Universal acquired melanosis. The carbon baby

Abstract

A Mexican child was born white and progressively became black. At the age of 21 months, the whole integument was deep black in the absence of other alterations. Electron microscopy showed a Negroid pattern in the epidermal melanosomes. Among the different forms of progressive mucocutaneous pigmentations previously described in the literature, we were unable to find a similar case.

Acquired Universal Melanosis (Carbon Baby Syndrome)

“…Histopathologically AUM is characterized by basal and suprabasal melanization of the epidermis and the presence of melanophages in the dermis. The presence of melanin in the stratum corneum has also been described, but rarely . Our patient had orthokeratotic hyperkeratosis in addition to the above‐mentioned features.…”

“…A few other similar conditions have also been described in the literature with different terminologies, such as familial progressive hyperpigmentation, melanosis universalis hereditaria, diffuse congenital melanosis, progressive hyperpigmentation, generalized lentiginosis, and dyschromatosis universalis hereditaria.…”

“…Ruiz‐Maldonado et al coined the term “carbon baby” to describe a distinctive variant of progressive hyperpigmentation in a child. The etiopathogenesis of AUM remains elusive, but an abnormal sensitivity of melanocytes to normal or abnormal endocrine or neural stimuli due to a genetic mutation could be a possibility .…”

Familial Progressive Hyperpigmentation: A Case Report

“…Histologically, biopsy from the involved site shows a significant increase in melanin throughout the epithelium including being more pronounced in the basal layer. Epithelial melanocytes are normal in size and number, a finding that has been confirmed by DOPA stains [3, 7]. However, the connective tissue remains unaffected.…”

A pilot study evaluating therapeutic response of different dosage of oral glucocorticoid in two children with familial glucocorticoid deficiency presenting with diffuse mucocutaneous hyperpigmentation

“…Dyschromatosis symmetrica hereditaria, congenital diffuse melanosis,[9] familial progressive hyperpigmentation,[10] and erythema dyschromicum perstans and carbon baby syndrome are important conditions that develop pigmentation very early in life. Carbon baby syndrome[11] is a diagnosis by exclusion for diffuse generalized pigmentation and has no systemic abnormality. Bronze baby syndrome[12] occurs among neonate with hepatic dysfunction and undergoing phototherapy.…”