Salt-and-pepper appearance: A cutaneous clue for the diagnosis of systemic sclerosis

Association of skin hyperpigmentation disorders with digital ulcers in systemic sclerosis: Analysis of a cohort of 239 patients

“…6 Several patterns of skin pigmentation disorders have been described so far. [7][8][9][10][11][12][13][14][15][16] The 3 most frequently described types are vitiligo-like depigmentation with perifollicular hyperpigmentation (also called salt-and-pepper skin), 7,12,15 diffuse hyperpigmentation with accentuation in sun-exposed areas, 4,5,16 and combined hyperpigmentation and hypopigmentation localized in the areas of sclerosis.…”

Clinical utility of hypo- and hyperpigmentation of skin in diffuse cutaneous systemic sclerosis

“…Temperature, genetics, hormonal and other physical factors may influence pigment formation and retention . Commonly involved sites are the retroauricular area, scalp, forehead, neck and dorsum of the fingertips as well as over the clavicles, suprascapular region and the extensor surface of the forearm as seen in most of our patients, with few exceptional ones over the back.…”

Appearances in clinical dermatology

“…[86,87] Occasionally, it may be the sole skin manifestation. [88] Salt and pepper appearance may also be seen as a feature of quadrichrome vitiligo which is characterized by depigmented and hypopigmented macules in addition to normally pigmented skin with the additional presence of marginal or perifollicular hyperpigmentation. This is observed, particularly in areas of repigmentation in lesions of vitiligo [89] [ Figure 16].…”