Erythema dyschromicum perstans and hepatitis c virus. Erythema dyschromicum perstans ashy dermatosis and. Erythema dyschromicum perstans edp was first described by oswaldo ramirez c. May 01, 2001 erythema dyschromicum perstans and hepatitis c virus infection erythema dyschromicum perstans and hepatitis c virus infection kontochristopoulos, george j aroni, kyriaki. Erythema dyschromicum perstans, clinical picture 4010 erythema dyschromicum perstans, clinical picture 4011 erythema dyschromicum perstans, clinical picture 40 histology vacuolar degeneration of the basal layer, superficial lymphocytic infiltrate. Dermis erythema dyschromicum perstans information on the. Erythema dyschromicum perstans brook e tlougan md, mercedes e gonzalez md, rajni v mandal md, roopal v kundu md, debra l skopicki md dermatology online journal 16 11. It is used in combination with rifampicin and dapsone for the treatment of the many forms of leprosy. This is a temporary file and hence do not link it from a website, instead link the url of this page if you wish to link the pdf file.
Erythema dyschromicum perstans is a form of acquired dermal macular hyperpigmentation characterised by well circumscribed round to oval or irregular patches on the face, neck and trunk that are grey in colour. However, the border can be difficult to discern in darker skinned populations 12. We present a case of edp in an adult that cleared significantly after 6 years. Erythema dyschromicum perstans edp was first described in 1957, and electron microscopic studies were reported in 1969. Clinically it presents as asymptomatic, ashengrayblue macules of varying sizes, most commonly on the trunk and proximal extremities. Erythema dyschromicum perstans definition of erythema. Herein, we present the successful use of nonablative fractional photothermolysis in combination with topical tacrolimus ointment. It also shows dermal infiltration by t lymphocytes of both helperinducer and suppressorcytotoxic phenotypes, a pattern commonly seen with lichen planus. Erythema dyschromicum perstans, also referred to as ashy dermatosis, is a benign disease of unknown origin that occurs more frequently in the latin american population. Erythema dyschromicum perstans with a wagyu beeflike appearance on dermoscopy. Erythema dyschromicum perstans response to isotretinoin. The terms lichen planus pigmentosus lpp, erythema dyschromicum perstans edp and idiopathic eruptive macular pigmentation iemp are names given to pigmentary disorders and often used interchangeably. We wish you a cure and never get sick of this disease. The list of acronyms and abbreviations related to edp erythema dyschromicum perstans.
Histopathological findings demonstrate lichenoid dermatitis with vacuolization of basal cells, colloid bodies, and a moderate infiltrate of lymphocytes in the papillary. Erythema anulare centrifugum eac, is a descriptive term for a class of skin lesion presenting redness in a ring form anulare that spreads from a center centrifugum. Dec 12, 2006 in 1961, convit et al described five patients with similar findings in venezuela. Erythema dyschromicum perstans or ashy dermatosis is a chronic hyperpigmentary disease of unknown etiology. Druginduced and postinflammatory hyperpigmentation may last for many months after the offending drug or dermatitis has been eliminated. A 39yearold hispanic man presented with widespread, symmetric, hyperpigmented, browngrayblue, ovaltocircular, discrete and.
Aliaga, ashy dermatosis in an hiv antibodypositive patient, acta dermatovenereologica, vol. Erythema dyschromicum perstans and ashy dermatosis the only significant difference between erythema dyschromicum perstans and ashy dermatosis has been the presence of a palpable erythematous border measuring 12 mm in width in the early stages of the former 12,19. It can slow down the growth and weakly kill mycobacterium leprae, the bacteria that cause leprosy. Dermatopathology reference describes erythema dyschromicum perstans ashy dermatosis histopathology including histologic features and. It typically presents as asymptomatic, chronic, slowly progressive ashygray hyperpigmented macules on the trunk and proximal extremities. Erythema dyschromicum perstans edp is a rare cutaneous eruption of unknown etiology that often resolves in prepubertal children but is generally thought to persist in adults. Erythema dyschromicum perstans edp is a rare disorder characterized by asymptomatic, slowly progressive, ashgray macular pigmentation of the skin which usually occurs from age 5 through adult life. See the analysis of the prevalence of 4 causes of erythema dyschromicum perstans conditions listing medical symptoms.
In south america, another name, erythema chronicum figuratum melanodermicum, also is used. Erythema dyschromicum perstansashy dermatosis causes. Herein, we describe five cases and compare light and electron microscopic findings, direct and indirect immunofluorescence, and dopapositive melanocyte counts between normal and affected skin. These changes were consistent with a diagnosis of erythema dyschromicum perstans edp. Mar 18, 2020 antonov nk, braverman i, subtil a, halasz cl. Ashy dermatosis definition of ashy dermatosis by medical.
Some authors include erythema dyschromicum perstans as a variant of lichen planus because of the many clinical and histopathologic similarities between the diseases,z3 we describe a patient with erythema dyschromicum perstans preceded by lichen planus and. Cutaneous mastocytosis must be distinguished from ashy dermatitis or erythema dyschromicum perstans, nodular scabies, neurofibromatosis, juvenile english pro pts in pair. Ashy dermatosis with significant perivascular and subepiderm. Apr 30, 2018 erythema dyschromicum perstans edp also known as ashy dermatosis refers to a persistent local redness of the skin. Lichen planus is a welldescribed entity of unknown cause and various presentations. Patch testing and histopathology in thai patients with hyperpigmentation due to erythema dyschromicum perstans, lichen planus pigmentosus, and pigmented contact dermatitis. A report of three cases, international journal of dermatology, vol. Acd az of skin erythema dyschromicum perstans and lichen. The rim of erythema that appears during the inflammatory phase of the disorder distinguishes it from other disorders of hyperpigmentation. Sep 20, 2018 erythema dyschromicum perstans and lichen planus. Our dermatology online original article ashy dermatosis.
Erythema annulare centrifugum secondary to treatment with finasteride. It is an acquired, chronic, idiopathic hypermelanosis of longstanding evolution that is characterized by bluegray color macules that look like ash. Current understanding of lichen planus pigmentosus, erythema dyschromicum perstans ashy dermatosis, and idiopathic eruptive macular pigmentation. Automatic update in citescore measures average citations received per document published. A variety dermatosis cenicienta predisposing factors have been cited. Erythema dyschromicum perstans edp is a rare disorder characterized by asymptomatic, slowly progressive, ashgray macular pigmentation of the skin, which usually occurs from age 5 years through. Stevensen and miura2 re ported the first case in the united states, in a puerto rican man. The following list of conditions have erythema dyschromicum perstans or similar listed as a symptom in our database. It is characterized by disseminated macular lesions of an ashy gray color. Many consider this condition to be a variant of lichen planus. These are the options to access the full texts of the publication piel. It typically presents as asymptomatic, chronic, slowly progressive ashygray hyperpigmented macules on. It is a chronic form of erythema multiforme in which the relapses recur so persistently that the eruption is almost permanent.
The lesions are usually distributed symmetrically on both sun and nonsunexposed areas including the trunk 69. This computergenerated list may be inaccurate or incomplete. Therapeutic outcome with clofazimine, dapsone, oral antibiotics, vitamins, isoniazid, choloroquin, gresiofulvin, topical corticosteroids, chemical peels, sun protection, and psychotherapy has been variable and unsatisfactory. From the department of dermatology, mount sinai school of medicine, new vork, new york ore than 25 years ago, ramirez described the first cases of erythema dyschromicum perstans edp. The hyperpigmented lesions vary in size from small 1cm lesions to large plaques. Chlorothalonil exposure among banana farm workers is another possible cause of edp. Later, erythema dyschromicum perstans was called dermatosis ceniciento, meaning ashy dermatosis, because of its ashy bluish gray color. Sulzbergers comment, in discussion of another paper, is as follows. Erythema dyschromicum perstans american osteopathic. Jul 31, 20 dermatopathology reference describes erythema dyschromicum perstans ashy dermatosis histopathology including histologic features and provides links to additional medical references. Erythema dyschromicum perstans ashy dermatitis entered by. The etiology of edp is unknown, but many associations have been described. Erythema dyschromicum perstans jama dermatology jama.
Erythema dyschromicum perstans is uncommon dermatosis of significant cosmetic morbidity. The photos of erythema dyschromicum perstans below are not recommended for people with a weak psyche. In particular, it is used to treat erythema nodosum leprosum, the red lumps and thickened patches often seen in lepromatous leprosy. What is erythema dyschromicum perstans erythema dyschromicum perstans is a form of acquired dermal macular hyperpigmentation characterised by wellcircumscribed round to oval or irregular patches on the face, neck and trunk that are grey in colour. Erythema dyschromicum perstans northwestern scholars. Erythema dyschromicum perstans is also called ashy dermatosis of ramirez, because of. In adults, erythema dyschromicum perstans is more prevalent in the latin american and asian population. Erythema dyschromicum perstans in early childhood md.
Erythema dyschromicum perstans edp is a cosmetically distressing, acquired pigmentary disorder of unknown etiology for which few successful therapies exist. Tomii k, fujimoto a, yokoyama r, kabata y, fujita s, hayashi r, et al. Erythema dyschromicum perstans and lichen planus pigmentosus. Erythema dyschromicum perstans is a dermal pigmentation seen on the trunk and proximal extremities, most commonly presenting in darkskinned hispanics. Learn the causes, symptoms, differential diagnosis and treatment. Erythema dyschromicum perstans erythema dyschromicum perstans novick, nelsonlee. The term erythema dyschromicum perstans is credited to marion b.
It affects both males and females, and is seen most commonly before the age of 40. It is a form of acquired dermal macular hyperpigmentation. Erythema dyschromicum perstans ashy dermatosis and related. Sulzberger, who suggested it when examining convits 2 patients in caracas. Erythema dyschromicum perstans, international journal of. Clinically, it is characterized by ashcolored, oval or round, asymptomatic macules that may disappear within several months. Erythema dyschromicum perstans is a recently described dermatosis that appears to be a distinct and diagnosable entity. Participation is free and the site has a strict confidentiality policy. Erythema dyschromicum perstans edp, also known as ashy dermatosis and dermatosis cenicienta, is a benign, uncommon skin condition that presents with generalized ashygray colored macules on the body. Erythema annulare centrifugum, medscape, sep 2014 al hammadi a, asai y, patt ml, et al. Involvement of cell adhesion and activation molecules in the pathogenesis of erythema dyschromicum perstans ashy dermatitis. Erythema elevatum diutinum is a rare form of necrotizing vasculitis which affects the skin covering joints fingers, toes, knees, elbows, wrists, ankles and other areas in some cases. It is an acquired, chronic, idiopathic hypermelanosis of longstanding evolution that is characterized by blue.
Erythema dyschromicum perstans response to isotretinoin author. Erythema dyschromicum perstans showing resolution in an adult. In view of their beliefs that this disorder belonged to the erythema perstans group, they proposed the term erythema dyschromicum perstans, as originally suggested by dr. Variable components include erythema and papulation. The ashy dermatosis erythema dyschromicum perstans. Immunopathologic study of erythema dyschromicum perstans shows immuneassociated ia antigen expression in keratinocytes and strong okt 4 and okt 6 staining of langerhans cells. The term erythema dyschromicum perstans was coined by venezuelan physician marion sulzberger to highlight the word erythema because an erythematous border is observed in the early lesions and also to suggest the variety and persistence of the dyschromia. Jul 18, 2019 in south america, another name, erythema chronicum figuratum melanodermicum, also is used. Simultaneously active lesions of vitiligo and erythema.
Erythema dyschromicum perstans is also called ashy dermatosis of ramirez. Mar 18, 2020 erythema dyschromicum perstans ashy dermatosis is a distinct and somewhat controversial cutaneous eruption that may be best regarded as a form of lichen planus or lichen planus actinicus. Lee, ashy dermatosis erythema dyschromicum perstans induced by omeprazole. Erythema dyschromicum perstans american osteopathic college. Erythema dyschromicum perstans edp is a disorder of pigmentation that is characterized by gray or bluebrown macules or patches in individuals with fitzpatrick skin types iiiv chang et al. Improvement of erythema dyschromicum perstans using a. We have experienced two cases of edp in children aged 2 and 3, both exceptionally younger than the previously reported cases. Current understanding of lichen planus pigmentosus, erythema.
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