By Thierry Passeron, Jean-Paul Ortonne
The dermis is coloured through a mix of pigments, which shape a part of a fancy and hugely regulated technique. Pigmentary defects typically current with dyschromia and will be because of genetic defects, systemic illness, inflammatory techniques, metabolic defects, infections, tumors, or poisonous or iatrogenic explanations. This atlas is an intensive textual content written via key opinion leaders inside of dermatology, it has a complete layout that publications the reader throughout the epidemiology, pathophysiology, prognosis, remedy, and differential analysis of either universal and infrequent pigmentary issues. It illustrates the prognosis and popularity of pigmentary issues with a variety of images.
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Extra resources for Atlas of Pigmentary Disorders
EXTRACUTANEOUS SIGNS None. HISTOPATHOLOGY PATHOPHYSIOLOGY Chemical photosensitizers and excessive sun exposure have been suggested, but the pathophysiology remains poorly understood. CLINICAL DERMATOLOGICAL PRESENTATION Light-brown hyperpigmented band. Asymptomatic. 50 TREATMENT Sun protection is required. Azelaic acid has been proposed. In our practice, Kligman’s trio with pulse dye laser to treat the vascular component is useful. None reported. The clinical pattern is highly suggestive of the diagnosis.
33 CAFÉ-AU-LAIT SPOTS Café-au-lait spot in McCune-Albright syndrome. The jagged edges are characteristic of the diagnosis. Isolated café-au-lait spot of the arm. Large café-au-lait spot in neurofibromatosis type 1. Note the smooth margins. Small café-au-lait spot associated with a nevus depigmentosus on the abdomen. SYNONYMS EXTRACUTANEOUS SIGNS Café-au-lait macules. None when café-au-lait spots are isolated. More than six lesions should prompt the search for neurofibromatosis or Legius syndrome.
Widespread fibrosis in the dermis and subcutis with an interstitial mononuclear infiltrate, composed of small to medium-sized CD68+, S100+ CD1- histiocytes and CD34+ and factor XIIIa+ dendrocytes. Similar findings are observed in enlarged lymph nodes and from nasal mucosa. DIFFERENTIAL DIAGNOSIS • Rosai Dorfman disease. • Scleroderma. • Panniculitis. TREATMENT Various treatments have been used, usually with failure or with only partial response, including: systemic corticosteroids, methotrexate, cyclophosphamide, cyclosporine, 6-mercaptopurine, interferon alfa, colchicine, anakinra, canakinumab, adalimumab, nonsteroidal anti-inflammatory drugs and radiotherapy.
Atlas of Pigmentary Disorders by Thierry Passeron, Jean-Paul Ortonne