Type B pigmentary demarcation lines in a Chinese amenorrheic woman

Abstract

A 51‐year‐old Chinese woman (phototype III) presented to our dermatology clinic with a 3‐month history of asymptomatic pigmented maculae on the lower limbs that developed in the 11th month of amenorrhea. She had noticed no other areas of pigmentary change and denied any inflammatory episode or topical medication before their development. No personal or family history of hormonal imbalance or pigmentary demarcation lines (PDLs) was found. Physical examination revealed broad, band‐like pigmentation symmetrically distributed all over the flexor aspects of the lower limbs (Fig. 1). The medial borders of the pigmented areas were sharply demarcated, but the lateral borders merged imperceptibly into the normal skin. The patient was otherwise healthy. Laboratory examination, including full blood count, liver tests, triiodothyronine (T3), thyroxine (T4), and thyrotropic‐stimulating hormone (TSH), were normal. Hormonal investigations (Table 1) were within normal limits, except that estradiol (E2) was sharply decreased and follicle‐stimulating hormone (FSH) was highly elevated. Ultrasonic B‐mode examination showed a normal uterus and ovaries. No treatment was applied to the lesions. At a follow‐up visit, 16 months after onset, the pigmentary lines had resolved spontaneously. Moreover, the titers of hormones in serum had moved closer to normal values (Table 1). 1 Pigmentary demarcation lines on the buttocks and flexor aspect of the legs. The outer part is darker Hormone investigations on the serum of our patient with pigmentary demarcation lines (PDLs) 3 months after onset 16 months after onset Normal results Abnormal results Normal results Abnormal results 1. Prolactin1. Estradiol, 12.9 pmol/L Normal, 40.0–100 pmol/L1. Prolactin1. Estradiol, 36.46 pmol/L Normal, 40.0–100 pmol/L2. Luteotropic hormone2. Follicle‐stimulating hormone, 94.3 U/L Normal, 1.5–33.4 U/L2. Luteotropic hormone2. Follicle‐stimulating hormone, 53.2 U/L Normal, 1.5–33.4 U/L3. Progestone3. Progestone4. Total testosterone4. Total testosterone5. Free triiodothyronine5. Free triiodothyronine6. Free thyroxine6. Free thyroxine7. Thyroid‐stimulating hormone7. Thyroid‐stimulating hormone

Clinical and hormonal evaluation in facial pigmentary demarcation lines: A pilot study

“…However, a single case report of amenorrheic Chinese woman documents low estradiol and FSH with type B PDL. [4] It is difficult to correlate the abnormal hormonal profile with pathogenesis of facial PDL in this study as one does not know if abnormal hormonal levels preceded the onset of PDL. The heterogeneous nature of hormonal levels further complicates the interpretation.…”

Coexistence of pigmentary demarcation lines types C and E in one subject

“…Ma et al. reported a Chinese amenorrheic woman with type B lines 11 . Our patient is a Chinese girl of normal intelligence and development and without remarkable medical history.…”

“…9,10 Ma et al reported a Chinese amenorrheic woman with type B lines. 11 Our patient is a Chinese girl of normal intelligence and development and without remarkable medical history. Lesions such as those on our subject may sometimes be misdiagnosed as vitiligo, depigmented nevi, or ash-leaf maculae of tuberous sclerosis.…”

Type B Pigmentary Demarcation Lines of Pregnancy Involving the Anterior Thighs and Knees

“…The role of hormonal alterations in PDLs is further supported by the report of a nonpregnant woman with type B PDLs, receiving long-term estrogenic medication6. An amenorrheic woman with type B PDLs and decreased titers of estradiol and elevated levels of follicle-stimulating hormone has also been reported7. In the latter case, the hormonal changes were different from the changes in sex hormones during pregnancy.…”