10.5826/dpc.1201a41
text/xml
2160-9381
1806
en
Gabriela Maldonado
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
A Gray Patient
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-02-02
2021-05-25
2022-02-02
2022-02-09
e2022041
Dermatol Pract Concept
Gabriela Maldonado
2022/02/02
10.5826/dpc.1201a41
e2022041
Private Practice- Rua 24 de Outubro, 1440 /Sala 1103, Porto Alegre , Brasil
2160-9381
en
e2022041
Baykal C, Yılmaz Z, Sun GP, Büyükbabani N. The spectrum of benign dermal dendritic melanocytic proliferations. J Eur Acad Dermatol Venereol. 2019;33(6):1029-1041. DOI: 10.1111/jdv.15492. PMID: 30767282
A Gray Patient
https://dpcj.org/index.php/dpc/article/download/1806/1488
                                                   A Gray Patient
             Gabriela Fortes Escobar1, Kelli Wagner Gomes2, Mariana Quirino Tubone3,
                                       Gabriela Maldonado4


1 Department of Dermatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil
2 Private Practice - Rua Felipe Camarão 690/Sala 402, Porto Alegre, Brasil
3 Private Practice - Av. Marcolino Martins Cabral, 2099/ Sala 902, Tubarão, Brasil
4 Private Practice - Rua 24 de Outubro, 1440 /Sala 1103, Porto Alegre, Brasil



Citation: Escobar GF, Gomes KW, Tubone MQ, Maldonado G. A gray patient. Dermatol Pract Concept. 2022;12(1):e2022041.
DOI: https://doi.org/10.5826/dpc.1201a41
Accepted: July 1, 2021; Published: January 2022
Copyright: ©2022 Escobar et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Gabriela Fortes Escobar, MD MSc Department of Dermatology, Hospital de Clínicas de Porto Alegre, Porto Alegre,
Brasil. E-mail: gescobar@hcpa.edu.br




Case Presentation                                                        Teaching Point
A 46-year-old Caucasian woman presented with a 10-year                   Acquired dermal melanocytosis is a rare pigmentary disor-
history of an asymptomatic progressive darkening of the                  der and its etiology remains unknown. Three theories may
skin. There was no previous history of inflammation, and                 explain this disorder: migration of epidermal melanocytes to
she denied the use of medications. Examination revealed                  the dermis; migration of hair bulb melanocytes; or reactiva-
symmetric blue-gray patches involving the face, trunk                    tion of pre-existing latent dermal melanocytes triggered by
(Figure 1, A and B) and extremities. Dermoscopy showed                   local inflammation or an unknown stimulus [1,2]. Melanin-­
a diffuse reticulated-­homogenous brown-gray pigmentation                containing dendritic melanocytes can be seen in the upper-­
(Figure 1C). Skin biopsy revealed multiple spindle-shaped                middle portions of the dermis and, with the Tyndall effect,
dendritic melanocytes in the dermis (Figure 1D) and immu-                they result in a brown to bluish-gray skin pigmentation [2].
nohistochemical staining was positive for Melan-A and                         Informed consent: Written informed consent for publi-
HMB-45.                                                                  cation of clinical details and clinical images was obtained
                                                                         from the patient.




Image Letter | Dermatol Pract Concept. 2022;12(1):e2022041                                                                          1
Figure 1. (A) and (B) Remarkable blue-gray pigmentation on the trunk. (C) Dermoscopy (10x) revealing a diffuse reticulated-homogenous
brown-gray pigmentation. (D) Histopathology showing multiple spindle-shaped dendritic melanocytes in the dermis (arrows).




References                                                             2. Baykal C, Yılmaz Z, Sun GP, Büyükbabani N. The spectrum of
                                                                          benign dermal dendritic melanocytic proliferations. J Eur Acad
 1. Harrison-Balestra C, Gugic D, Vincek V. Clinically distinct form      Dermatol Venereol. 2019;33(6):1029–1041. DOI: 10.1111/
    of acquired dermal melanocytosis with review of published             jdv.15492. PMID: 30767282.
    work. J Dermatol. 2007;34(3):178–182. DOI: 10.1111/j.1346-
    8138.2007.00245.x. PMID: 17291298.




2                                                                            Image Letter | Dermatol Pract Concept. 2022;12(1):e2022041
