Document Detail

Hypopigmented macules in acantholytic disorders.
MedLine Citation:
PMID:  7657436     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Widespread hypopigmented macules are rarely seen in heavily pigmented patients with Darier's disease. Previous hypotheses concerning the cause of decreased pigmentation suggest it is a postinflammatory phenomenon or that the hypomelanosis is evidence of subclinical acantholysis. PATIENTS: This report presents 2 patients: a new case of disseminated guttate leukoderma in a black patient with Darier's disease and the first such case in a patient with transient acantholytic dermatosis (Grover's disease). Direct immunofluorescence and electron-microscopic studies were carried out on lesional biopsies. OBSERVATIONS: Numerous small hypopigmented macules were observed in two black patients followed for acantholytic disorders. Three biopsies of the hypopigmented macules revealed acantholysis, while one showed only decreased melanin. Direct immunofluorescence studies were negative. Electron-microscopic studies of the leukodermic macules showed sparse melanocytes and melanosomes that were mostly pigmented stage IV melanosomes. CONCLUSIONS: Disseminated guttate leukoderma can occur in transient acantholytic dermatosis, as well as in Darier's disease. It is readily apparent on darkly pigmented skin because of contrast. The etiology of this phenomenon is still unknown.
M J Rowley; L T Nesbitt; P R Carrington; C G Espinoza
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  International journal of dermatology     Volume:  34     ISSN:  0011-9059     ISO Abbreviation:  Int. J. Dermatol.     Publication Date:  1995 Jun 
Date Detail:
Created Date:  1995-10-05     Completed Date:  1995-10-05     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0243704     Medline TA:  Int J Dermatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  390-2     Citation Subset:  IM    
Department of Dermatology, Louisiana State University School of Medicine, New Orleans 70112-2822, USA.
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MeSH Terms
Acantholysis / complications*,  pathology
Darier Disease / complications
Fluorescent Antibody Technique
Hypopigmentation / etiology*,  pathology
Melanocytes / ultrastructure
Microscopy, Electron
Middle Aged
Skin / pathology,  ultrastructure

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