and Pigmented contact dermatitis

Tienthavorn, Tanongkiet; Tresukosol, Poohglin; Sudtikoonaseth, Poonnawis

doi:10.12932/ap0376.32.2.2013

Cited by 24 publications

(31 citation statements)

References 16 publications

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“…7 Overall, the usage of hair dyes is increasing throughout the world. [29][30][31][32] A prior Indian study also found PPD to be the most common antigen in these patients, 31 and it is plausible that our patients (majority of whom had constitutional phototype III-V) represent the inherent susceptibility of an ethnic population to develop dermal hyperpigmentation instead of frank eczematous dermatitis after sensitization to hair colours. 27,28 Though we identified PPD and hair colours as the predominant contact sensitizers amongst our patient population having dermal hyperpigmentation, the type of antigens can vary depending upon the skin phototype, geographical localization and cultural practices of the studied population.…”

Section: Discussionmentioning

confidence: 52%

Contact sensitization to hair colours in acquired dermal macular hyperpigmentation: results from a patch and photo‐patch test study of 108 patients

Bishnoi

Vinay

Arshdeep

et al. 2019

Acad Dermatol Venereol

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Background Acquired dermal macular hyperpigmentation (ADMH) is an umbrella term including lichen planus pigmentosus, erythema dyschromicum perstans and pigmented contact/cosmetic dermatitis. Objective To establish contact sensitization to hair colours as an aetiological factor for ADMH. Methods Detailed clinical examination, skin biopsies, and patch and photo‐patch testing with Indian standard series and patient's own cosmetic products were performed. Results Thirty‐nine (36.1%) patients were found to demonstrate a positive patch/photo‐patch test with 35/39 reacting to their own products (all were hair colours) and 16/39 reacting to antigens from commercial series (commonly paraphenylenediamine). Fourteen patients developed delayed hyperpigmentation on positive patch‐test sites at 1 month. Higher mean age, symptomatic pigmentation (pruritus, burning and photosensitivity), hair margins involvement (outer surface, helix and lobule of ear; temples and preauricular area), ill‐defined lesions, epidermal atrophy and epidermal melanization extending >3 layers were significantly common in patch‐test‐positive patients. Well‐defined lesions, perioral involvement and associated lichen planus were clinical pointers towards patch‐test negativity. Conclusion Index study exemplifies that patch‐test results have distinct clinical and histopathological correlates in ADMH. Hair dye contact sensitization appears to be an important aetiological factor in about one‐third patients presenting with ADMH.

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Section: Discussionmentioning

confidence: 52%

Contact sensitization to hair colours in acquired dermal macular hyperpigmentation: results from a patch and photo‐patch test study of 108 patients

Bishnoi

Vinay

Arshdeep

et al. 2019

Acad Dermatol Venereol

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“…LPP: Avoid mustard oil, amla oil, henna, hair dyes, cold cream, products with nickel or nickel‐containing food, cosmetics suspected as contactants, and sun exposure …”

Section: Treatmentmentioning

confidence: 99%

“…1,16 Patch tests have proved positive mainly for nickel, although this is also common in nonaffected individuals. 17,18 LPP often presents in women around the time of menopause, suggesting a possible influence of hormonal factors on pathogenesis. [1][2][3] Clinical presentation LPP mainly affects the face and neck ( Fig.…”

Section: And Langerhansmentioning

confidence: 99%

Lichen planus pigmentosus and its variants: review and update

Robles-Méndez¹,

Rizo-Frías²,

et al. 2017

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Lichen planus pigmentosus (LPP) is considered a rare variant of lichen planus (LP). It is characterized by acquired dark brown to gray macular pigmentation located on sun-exposed areas of the face, neck, and flexures, commonly found in dark-skinned patients. In patients with LPP, an inflammatory lichenoid response results in marked pigmentary incontinence. It has been associated with hepatitis C virus, sun exposure, and contactants such as mustard oil and nickel. LPP-inversus affects fair and dark skin, predominantly involving flexural and intertriginous areas, while sun-exposed areas are spared; friction is an associated trigger. LPP along Blaschko's lines has been associated with susceptibility to genetic mosaicisms. LPP can present concomitantly with other variants of LP such as frontal fibrosing alopecia, as well as endocrinopathies, and autoimmune diseases. Treatment is difficult and consists of avoidance of triggers and topical and systemic medications in order to stop the inflammatory reaction and reduce pigmentation, improving aesthetic appearance and quality of life.

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“…The diagnosis of mercury‐induced LPP in our patient was suggested by a positive patch test to mercury, exclusion of other triggering factors for LPP and clinical improvement after amalgam removal. Recently, contact sensitization has been reported to rarely be associated with LP and its variants . Para‐phenylenediamine, commercial hair dyes, and nickel are the most common allergens in association with LPP .…”

Section: Discussionmentioning

confidence: 99%

“…Recently, contact sensitization has been reported to rarely be associated with LP and its variants . Para‐phenylenediamine, commercial hair dyes, and nickel are the most common allergens in association with LPP . However, mercury hypersensitivity has not been described in association with LPP, and all the cases of contact‐allergen‐induced LPP have been described among adults.…”

Section: Discussionmentioning

confidence: 99%

Pediatric lichen planus pigmentosus possibly triggered by mercury dental amalgams

Belhareth

Korbi

Belhadjali

et al. 2019

Pediatric Dermatology

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Lichen planus pigmentosus is uncommon in childhood and its treatment is often challenging. We report a case of cutaneous lichen planus pigmentosus in a 10‐year‐old boy, without oral mucosal involvement, two months after an amalgam dental restoration. The diagnosis was based on the histopathological examination of a skin biopsy, the positive patch test to mercury, and the improvement after amalgam removal. Our case report suggests that metal allergy may play a role, and amalgam replacement may be followed by clinical improvement.

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Patch testing and Histopathology in Thai patients with hyperpigmentation due to Erythema dyschromicum perstans, Lichen planus pigmentosus, and Pigmented contact dermatitis

Cited by 24 publications

References 16 publications

Contact sensitization to hair colours in acquired dermal macular hyperpigmentation: results from a patch and photo‐patch test study of 108 patients

Contact sensitization to hair colours in acquired dermal macular hyperpigmentation: results from a patch and photo‐patch test study of 108 patients

Lichen planus pigmentosus and its variants: review and update

Pediatric lichen planus pigmentosus possibly triggered by mercury dental amalgams

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