2023, Number 05
Acquired dermal macular hyperpigmentation: an update on terminology, diagnosis and management
Language: Spanish
References: 17
Page:
PDF size: 445.34 Kb.
ABSTRACT
Lichen planus pigmentosum, erythema dyschromicum perstans/ashy dermatosis, and pigmented contact dermatitis (also known as Riehl's melanosis or pigmented cosmetic dermatitis), are acquired disorders of skin hyperpigmentation of uncertain etiology that have shown considerable clinical-pathological and dermoscopic overlap. Consequently, the nosology of these conditions has been under debate, and to simplify their study, experts have suggested a unifying term that includes all these dermatoses. Thus, different denominations have been proposed; however, the generic term “acquired dermal macular hyperpigmentation” (ADMH), presented in 2017 by the Pigmentary Disorders Society of India, seems to be the most accepted to date. ADMH describes disorders clinically characterized by small and large, usually asymptomatic, greyish-brown hyperpigmented macules/patches; that histopathologically show current or resolved interface dermatitis and pigmentary incontinence, without any signs of previous inflammation. This is a complex condition to treat due to the dermal location of the pigment deposit, and there are minimal data on effective treatments. Progress has been achieved in key aspects of epidemiology, pathogenesis, histology, and dermoscopy of ADMH, and even a scale to assess the severity of the disease has been validated; however, a global consensus has not yet been established on the nomenclature and the entities that should be considered under the spectrum of ADMH, and more studies are needed to explore effective therapies for its management.REFERENCES
Sarkar R, Vinay K, Bishnoi A, Poojary S, Gupta M, Kumaran MS, Jain A, Gurumurthy C, Arora P, Kandhari R, Rathi S, Zawar V, Gupta V, Ravivarma VN, Rodrigues M, Parsad D. A Delphi consensus on the nomenclature and diagnosis of lichen planus pigmentosus and related entities. Indian J Dermatol Venereol Leprol [Internet]. 2023 [citado el 13 de febrero, 2023]; 89(1):41-46. doi: 10.25259/IJDVL_804_2021. PMID: 35593293. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35593293/
Kumarasinghe SPW, Pandya A, Chandran V, Rodrigues M, Dlova NC, Kang HY, Ramam M, Dayrit JF, Goh BK, Parsad D. A global consensus statement on ashy dermatosis, erythema dyschromicum perstans, lichen planus pigmentosus, idiopathic eruptive macular pigmentation, and Riehl's melanosis. Int J Dermatol [Internet]. 2019 [citado el 13 de febrero, 2023];58(3):263-272. doi: 10.1111/ijd.14189. Epub 2018 Sep 3. PMID: 30176055. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30176055/
Wang RF, Ko D, Friedman BJ, Lim HW, Mohammad TF. Disorders of hyperpigmentation. Part I. Pathogenesis and clinical features of common pigmentary disorders. J Am Acad Dermatol [Internet]. 2023 [citado el 13 de febrero, 2023];88(2):271-288. doi: 10.1016/j.jaad.2022.01.051. Epub 2022 Feb 11. PMID: 35151757. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0190962222002511
Vinay K, Bishnoi A, Kamat D, Chatterjee D, Kumaran MS, Parsad D. Acquired Dermal Macular Hyperpigmentation: An Update. Indian Dermatol Online J [Internet]. 2021 [citado el 13 de febrero, 2023];12(5):663-673. DOI: 10.4103/idoj.IDOJ_881_20. PMID: 34667751; PMCID: PMC8456249. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34667751/
Kumaran MS, Dabas G, Vinay K, Parsad D. Reliability assessment and validation of the dermal pigmentation area and severity index: a new scoring method for acquired dermal macular hyperpigmentation. J Eur Acad Dermatol Venereol [Internet]. 2019 [citado el 13 de febrero, 2023]; 33(7):1386-1392. DOI: 10.1111/jdv.15516. Epub 2019 Apr 15. PMID: 30801771. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30801771/
Ahmed WA, Badirah SB, Abdulwahab RA, Al Hawsawi K. Acquired Dermal Macular Hyperpigmentation Mimicking Dowling Degos Disease: A Case Report. Cureus [Internet]. 2022 [citado el 13 de febrero, 2023];14(8):e28150. DOI: 10.7759/cureus.28150. PMID: 36148207; PMCID: PMC9482672. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36148207/
Bishnoi A, Vinay K, Kumaran SM, Parsad D. Everything is in the name: Macular hyperpigmentation of uncertain etiology or acquired dermal macular hyperpigmentation of varied etiologies? Indian J Dermatol Venereol Leprol [Internet]. 2019 [citado el 13 de febrero, 2023];85(1):85-87. DOI: 10.4103/ijdvl.IJDVL_373_18. PMID: 30460929. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30460929/
10.Sasidharanpillai S, Govindan A, Ajithkumar KY, Mahadevan ST, Bindu V, Khader A, Sathi PP. Histological Evaluation of Acquired Dermal Macular Hyperpigmentation. Indian Dermatol Online J [Internet]. 2019 [citado el 13 de febrero, 2023];10(5):542-546. DOI: 10.4103/idoj.IDOJ_426_18. PMID: 31544073; PMCID: PMC6743398. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31544073/
Rodrigues M, Pandya AG, Bekkenk M, Parsad D, Kumarasinghe SP. Current understanding lichen planus pigmentosus, erythema dyschromicum perstans (ashy dermatosis), and idiopathic eruptive macular pigmentation. Pigment Int [Internet]. 2019 [citado el 13 de febrero, 2023];6(1):4-8. DOI: 10.4103/Pigmentinternational.Pigmentinternational_18_18. Disponible en: https://www.pigmentinternational.com/
Razmi TM, Thakur V, Vinay K, Aggarwal D, Radotra BD, Kumaran MS, Parsad D. Periorbital Acquired Dermal Macular Hyperpigmentation: A Distinctive Clinical Entity in Young Adults-Observational Case-Control Study. Indian Dermatol Online J [Internet]. 2020 [citado el 13 de febrero, 2023];11(4):590-593. DOI: 10.4103/idoj.IDOJ_415_19. PMID: 32832448; PMCID: PMC7413451. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32832448/
Krueger L, Saizan A, Stein JA, Elbuluk N. Dermoscopy of acquired pigmentary disorders: a comprehensive review. Int J Dermatol [Internet]. 2022 [citado el 13 de febrero, 2023];61(1):7-19. DOI: 10.1111/ijd.15741. Epub 2021 Jul 7. PMID: 34235719. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34235719/
Tsentemeidou A, Vakirlis E, Sideris N, Bobos M, Panagopoulou A, Ioannides D, Sotiriou E. Extensive acquired macular hyperpigmentation in a teenager. Clin Exp Dermatol [Internet]. 2022 [citado el 13 de febrero, 2023];47(10):1882-1885. DOI: 10.1111/ced.15284. Epub 2022 Jul 16. PMID: 35841289. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35841289/
Kumaran MS, Bishnoi A, Srivastava N, Tekumalla S, Vinay K, Bhatia A, Parsad D. Significant reduction in the expression of interleukins-17A, 22 and 23A, forkhead box p3 and interferon gamma delineates lichen planus pigmentosus from lichen planus. Arch Dermatol Res [Internet]. 2019 [citado el 13 de febrero, 2023];311(7):519-527. DOI: 10.1007/s00403-019-01926-9. Epub 2019 May 14. PMID: 31089878. Disponible en: https://link.springer.com/article/10.1007/s00403-019-01926-9